Department of Emergency Medicine, Faculty of Medicine, University of Ataturk, Erzurum, Turkey.
Department of Anesthesia and Reamination, Faculty of Medicine, University of Ataturk, Erzurum, Turkey.
Am J Emerg Med. 2019 Oct;37(10):1927-1931. doi: 10.1016/j.ajem.2019.01.015. Epub 2019 Jan 15.
Low back pain (LBP) is a common complaint originating from muscles Myofascial pain syndrome (MPS) is mainly associated with trigger points (TrP) in the muscle tissue. We compared the intravenously administered non-steroidal anti-inflammatory drug (NSAID) and trigger point injection (TPI) in the treatment of LBP patients admitted to the emergency department due to pain caused by TrPs.
After randomization, NSAID was administered intravenously in group 1 and TPIs were performed as specified by Travell and Simons in group 2. The TrPs were identified with the anamnesis and physical examination Demographic characteristics and vital signs of the patients were recorded. Pain scores were measured with the Visual Analogue Scale (VAS) at admission; and in minutes 5, 10, 15, 30, and 60.
There were 32 patients in group 1 and 22 patients in group 2. The demographics, vital signs, and pain scores at admission were not statistically significantly different between the groups. The pain scores decreased significantly in the TPI group. During the 60 min' follow-up period, the mean VAS pain score decreased by 0.41 ± 1.30 in the TPI group and by 2.59 ± 2.37 in the NSAID group (p < 0.001). Respond the treatment was significantly higher group TPI than Group NSAID (21/22 vs 20/32 respectively, p = 0.008).
In this small randomized study with several methodological limitations, TPI was superior to the intravenous NSAIDs in the treatment of acute LBP due to TrPs. TPI can be used in the emergency departments for the acute treatment of LBP in selected patients.
下腰痛(LBP)是一种常见的主诉,源自肌肉肌筋膜疼痛综合征(MPS)主要与肌肉组织中的触发点(TrP)有关。我们比较了静脉内给予非甾体抗炎药(NSAID)和触发点注射(TPI)治疗因 TrP 引起疼痛而就诊于急诊科的 LBP 患者。
随机分组后,第 1 组静脉内给予 NSAID,第 2 组按 Travell 和 Simons 的规定进行 TPI。通过病史和体格检查确定 TrP。记录患者的人口统计学特征和生命体征。入院时使用视觉模拟评分(VAS)测量疼痛评分;在第 5、10、15、30 和 60 分钟时测量。
第 1 组有 32 例患者,第 2 组有 22 例患者。两组患者的人口统计学、生命体征和入院时的疼痛评分无统计学差异。TPI 组疼痛评分显著下降。在 60 分钟的随访期间,TPI 组的平均 VAS 疼痛评分下降了 0.41±1.30,而 NSAID 组下降了 2.59±2.37(p<0.001)。TPI 组的治疗反应明显高于 NSAID 组(分别为 21/22 与 20/32,p=0.008)。
在这项具有多种方法学局限性的小随机研究中,TPI 在治疗因 TrP 引起的急性 LBP 方面优于静脉内 NSAID。TPI 可用于急诊科,为选定的患者急性治疗 LBP。