Objectives The objective of this study was to compare the effects of botulinum toxin-A (BTX-A) injection and prilocaine injection in the treatment of myofascial pain syndrome (MAS).
Methods Thirty eight patients, having trigger points in the muscles diagnosed as MAS were analyzed in this randomized, single blind, comparative study.
Setting: Patients were randomized into two treatment groups namely BTX-A injection group and prilocaine group. Each group consisted of 19 patients.
Intervention: In BTX-A injection group, 10 U of BTX was injected to each trigger point. In the prilocaine group 2ml prilocaine was injected to each trigger point. All the patients were asked to do stretching exercises at home.
Main outcome measure: Treatment efficacy was evaluated clinically before and 2 and 6 weeks after treatment. Evaluation parameters were during function visual analog scale (VAS), pain score (PS), pain pressure threshold (PPT), general well-being by short form-36 (SF-36) and Beck Depression Inventory (BDI).
Results Statistically significant improvements were observed during function VAS, PS, PPT, SF36 and BDI in both treatment group. Improvement in VAS and PPT at 2 weeks was more significant in the BTX-A group. Improvement in VAS, PPT, PS at 6 weeks was more significant in BTX-A group. There is no difference between two groups in BDI. Borderline improvement was observed in BTX-A group at 6 weeks.
Conclusions BTX-A injections and prilocain injections are the beneficial treatment choices in this syndrome. But we observed the progressive cumulative effect of BTX-A in the course of time. Although cost effectivity limitation we suggest that patients with chronic persistant myofascial trigger points can be convenient candidates for BTX-A injections. Adjuvant appropriate exercises program should be included in primary treatment modality for optimal success.
Disclosure of Interest None declared