Hyaluronidase for Trigger Point Injection in Myofascial Pain Syndrome
Status:
Completed
Trial end date:
2011-05-01
Target enrollment:
Participant gender:
Summary
Myofascial pain syndrome (MPS) is the most common cause of persistent regional pain
characterized by myofascial trigger points. Trigger point injection (TPI) using local
anesthetics is one of the most effective methods for treatment of MPS, and steroids or
botulinum toxin can be added to local injections .
Recent study suggested that the hyaluronan (HA) could be the basis of myofascial pain. HA
within the deep fascia facilitates the free sliding of two adjacent fibrous fascial layers.
If the HA assumes a more packed conformation, or more generally, if the loose connective
tissue inside the fascia alters its density, the behavior of the entire deep fascia and the
underlying muscle would be compromised.
The investigators anticipated that hyaluronidase could decrease the viscosity of HA near the
muscle and fascia of trigger points. Meanwhile, hyaluronidase is thought to promote the
spread of local anesthetic solution by hydrolyzing glycosidic bonds within HA. Hyaluronidase
was shown to be effective in retro- and peribulbar block for ophthalmologic surgery or
reducing tissue edema in dermatology, and adhesiolysis for some interventional pain
managements.
However, the effect of the addition of hyaluronidase to local anesthetics during TPI has not
been studied. The investigators aimed to compare the efficacy of TPI with the addition of
hyaluronidase compared to local anesthetic alone on pain and quality of life in MPS patients.