Efficacy of Lidocaine/Prilocaine Cream During Dry Needling of Upper Trapezius Myofascial Trigger Points: A Double-blinded Randomized Controlled Trial

Pimpika Fuktongphan; Thong Phonghanyudh; Chanwit Phongamwong

Authors

Pimpika Fuktongphan Department of Rehabilitation Medicine, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Thailand https://orcid.org/0009-0002-1268-9012
Thong Phonghanyudh Department of Rehabilitation Medicine, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Thailand https://orcid.org/0000-0003-4916-1860
Chanwit Phongamwong Department of Rehabilitation Medicine, Phramongkutklao Hospital and Phramongkutklao College of Medicine, Thailand https://orcid.org/0000-0002-5562-8175

Keywords:

EMLA, Local anesthetic, Upper trapezius, Dry needling, Myofascial trigger point

Abstract

Objective This study aimed to evaluate the efficacy of a eutectic mixture of local anesthetics (EMLA) cream in reducing pain during dry needling (DN) of active myofascial trigger points (MTrP) in the upper trapezius muscle.

Methods This prospective, randomized, double-blind, placebo-controlled trial was conducted with participants aged 20 years and older who had active MTrP in the upper trapezius muscle. Recruitment occurred from 11 July 2023 to 4 March 2024. Participants were randomly assigned to receive either EMLA cream (n = 32) or a placebo cream (n = 32) which was applied over the active MTrP 60 minutes prior to the DN procedure. After the DN procedure, patients rated their pain using a 100-mm visual analog scale during DN (VAS_TrP) as the primary outcome and during the needle’s skin penetration (VAS_skin) as the secondary outcome.

Results Patients in the EMLA group reported significantly lower scores for VAS_TrP and VAS_skin than those in the placebo group (p < 0.05). Specifically, 53.1% of patients in the EMLA group reported ‘moderate to severe pain’ according to VAS_TrP, significantly lower than the 78.10% in the placebo group (p = 0.035). Moreover, 65.63% of patients in the EMLA group reported ‘no pain’ on the VAS_skin scale, compared to just 15.63% in the placebo group (p < 0.001). Importantly, no significant adverse events associated with EMLA were observed.

Conclusion EMLA cream is effective in providing analgesia during DN of an active MTrP in the upper trapezius muscle.

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