Trigger Point Injection with 1% versus 2% Lidocaine for Treatment of Myofascial Pain Syndrome at Neck and Upper Back: A Randomized Controlled and Double-blinded Clinical Trail


  • Prapanbandit N


myofascial pain syndrome, neck, upper back, injection, lidocaine


Objectives: To study and compare the effectiveness of trigger point injection with 1% versus 2% lidocaine for treatment of myofascial pain syndrome (MPS) at neck and upper back.

Study design: Randomized controlled and double-blinded clinical trial.

Setting: King Mongkut Memorial Hospital, Phetchaburi Province, Thailand.

Subjects: Patients with MPS at neck and/or upper back not more than 6 months

Methods: There were 30 patients treated with 1% lidocaine trigger point injection, and 31 patients with 2% lidocaine. Pain score, pressure pain threshold, post injection soreness, active range of motion (AROM) of neck, and quality of life (QoL) before and after treatment, were compared within the same group and between the two groups at different times after treatment.

Results: Immediately after treatment, 1 week, 2 weeks and 4 weeks after treatment, there were significant decrease in pain score, increases in pressure pain threshold and AROM of neck in both groups (p ≤ 0.05), but there were no differences between the two groups (p > 0.05). There was no difference in post injection soreness between 2 groups (p > 0.05). At 4 weeks after treatment, QoL in the components of physical functioning, role limitation due to physical problems, and bodily pain were significantly increase in both groups (p ≤ 0.05), but there was no difference between the two groups (p > 0.05).

Conclusion: There was no evidence of higher effectiveness of 2% over 1% lidocaine trigger point injection in treating patients with myofascial pain at neck and upper back. Thus 1% lidocaine is recommended for trigger point injection because it is safer for patients and more economical.


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