The Feasibility of Vitamin B Complex Additive to Lidocaine for Myofascial Trigger Point Injection in Neck and Upper Back Muscles: A Pilot Trial



pain, myofascial pain syndrome, trigger point injection, lidocaine, vitamin B complex


Objectives: To explore the feasibility and result of adding the vitamin B complex to lidocaine for a myofascial trigger point (MTrP) injection in reducing pain and disability in patients with myofascial pain syndrome (MPS).

Study design: A pilot randomized double-blind controlled trial.

Setting: Thammasat University Hospital, Thailand.

Subjects: Thirty-eight patients aged between 18 to 70-year-old with active MTrP on neck and upper back and pain less than 6 months.

Methods: The patients were randomly assigned into two groups. The treatment group (n = 20, side = 33) were treated with 0.4 ml mixture of vitamin B complex and 1% lidocaine (1:1 ratio) whereas the control group (n = 18, side = 29) was treated with 0.2 ml of 1% lidocaine only. The patients and assessors were blinded to the treatments assigned. Numeric rating scale (NRS) for pain and neck disability index (NDI) were rated by the patients at baseline and at the end of week 1, 2 and 4.  A linear mixed effect model was used.

Results: The NRS and NDI scores were significantly decreased at the end of week 1, 2 and 4 but no significant differences between the two groups (p-value = 0.802 and 0.072, respectively).  Post-injection soreness was mostly found with significant difference between the two groups (p = 0.042).

Conclusions: Adding vitamin B complex to lidocaine for MTrP injection in neck and upper back muscles does not give better outcomes in pain and disability than injection with lidocaine alone. The feasibility and result of pilot study in term of design is useful, although vitamin B complex as an intervention should be reconsidered in preparation and adverse event.


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