Synergistic Effects Of Transcranial Direct Current Stimulation and Trigger Point Injection For Treatment Of Myofascial Pain Syndrome: A Pilot Study With Randomized, Single-Blinded Trial

Shi-Uk Lee¹, Chang Han Lee¹ and Yoon-Hee Choi², ¹Physical Medicine & Rehabilitation, Seoul National University Boramae Medical Center, Seoul, South Korea, ²Physical Medicine & Rehabilitation, Seoul National University Bundang Hospital, Seoul, South Korea

Meeting: 2013 ACR/ARHP Annual Meeting

Keywords: Pain management and physical therapy

Session Information

Title: Fibromyalgia, Soft Tissue Disorders and Pain II

Session Type: Abstract Submissions (ACR)

Background/Purpose:

Chronic pain caused by myofascial pain syndrome (MPS) results in generalized and debilitating conditions. Trigger point injection (TPI) is the mainstay of MPS management to reduce acute and localized pain. Other adjunctive intervention to modulate the central pain pathway might be helpful if they are combined with TPI. Transcranial direct current stimulation (tDCS) which is a form of neurostimulation has been reported to be safe and effective in treating chronic pain by changing cortical excitability.

The purpose of this study was to determine whether there is synergistic effect of tDCS and TPI to reduce pain in patients with MPS.

Methods:

Subjects: Patients (n=21, 8: M1, 7: DLPFC, 6: sham) with newly diagnosed MPS of shoulder girdle muscles.

Interventions: Patients were randomized into one of 3 groups (2 active and 1 sham stimulation groups) and received TPI. Immediately after TPI, tDCS (2mA, 20min for 5 consecutive days) was administered. For active stimulation groups, tDCS was applied over 2 different locations (primary motor cortex (M1) and dorsolateral prefrontal cortex (DLPFC)).

Outcome Measures: Visual Analogue Scale (VAS), Pain Threshold Test (PTT) and short form of the McGill Pain Questionnaire (SF-MPQ) was measured prior to and immediately after stimulation for 5 consecutive days.

Results:

The mean VAS values were decreased in all three groups after 5 days. There was a significant change between before and after stimulation only in the DLPFC group. The significant change in the mean VAS value was shown from after the second stimulation session (p= 0.031) and those remained significant until the last stimulation session (p=0.027).

Conclusion:

tDCS over DLPFC may have synergistic effects with TPI to reduce pain in patient with myofascial pain syndrome. tDCS over DLPFC can be used to reverse central pain pathway by modulating cortical plasticity.

Disclosure:

S. U. Lee,
None;

C. H. Lee,
None;

Y. H. Choi,
None.

« Back to 2013 ACR/ARHP Annual Meeting

ACR Meeting Abstracts - https://acrabstracts.org/abstract/synergistic-effects-of-transcranial-direct-current-stimulation-and-trigger-point-injection-for-treatment-of-myofascial-pain-syndrome-a-pilot-study-with-randomized-single-blinded-trial/