Abstract
Background: The aim of the study was to determine whether mesotherapy is effective in treating Chronic Neck Pain (CNP) and to evaluate the effects of superficial trigger point injections with lidocaine versus dry ones. Methods: A retrospective study was conducted. Forty-two subjects were recruited and divided into two groups: the Drug Mesotherapy Group (Group A: n=22) who received local microinjections of 1 cc of local anesthetic lidocaine 2% and the Dry Mesotherapy Control Group (Group B: n=20) who received microinjections (performed with a needle) without any drugs (dry mesotherapy). The treatments involved 8 local superficial trigger points of the cervical tract. Pain was assessed using the Visual Analogue Scale (VAS) and Verbal Rating Scale, disability using the Neck Disability Index (NDI), the quality of life using the Short Form-12 Health Survey (SF-12). Data were collected at the baseline (T0), at the end of the treatment program (Tend) and at the three month (T3m) follow up. Results: Group A treatment significantly reduced pain for VAS at T1 (p=0,000), which rose after the end of treatment at T-follow-up and remained significantly lower than baseline levels (p=0,003). Short-term benefits were also observed in terms of the secondary outcome measures, but the medium-term effects were less significant. Conclusion: Administration of lidocaine using superficial trigger points mesotherapy is efficacy and well tolerated method for managing chronic neck pain in the short-term.
Highlights
The lifetime prevalence of neck pain in Western populations has been estimated at around 70%, while annual or point prevalence rates range from 10% to 35% [1,2,3]
Publication History: Background: The aim of the study was to determine whether mesotherapy is effective in treating Chronic Neck Pain (CNP) and to evaluate the effects of superficial trigger point injections with lidocaine versus dry ones
Chronic neck pain (CNP) can be defined as pain experienced in the anatomic region of the cervical spine between C1 and C7 and the surrounding musculature only, in accordance with the criteria set by the International Association for the Study of Pain and the American Pain Society which defines the condition as chronic when pain persists beyond 3 months regards the normal tissue healing time [4,5]
Summary
The lifetime prevalence of neck pain in Western populations has been estimated at around 70%, while annual or point prevalence rates range from 10% to 35% [1,2,3]. Like CNP for instance, usually develops as a result of an injury or an insult followed by neurogenic inflammation, hyperalgesia, and allodynia; occurs a central sensitization followed by a loss of nociceptive control [6,7]. Clinical guidelines for CNP treatment recommends cervical mobilization, thoracic spine thrust manipulation, flexibility exercises for specific muscles group (anterior/medial/posterior scalene, upper trapezius, elevator scapulae, pectoralis minor, and pectoralis major), the use of coordination, strengthening, and endurance exercises to reduce neck pain and headache. Between the flexibility muscles exercises, the relaxation of myofascial trigger points (MTrPs) in the splenius capitis, elevator scapulae, or upper trapezius muscles as a clinical entity seems to contribute to CNP [9]. An MTrP is defined as a hyperirritable focus within a taut band of skeletal muscle that is painful on compression and that, when stimulated (usually by compression, percussion, or needling), can evoke a characteristic pattern of reported pain and related autonomic phenomena [12]
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