Myofacial pain syndrome with patient admitted to algologia department, retrospective investigation of effectiveness of methods to triger point injection

Purpose : It was aimed with this study to compare dry needling technigue that is used in theatment of myofascial pain syndrome cases and local anestesia injection method that is mixed with steroids and also to compare the effects of these two methods on the pain level, life quality and anxiety depression on people and consequently to evaluate the effects of these methods on the daily life quality and on the society by examining the files of the patients.Material and Method : 200 patients that applied to Dicle University Medicine Faculty Anestesiology and Reanimation Department Algology Clinic between 2006 and 2010 and that were treated with trigger point injection were retrospectively evaluated. Patient data was obtained from patient files, service protocol books and polyclinic follow-up books. Patientswere called via phone where necessary. Demographic data of patients included age-weight-height information and gender data. VAS ( Visual Analog Scale), Back Depression Scale ( BDS ) and Nottingham Health Profile ( NHP ) data was recorded at the time of trigger point injection and also 1 week, 1 month and 3 months thereafter. All of the interventions were performed after having determined according to patient prone position and the specific criteria determined by Travell- Simons and sterilized with Povidon solution. Some of the patients were applied with the needle of the injector that didn?t contain any medicine for 5 minutes. And some other patients were applied with medicine in such a way to allocate 1 cc to each TP after having prepared 10 cc injector that contained bupivacaine, triamcinolone acetate and serum physiological solution. In order to dispense with intravascular injection during the application of medicine , aspiration was given after each 1 cc delivery.In respect of pain evalution VAS was used while Beck depression scale (BDS ) was applied in respect of pyschological evaluation and Nottingham Health Profile (NPH) was used in respect of life quality. Data was evaluated by using the function add icon in Microsoft Excel software. The results were presented as average. In this study, all statistical calculations were carried out by means of SPSS version 15.0 for Windows package software. In the normality distribution of data, repeated Anova , Paired T- test , Independent t- test regression analyses were used. For the homogeneity test of data, on the other hand, Levene?s tests were used . In statistical evaluations, margin of error was taken as ( p < 0.005 ).Findings : When VAS , NPH and BDS values of patients before and 1 week , 1 month and 3 month after the treatment were evaluated , it was seen that there was a progressive reduction in the values of local anesthesia steroid needle injection and dry needle injection groups compared to before and 1 week, 1 month and 3 months after the treatment according to BDS and it was observed that this reduction was significant in both groups and represented values that were close to each other. ( p < 0,01 ). It was also seen that there was a progressive reduction in the values of local anesthesia steroid needle injection and dry needle injection group compared to before and 1 week, 1 month and 3 months after the treatment according to NPH and it was observed that this reduction was significant in both groups and represented values that were close to each other. ( p < 0.001)It was again observed that there was a progressive reduction in the values of local anesthesia steroid needle injection and dry needle injection groups compared to before and 1 week, 1 month and 3 months after the treatment according to VAS however that this differed was more evident in the early period in the local anesthesia steroid needle injection group ( p < 0,01).Conclusion : Myofascial pain syndrome is a chronic disease. Most of the methods that are appled in this syndrome have effects on the life quality, psychology and pain quality of the patient. In this retrospective study, both local anesthesia steroid needle injection and also dry needle injection method had positive effects. However, we believe that it shall be more convenient to apply dry needle injection method io order to reduce costs.