Comparing of non-invasive and invasive techniques in the treatment of patients with myofascial pain syndrome

We aimed to compare the efficiency of non-invasive techniques including transcutaneous electrical nerve stimulation (TENS) and laser treatments and invasive techniques including lidocaine and botulinum toxin-A injection, in the patients with myofascial pain syndrome (MPS) commonly faced.Hundred patients who resorted to Firat University Hospital Pain Department and clinically diagnosed as MPS were included the study. Patients were randomized into four groups and each group consisted of 25 patients; 60 session of TENS and 20 session of laser treatments applied to first and second groups while lidocaine and botulinum toxin-A injection applied to third and fourth groups. For each trigger point 2ml (20 mg) %1 lidocaine injection was applied twice in a week for one month and 25 U (0.5 ml) of botulinum toxin-A was injected to each trigger point only once for a patient.Pain evaluation of patients was made with visual analogue scale (VAS), palpabl muscle spasm scoring (PMSS) and anesthesiometer at baseline, 15, 30 and 45 days.There was not statistically difference between the groups for the age, sex and education level. After the treatment, we have determined botulinum toxin-A injection statistically had beter results when compared with lidocaine trigger point injection, TENS and laser treatments in all parameters VAS, PMSS and anesthesiometer.All the methods used in this study were efficient however, we concluded that invasive techniques including especially botulinum toxin-A injection for long-term treatment and lidocaine injection were more efficient accordig to non-invasive techniques including TENS and laser treatments.