Do trigger point injections effectively treat fibromyalgia?

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Small study shows improvement with injections after 2 weeks

An uncontrolled prospective before-after study in 1996 evaluated the effectiveness of 0.5% lidocaine trigger point injections in 9 patients with myofascial trigger points plus fibromyalgia compared with 9 patients with myofascial trigger points alone.2

Immediately after injection, patients with fibromyalgia had a nonsignificant worsening in pain intensity (pain scale 8.1 to 8.4/10; P>.1), but there was a significant improvement at 2 weeks (5.9; P<.01). The pressure threshold also decreased initially (1.7 to 1.4 kg/cm2; P>.1), but significantly increased at 2 weeks (2.4 kg/cm2; P<.01). In comparison, patients without fibromyalgia showed immediate improvement in all domains, which persisted at 2 weeks (P<.01).

What the guidelines say

Recent Canadian Fibromyalgia Guidelines discuss trigger point injections in the section on “off-label” medications, stating that they “may have some place in treatment of fibromyalgia.”3

Evidence-based answers from the Family Physicians Inquiries Network

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