A prospective, randomized, double-blind evaluation of trigger-point

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injection therapy for low-back pain. Garvey-T-A. Marks-M-R. Wiesel-S-W. Department of Orthopaedic Surgery, George Washington University Spine. 1989 Sep. 14(9). P 962-4. The efficacy of trigger-point injection therapy in treatment of low-back strain was evaluated in a prospective, m randomized, double-blind study. The patient population consisted of 63 individuals with low-back strain. Patients with this diagnosis had nonradiating low-back pain, normal neurologic examination, absence of tension signs, and lumbosacral roentgenograms interpreted as being within normal limits. They were treated conservatively for 4 weeks before entering the study. Injection therapy was of four different types: lidocaine, lidocaine combined with a steroid, acupuncture, and vapocoolant spray with acupressure. Results indicated that therapy without injected medication (63% improvement rate) was at least as effective as therapy with drug injection (42% improvement rate), at a P value of 0.09. Trigger-point therapy seems to be a useful adjunct in treatment of low-back strain. The injected substance apparently is not the critical factor, since direct mechanical stimulus to the trigger-point seems to give symptomatic relief equal to that of treatment with various types of injected medication. Author-abstract.