Comparison of Trigger Point Injections Versus Traditional Therapies in the Management of Postsurgical Pain in Patients Who Had Anterior Cervical Surgery

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    George Washington University
Updated on 25 October 2022
dry needling
pain relieving
trigger point injection


To achieve appropriate exposure for an anterior neck surgery (for example an Anterior Cervical Discectomy and Fusion or ACDF), patients are positioned supine with their neck extended. Due to being in this position, patients frequently complain of posterior neck stiffness and pain postoperatively in addition to the anterior incisional pain. This posterior cervical pain can be classified as myofascial pain.

Cervical myofascial pain is thought to be the result of overuse or trauma to the supporting muscles of the neck and shoulders. Trigger point injections are one of the methods used to treat myofascial pain. The trigger point injection procedure is where a physician (typically an anesthesiologist) performs an exam of the patient neck and upper back and finds areas of point tenderness. The physician will then inject a small amount of numbing medication (such as bupivacaine) into the muscle or tissue in that area.

Trigger point injections have been shown to be superior to botox injections or dry needling, and equivalent to physical therapy. However, these studies were performed on patients with chronic neck pain. There are no studies evaluating the effectiveness of trigger point injections on post anterior cervical surgery patients.

At our institution, trigger point injections with local anesthetic are used as part of a multimodal pain control regimen for post-anterior cervical surgery patients. Our hypothesis is if the addition of trigger point injections to standard of care multi-modal post-operative pain control will decrease patients' myofascial pain, and thereby decrease the amount of narcotic pain medication used.

Condition Myofacial Pain, Pain, Neck, Pain, Back, Cervical Fusion
Treatment Trigger point injection with bupivacaine, Trigger point injection with normal saline, Lidocaine skin wheal
Clinical Study IdentifierNCT04640896
SponsorGeorge Washington University
Last Modified on25 October 2022


Yes No Not Sure

Inclusion Criteria

Elective anterior cervical surgery

Exclusion Criteria

Emergency surgery
Local anesthetic allergy
Long term opioid usage (not including tramadol and codeine)
Intra-operative complication (e.g. unstable cervical spine)
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