Dry Needling + Lidocaine/Bupivacaine for Myofascial Pain Syndrome

Overseen By Andre Guthrie, BS

Age: 18+

Sex: Any

Trial Phase: Academic

Sponsor: Washington University School of Medicine

Must not be taking: Pain medications, Botox

Disqualifiers: Cancer, Pregnancy, Fibromyalgia, others

Compensation: Varies

Number of Visits: 3

Duration: 2 weeks

100 Participants Needed

What You Need to Know Before You Apply

What is the purpose of this trial?

This trial aims to evaluate the effectiveness of a mixture of Lidocaine and Bupivacaine in treating myofascial pain syndrome, a condition that causes muscle pain. Researchers plan to use imaging to monitor how these treatments impact pain. The study compares two approaches: chemical injections and dry needling, which involves using thin needles without medicine, at specific muscle spots. It targets adults who have experienced neck or shoulder pain for at least three months and can identify a painful spot in their upper trapezius muscles. Participants should have pain that intensifies when these spots are pressed. As an unphased trial, this study provides a unique opportunity to contribute to the understanding of new treatment methods for muscle pain.

Will I have to stop taking my current medications?

The trial does not specify if you need to stop taking your current medications, but you should not have changed your pain medications within 6 weeks before joining the study.

Is there any evidence suggesting that this trial's treatments are likely to be safe?

Research has shown that bupivacaine injections are usually well-tolerated, with most people not experiencing side effects. In one study, 94.2% of patients reported no negative effects after receiving bupivacaine injections for muscle pain, suggesting the treatment is quite safe for most people. Although mixtures of lidocaine and bupivacaine are often used for pain relief, specific data about this combination in clinical trials is limited. However, both lidocaine and bupivacaine have FDA approval for other uses, indicating they are considered safe when used as directed. ^{1 2 3 4 5}

Why are researchers excited about this trial?

Researchers are excited about the treatment for myofascial pain syndrome because it combines dry needling with a 50/50 mixture of lidocaine and bupivacaine. Unlike most common therapies like physical therapy or oral pain medications, this approach delivers localized relief directly at the pain trigger points. Lidocaine and bupivacaine provide dual-action pain relief, offering both immediate and longer-lasting effects, which could potentially enhance the overall effectiveness and duration of pain management. Additionally, dry needling itself is a non-pharmacological technique that may help release muscle tightness and improve pain symptoms without systemic side effects.

What evidence suggests that this trial's treatments could be effective for myofascial pain syndrome?

Studies have shown that injections combining lidocaine and bupivacaine effectively treat myofascial pain syndrome. In this trial, some participants will receive this chemical injection, which has reduced pain more effectively than placebo injections. One study found that patients experienced noticeable pain relief within 30 to 60 minutes after receiving the treatment. This suggests that the lidocaine-bupivacaine mix can quickly ease discomfort in patients with myofascial pain. This combination works by relaxing tight muscles and numbing pain at specific trigger points. Consistent results across studies support its potential benefits for managing myofascial pain syndrome. ^{1 6 7 8 9}

Are You a Good Fit for This Trial?

This trial is for individuals with Myofascial Pain Syndrome. Specific eligibility criteria are not provided, but typically participants must meet certain health conditions and cannot have factors that would exclude them from safely participating.

Inclusion Criteria

I have a noticeable knot in one or both of my upper back muscles.

I am between 18 and 80 years old.

I have had neck or shoulder pain for at least 3 months.

Exclusion Criteria

Contraindication to MRI

I have a recent neck injury or nerve pain in my neck.

I am younger than 18 or older than 80.

Timeline for a Trial Participant

Screening

Participants are screened for eligibility to participate in the trial

2-4 weeks

Treatment

Participants undergo multi-modal imaging and receive either chemical injection or dry needling at identified trigger points

2 weeks

2 visits (in-person)

Follow-up

Participants are monitored for safety and effectiveness after treatment

2 weeks

1 visit (in-person)

What Are the Treatments Tested in This Trial?

Interventions

• 50/50 Mixture of Lidocaine 1% injection + Bupivacaine 0.25% Injectable Solution
• Dry Needling

Trial Overview

The study tests the effectiveness of Dry Needling and a mixed injection of Lidocaine and Bupivacaine in treating Myofascial Pain Syndrome. It also aims to evaluate imaging techniques as tools to monitor treatment response.

How Is the Trial Designed?

Group I: Chemical Injection Active Control 1 Intervention

Local chemical injection at clinician-identified myofascial trigger points.

Group II: Dry Needle Placebo Group 1 Intervention

Dry needling at clinician-identified myofascial trigger points.

Who Is Running the Clinical Trial?

Washington University School of Medicine

Lead Sponsor

Trials

2,027

Recruited

2,353,000+

National Center for Complementary and Integrative Health (NCCIH)

Collaborator

Trials

886

Recruited

677,000+

Citations

1.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC4766655/

Treatment of myofascial pain syndrome with lidocaine ...

Lidocaine and bupivacaine injections were found to be more effective than placebo injections for improving pain [25, 26], with the needle size ...

2.

sciencedirect.com

sciencedirect.com/science/article/pii/S0196064425002987

Trigger Point Injection for Myofascial Pain Syndrome of the ...

All treatment arms demonstrated pain reduction at 30 minutes. Compared with standard therapy alone, pain reduction at 30 to 60 minutes was 0.55 (95% confidence ...

3.

clinicaltrials.gov

clinicaltrials.gov/study/NCT04704297

NCT04704297 | Trigger Point Injection for Myofascial Pain ...

Comparison of ozone and lidocaine injection efficacy vs dry needling in myofascial pain syndrome patients. J Pain Res. 2018 Jun 29;11:1273-1279. doi ...

4.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC11460881/

Current advances in the treatment of myofascial pain ...

A study of 177 patients with MPS who received 20% glucose injections showed significant relief of chronic myofascial pain and dysfunction, with ...

5.

rapm.bmj.com

rapm.bmj.com/content/26/4/333

Water-Diluted Local Anesthetic for Trigger-Point Injection in ...

Results Less injection pain was experienced with the water-diluted 0.25% lidocaine and water-diluted 0.25% mepivacaine than the saline-diluted 0.25% lidocaine ...

6.

maedica.ro

maedica.ro/articles/2025/3/2025_20(23)_No3_pg555-559.pdf

Assessment of Effectiveness of Bupivacaine Trigger-Point ...

Most patients. (n = 65, 94.2%) experienced no adverse effects. Overall, 48 (70.6%) of patients were satisfied with the treatment. Conclusion: ...

7.

sciencedirect.com

sciencedirect.com/science/article/am/pii/S1047965122000110

Trigger Point Injections

The objectives of this review are to describe the known pathophysiology of myofascial pain and trigger points (TrPs), discuss the clinical presentation of ...

8.

pmc.ncbi.nlm.nih.gov

pmc.ncbi.nlm.nih.gov/articles/PMC12631585/

Assessment of Effectiveness of Bupivacaine Trigger-Point ...

Conclusion. Bupivacaine trigger point injections are effective and safe for pain relief and functional improvement in trapezius MPS. Keywords: trigger-point ...

9.

clinicaltrials.gov

clinicaltrials.gov/study/NCT04732507?locStr=United+States&country=United+States&aggFilters=status%3A

Investigating the Minimum Number of Needling Required ...

A 5- or 10-ml syringe will be filled equally with 1% plain lidocaine and 0.25% plain bupivacaine. A 1.5-inch 25-gauge needle will be attached to the syringe.