Pain Clinical Trial
Official title:
MuscleCare™ Pain Relief Therapy vs. Voltaren® in the Relief of Trapezius Trigger Point Musculoskeletal Pain.
To determine the difference in efficacy of an all natural topical analgesic (MuscleCare) to a product containing the non-steroidal anti-inflammatory drug diclofenac (Voltaren) on trapezius trigger point pain.
Myofascial pain syndromes (MPS) are common in Western society. Vernon and Schneider note that
MPS is thought to be the leading diagnosis among pain management specialists and the leading
diagnosis in pain patients reporting to general practitioners. MPS can be viewed as a
regional pain syndrome such as, neck, low back and upper quadrant pain syndromes. MPS can
also be found focally in discrete painful sites known as Myofascial Trigger Points (MTP).
Locations of MTP's have been characterized on clinical grounds throughout the musculoskeletal
system, starting with the seminal work of Travell and Simons. MTP's have been described as
active (clinically active with pain referral upon palpation) or latent (not clinically
active, but tender on manual palpation). The presence of associated features such as "local
twitch sign" and palpable taut bands is thought to confirm the presence of an active MTP,
while latent TP's may not present with the classic features.
Numerous treatments are currently available for MPS and MTP's. Several systematic reviews
have recently been published on a variety of treatments, including pharmacologic agents,
physical agents, complementary and alternative therapies. One commonly used therapy is the
application of topical agents to relieve pain. These agents can be classified as
pharmacologic or non-pharmacologic. The former category includes non-steroidal
anti-inflammatory agents (such as ketoprofen), opioid agents, classical analgesic agents
(such as lidocaine), novel analgesic agents such as capsaicin and rubefascient agents
(containing salicylates or nicotinamides). Non-pharmacologic agents generally fall into the
complementary and alternative medicine (CAM) category for MPS and MTP treatments. They may
contain putative analgesic agents or counterirritant agents and they may exert cold, hot or
neutral effects.
The literature on myofascial trigger points and non-pharmacologic topical agents is sparse
with no randomized clinical trials found to date. Several studies have investigated the
effect of such topicals in the treatment of osteoarthritis, particularly of the knee.
However, there appears to be a lack of studies investigating the effects of topicas for the
treatment of MPS or MTP. A randomized, placebo-blinded clinical trial of non-pharmacological
topical analgesics is warranted.
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