Trigger point injection with steroids and pulsed radiofrequency treatment of trigger points may relieve pain associated with abdominal myofascial pain syndrome (AMPS) effectively, according to a study published in Pain Medicine. In addition, trigger point injection with anesthetics was found to be useful in diagnosing AMPS.
In this prospective audit of chronic refractory abdominal pain management, the investigator assessed localized chronic abdominal pain in 153 adult patients who were seen by a pain physician.
The management pathway for these patients included a medical management protocol consisting of 4 steps. Step 1 was a trial of amitriptyline, pregabalin, and tramadol. Patients with localized myofascial pain were given 5% lidocaine plaster and offered transcutaneous electrical nerve stimulation plus acupuncture.
Step 2 consisted of trigger point injection with local anesthetic within 8 weeks of diagnosis. Step 3 was undertaken for patients unresponsive to step 2 treatment and consisted of trigger point injection of depot steroid plus local anesthetic. Step 4 was pulsed radiofrequency of the trigger points, which was administered to those who did not respond to step 3 treatment. After each intervention, a nurse specializing in pain management followed up with the patient by telephone.