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Injections of Local Anesthetics into the Pharyngeal Region Reduce Trapezius Muscle Tenderness

Weinschenk, Stefan ; Hollmann, Markus W. ; Göllner, Richard ; Picardi, Susanne ; Strowitzki, Thomas ; Diehl, Leon ; Hotz, Lorenz ; Meuser, Thomas

In: Forschende Komplementärmedizin : Wissenschaft, Praxis, Perspektiven, 23 (2016), Nr. 2. pp. 111-116. ISSN 2504-2092

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Background: Neck pain is a frequent reason for seeking medical advice. Neuroanatomical findings suggest a close connection between the pharynx and the trapezius region. Irritation of the pharynx may induce tenderness of this area. Specific tender points, called neck reflex points (NRPs), can be identified here with high reproducibility. We hypothesized that therapeutic local anesthesia (TLA; or neural therapy, NT) in the pharyngeal region can reduce tenderness in patients with therapy-resistant neck pain.

Patients and Methods: 17 consecutive female patients with chronic cervical pain and positive trapezius NRPs received bilateral injections of 0.5 ml 1% procaine into the palatine velum. The NRPs were assessed using a 3-level pain index (PI = 0, 1, or 2) before and 3-5 min after each injection.

Results: We found a significant reduction in tenderness of the NRP of the trapezius region (NRP C7) immediately after TLA/NT. 30 positive NRPs were found before therapy and only 13 after therapy (p < 0.01). The average PI of the NRP C7 was 1.24 ± 0.77 before and 0.35 ± 0.59 after therapy (right side), and 1.34 ± 0.59 before and 0.59 ± 0.69 after therapy (left side). The pre- and post-therapy PI values were significantly different on both the right and left sides of the trapezius region (p < 0.01). No adverse effects were observed.

Conclusions: Pharyngeal irritation may induce and maintain therapy-resistant cervical pain in patients with chronic pharyngeal disease. These patients could benefit from remote TLA/NT injections in the pharyngeal region.

Document type: Article
Journal or Publication Title: Forschende Komplementärmedizin : Wissenschaft, Praxis, Perspektiven
Volume: 23
Number: 2
Publisher: Karger
Place of Publication: Basel ; Freiburg
Date Deposited: 04 Nov 2019 10:14
Date: 2016
ISSN: 2504-2092
Page Range: pp. 111-116
Faculties / Institutes: Medizinische Fakultät Heidelberg > Universitätsklinik für Anaesthesiologie
Medizinische Fakultät Heidelberg > Universitäts-Frauenklinik
DDC-classification: 610 Medical sciences Medicine
Uncontrolled Keywords: Nackenreflexpunkte , Neuraltherapie , Nackenschmerzen , Racheninjektion , Procain , neck reflex points , neural therapy , neck pain , Pharyngeal injection , Procaine
Additional Information: Dieser Beitrag ist aufgrund einer (DFG-geförderten) Allianz bzw. Nationallizenz frei zugänglich. This publication is freely accessible due to an Alliance licence and a national licence (funded by the DFG, German Research Foundation) respectively.
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