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Open Access 01-12-2015 | Research article

Repeated tender point injections of granisetron alleviate chronic myofascial pain - a randomized, controlled, double-blinded trial

Authors: Nikolaos Christidis, Shahin Omrani, Lars Fredriksson, Mattias Gjelset, Sofia Louca, Britt Hedenberg-Magnusson, Malin Ernberg

Published in: The Journal of Headache and Pain | Issue 1/2015

Abstract

Background

Serotonin (5-HT) mediates pain by peripheral 5-HT₃-receptors. Results from a few studies indicate that intramuscular injections of 5-HT₃-antagonists may reduce musculoskeletal pain. The aim of this study was to investigate if repeated intramuscular tender-point injections of the 5-HT₃-antagonist granisetron alleviate pain in patients with myofascial temporomandibular disorders (M-TMD).

Methods

This prospective, randomized, controlled, double blind, parallel-arm trial (RCT) was carried out during at two centers in Stockholm, Sweden. The randomization was performed by a researcher who did not participate in data collection with an internet-based application (www.randomization.com). 40 patients with a diagnose of M-TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were randomized to receive repeated injections, one week apart, with either granisetron (GRA; 3 mg) or isotonic saline as control (CTR).

Results

The median weekly pain intensities decreased significantly at all follow-ups (1-, 2-, 6-months) in the GRA-group (Friedman test; P < 0.05), but not in the CTR-group (Friedman-test; P > 0.075). The numbers needed to treat (NNT) were 4 at the 1- and 6-month follow-ups, and 3.3 at the 2-month follow-up in favor of granisetron.

Conclusions

Repeated intramuscular tender-point injections with granisetron provide a new pharmacological treatment possibility for myofascial pain patients with repeated intramuscular tender-point injections with the serotonin type 3 antagonist granisetron. It showed a clinically relevant pain reducing effect in the temporomandibular region, both in a short- and long-term aspect.

Trial registration

European Clinical Trials Database 2005-006042-41 as well as at Clinical Trials NCT02230371.

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Title: Repeated tender point injections of granisetron alleviate chronic myofascial pain - a randomized, controlled, double-blinded trial
Authors: Nikolaos Christidis
Shahin Omrani
Lars Fredriksson
Mattias Gjelset
Sofia Louca
Britt Hedenberg-Magnusson
Malin Ernberg
Publication date: 01-12-2015
Publisher: Springer Milan
Published in: The Journal of Headache and Pain / Issue 1/2015
Print ISSN: 1129-2369
Electronic ISSN: 1129-2377
DOI: https://doi.org/10.1186/s10194-015-0588-3

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Repeated tender point injections of granisetron alleviate chronic myofascial pain - a randomized, controlled, double-blinded trial

Abstract

Background

Methods

Results

Conclusions

Trial registration

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Abstract

Background

Methods

Results

Conclusions

Trial registration

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