Myofascial pain syndrome (MPS) is a common musculoskeletal disorder among young adults. There are many therapeutic options including oral medications, physical agent modalities and some alternative treatments like dry needling (DN) without any drugs, ozone (OI) or lidocaine injection (LI). Our aim is to compare these last three methods in a randomized clinical trial.

In this single-blinded study among patients who presented at our musculoskeletal clinic, a total of 72 eligible participants were enrolled. Patients were randomly divided into three groups: first group (DN group) underwent dry needling, while the second and third groups received wet needling with ozone and lidocaine injection, respectively. All injections were repeated in three weekly sessions. Visual Analog Scale (VAS) for pain, neck range of motion (ROM), pain pressure threshold (PPT) and Neck Disability Index (NDI) were the main outcome measures, applied two times: once before intervention and another at 4 weeks after the last injection.

One month after injections in comparison to baseline, significant improvement was seen in pain and function for all three groups. Cervical ROM, except for dry needling group, was significantly improved in ozone and lidocaine groups (P-value=0.025 and 0.009, respectively). In comparison to DN group, both ozone and lidocaine had significantly better efficacy in PPT and NDI improvement (P-value=0.05 and 0.01, respectively); however there was no significant difference regarding to VAS changes between three groups (P-value=0.21).

While it seems that in short-term follow-up all three methods of dry needling, ozone and lidocaine were effective in MPS patients, the two latter treatments were more successful, with no preference between them.