Randomized Controlled TrialTreatment: Trigger Point InjectionClinical RelevanceDOI
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Study Summary

Background

This study addresses myofascial pain in masseter muscles, which is common among dental patients and often related to temporomandibular disorders. Current treatment options include trigger point injections with anesthetics like lidocaine, but muscle regeneration remains a challenge. The researchers explored collagen injections as a novel therapy, hypothesizing that collagen could not only provide pain relief but also support muscle tissue regeneration by providing the extracellular matrix components needed for proper muscle healing.

What They Did

The researchers conducted a three-arm randomized controlled trial with 43 patients diagnosed with myofascial pain in their masseter muscles. Participants were randomly divided into three groups: Group I received collagen injections (Collagen MD Muscle, n=15), Group II received 2% lidocaine injections (n=13), and Group III received saline injections as a control (n=15). All patients received two injections one week apart (days 0 and 7) directly into their masseter muscle trigger points. The researchers measured pain using a visual analog scale (VAS) and muscle activity using surface electromyography (sEMG) at baseline, after 7 days, and after 14 days.

What They Found

Collagen injections proved most effective for both pain relief and muscle function improvement. Pain intensity reduction was 53.75% in the collagen group, compared to 25% with lidocaine and 20.1% with saline. Muscle activity measured by sEMG decreased significantly more in the collagen group (59.2% reduction) versus lidocaine (39.3%) and saline (14%). The differences were statistically significant (p<0.001) across all measurements.

Patients experienced temporary mild side effects after collagen injections including brief pain, swelling, and muscle stiffness that resolved within an hour, plus occasional bruising at injection sites.

What This Means

This study suggests that collagen injections offer superior benefits compared to traditional lidocaine injections for treating masseter muscle trigger points. The collagen likely works by providing the building blocks needed for proper muscle tissue regeneration, addressing not just symptoms but the underlying tissue dysfunction. For patients with chronic jaw pain and temporomandibular disorders, this could represent a more effective treatment option that promotes actual healing rather than just temporary pain relief. However, the study's short 14-day observation period means longer-term benefits and durability of treatment remain unknown.

70/100
Evidence StrengthModerate
Study Quality
Sample Size
Replication
53.75%
Pain Reduction (Collagen)
59.2%
EMG Activity Reduction
p<0.001
Statistical Significance
Enrolled

43

Randomized
n=15

Collagen

2ml collagen injections x2

n=13

Lidocaine

2ml 2% lidocaine injections x2

n=15

Saline Control

2ml saline injections x2

Results Comparison

Pain Reduction (%)

%
Collagen53.75 %
Lidocaine25 %
Saline20.1 %

EMG Activity Reduction (%)

%
Collagen59.2 %
Lidocaine39.3 %
Saline14 %

Key Findings

Collagen injections provided superior pain relief compared to standard lidocaine treatmentHigh

53.75% pain reduction with collagen vs 25% with lidocaine (p<0.001)

Muscle activity improved most significantly with collagen treatmentHigh

59.2% reduction in EMG activity vs 39.3% with lidocaine and 14% with saline

Even saline injections showed some benefit due to mechanical disruptionMedium

20.1% pain reduction and 14% EMG reduction with saline control

Collagen therapy may promote muscle regeneration through ECM supportHigh

Collagen provides extracellular matrix components needed for proper muscle healing

Treatment was well-tolerated with only minor temporary side effectsMedium

Brief pain, swelling and stiffness resolved within 1 hour; occasional bruising

Study Methodology
Study Design
Randomized, single-blind, three-arm controlled trial
Sample Size
43
Duration
14 days with 2 treatment sessions
Population
Adults with myofascial pain and trigger points in masseter muscles
Outcome Measures
Visual Analog Scale (VAS) · Surface electromyography (sEMG)

Strengths

  • Well-designed randomized controlled trial with appropriate control groups
  • Used validated outcome measures (VAS and sEMG)
  • Novel therapeutic approach with biological rationale
  • Objective muscle activity measurements alongside subjective pain scores

Limitations

  • Short observation period (only 14 days) limits assessment of long-term efficacy
  • Single-blind design - investigators knew which substance was being injected
  • Small sample size (n=43) limits generalizability
  • Single-center study conducted in one population

Key Takeaways for Patients

What This Means for You

  1. 01Collagen injections may be more effective than traditional lidocaine injections for jaw muscle trigger points
  2. 02The treatment reduced pain by more than half and significantly improved muscle function
  3. 03Side effects were minor and temporary - brief swelling and occasional bruising
  4. 04Collagen may actually help heal muscle tissue rather than just masking pain
  5. 05More research is needed to understand long-term benefits beyond 2 weeks

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