Are there any alternative therapeutic options for the treatment of myofascial syndrome?
Pregabalin and duloxetine are examples of oral drugs, indicated for other disease states, that can be used with benefit in the treatment of myofascial syndrome. A number of topical options also exist. These include topical capsaicin, glyceryl trinitrate (which has a localized antiinflammatory effect), lidocaine (Lidoderm patch), and doxepin (a tricyclic antidepressant with localized analgesic effects). Injection of local anesthetic into tender points can be used, as well as injection with corticosteroid. Corticosteroids stabilize nerve membranes, reduce ectopic neural discharge, and have a specific effect on dorsal horn cells as well as their well-known antiinflammatory effects.