Muscle injections with lidocaine improve resting fatigue and pain in patients with chronic fatigue syndrome

Roland Staud,1 Taylor Kizer,1 Michael E Robinson2 1Department of Medicine, College of Medicine, 2Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA Objective: Patients with chronic fatigue syndrome (CFS) complain of long-lasting fatigue and pain which are not r...

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Main Authors: Staud R, Kizer T, Robinson ME
Format: Article
Language:English
Published: Dove Medical Press 2017-06-01
Series:Journal of Pain Research
Subjects:
Online Access:https://www.dovepress.com/muscle-injections-with-lidocaine-improve-resting-fatigue-and-pain-in-p-peer-reviewed-article-JPR
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author Staud R
Kizer T
Robinson ME
author_facet Staud R
Kizer T
Robinson ME
author_sort Staud R
collection DOAJ
description Roland Staud,1 Taylor Kizer,1 Michael E Robinson2 1Department of Medicine, College of Medicine, 2Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA Objective: Patients with chronic fatigue syndrome (CFS) complain of long-lasting fatigue and pain which are not relieved by rest and worsened by physical exertion. Previous research has implicated metaboreceptors of muscles to play an important role for chronic fatigue and pain. Therefore, we hypothesized that blocking impulse input from deep tissues with intramuscular lidocaine injections would improve not only the pain but also fatigue of CFS patients. Methods: In a double-blind, placebo-controlled study, 58 CFS patients received 20 mL of 1% lidocaine (200 mg) or normal saline once into both trapezius and gluteal muscles. Study outcomes included clinical fatigue and pain, depression, and anxiety. In addition, mechanical and heat hyperalgesia were assessed and serum levels of lidocaine were obtained after the injections. Results: Fatigue ratings of CFS patients decreased significantly more after lidocaine compared to saline injections (p = 0.03). In contrast, muscle injections reduced pain, depression, and anxiety (p < 0.001), but these changes were not statistically different between lidocaine and saline (p > 0.05). Lidocaine injections increased mechanical pain thresholds of CFS patients (p = 0.04) but did not affect their heat hyperalgesia. Importantly, mood changes or lidocaine serum levels did not significantly predict fatigue reductions. Conclusion: These results demonstrate that lidocaine injections reduce clinical fatigue of CFS patients significantly more than placebo, suggesting an important role of peripheral tissues for chronic fatigue. Future investigations will be necessary to evaluate the clinical benefits of such interventions. Keywords: muscle injections, lidocaine, metaboreceptor, chronic fatigue 
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spelling doaj.art-52d64283021445899ff536ee47785f4b2022-12-22T00:08:56ZengDove Medical PressJournal of Pain Research1178-70902017-06-01Volume 101477148633441Muscle injections with lidocaine improve resting fatigue and pain in patients with chronic fatigue syndromeStaud RKizer TRobinson MERoland Staud,1 Taylor Kizer,1 Michael E Robinson2 1Department of Medicine, College of Medicine, 2Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA Objective: Patients with chronic fatigue syndrome (CFS) complain of long-lasting fatigue and pain which are not relieved by rest and worsened by physical exertion. Previous research has implicated metaboreceptors of muscles to play an important role for chronic fatigue and pain. Therefore, we hypothesized that blocking impulse input from deep tissues with intramuscular lidocaine injections would improve not only the pain but also fatigue of CFS patients. Methods: In a double-blind, placebo-controlled study, 58 CFS patients received 20 mL of 1% lidocaine (200 mg) or normal saline once into both trapezius and gluteal muscles. Study outcomes included clinical fatigue and pain, depression, and anxiety. In addition, mechanical and heat hyperalgesia were assessed and serum levels of lidocaine were obtained after the injections. Results: Fatigue ratings of CFS patients decreased significantly more after lidocaine compared to saline injections (p = 0.03). In contrast, muscle injections reduced pain, depression, and anxiety (p < 0.001), but these changes were not statistically different between lidocaine and saline (p > 0.05). Lidocaine injections increased mechanical pain thresholds of CFS patients (p = 0.04) but did not affect their heat hyperalgesia. Importantly, mood changes or lidocaine serum levels did not significantly predict fatigue reductions. Conclusion: These results demonstrate that lidocaine injections reduce clinical fatigue of CFS patients significantly more than placebo, suggesting an important role of peripheral tissues for chronic fatigue. Future investigations will be necessary to evaluate the clinical benefits of such interventions. Keywords: muscle injections, lidocaine, metaboreceptor, chronic fatigue https://www.dovepress.com/muscle-injections-with-lidocaine-improve-resting-fatigue-and-pain-in-p-peer-reviewed-article-JPRMuscle InjectionsLidocaineMetaboreceptorChronic Fatigue
spellingShingle Staud R
Kizer T
Robinson ME
Muscle injections with lidocaine improve resting fatigue and pain in patients with chronic fatigue syndrome
Journal of Pain Research
Muscle Injections
Lidocaine
Metaboreceptor
Chronic Fatigue
title Muscle injections with lidocaine improve resting fatigue and pain in patients with chronic fatigue syndrome
title_full Muscle injections with lidocaine improve resting fatigue and pain in patients with chronic fatigue syndrome
title_fullStr Muscle injections with lidocaine improve resting fatigue and pain in patients with chronic fatigue syndrome
title_full_unstemmed Muscle injections with lidocaine improve resting fatigue and pain in patients with chronic fatigue syndrome
title_short Muscle injections with lidocaine improve resting fatigue and pain in patients with chronic fatigue syndrome
title_sort muscle injections with lidocaine improve resting fatigue and pain in patients with chronic fatigue syndrome
topic Muscle Injections
Lidocaine
Metaboreceptor
Chronic Fatigue
url https://www.dovepress.com/muscle-injections-with-lidocaine-improve-resting-fatigue-and-pain-in-p-peer-reviewed-article-JPR
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AT robinsonme muscleinjectionswithlidocaineimproverestingfatigueandpaininpatientswithchronicfatiguesyndrome