Steroid injections into myofascial trigger points versus joint injections for shoulder osteoarthritis

Clinical Study of Myofascial Trigger Points(MTrPs) Injection in the Treatment of Chronic Musculoskeletal Pain(CMP), Chronic Migraine and Cervicogenic Headache

This study will test whether steroid injections into muscle trigger points work as well as steroid injections into the shoulder joint for adults with shoulder osteoarthritis and ongoing shoulder pain.

Quick facts

• Phase: Not applicable
• Study type: Interventional
• Enrollment: 1036 (estimated)
• Ages: 45 Years and up
• Sex: All
• Sponsor: Beijing Tiantan Hospital (Academic / other)
• Locations: 1 site (Beijing, Beijing Municipality)
• Trial ID: NCT07347054 on ClinicalTrials.gov

What this trial studies

This is a prospective, randomized, controlled, blinded-outcome, non-inferiority trial comparing two injection approaches for shoulder osteoarthritis: glucocorticoid injection at myofascial trigger points (MTrPs) versus intra-articular (joint cavity) glucocorticoid injection. Eligible patients are randomized into one of the two treatment groups and receive the assigned injection, with standardized procedures and follow-up visits. Patients will be followed for two years with repeated measures of pain and function (for example, NRS and common osteoarthritis function scales) to compare long-term effects. The design focuses on whether MTrP injections can provide similar durable symptom relief while being easier to perform.

Who should consider this trial

Good fit: Adults aged 45 or older with radiographic shoulder osteoarthritis (Kellgren-Lawrence grade 1–4), at least one myofascial trigger point, disease >3 months, and NRS pain ≥3 despite prior conservative treatment are the intended participants.

Not a fit: Patients with corticosteroid allergy, recent intra-articular injections, long-term systemic steroid use, significant comorbidities (severe organ dysfunction, inflammatory rheumatic disease), substance abuse, or other exclusion criteria are unlikely to benefit from enrollment.

Why it matters

Potential benefit: If successful, patients could get similar long-term pain relief and improved shoulder function with a simpler, safer, and easier-to-deliver injection into trigger points instead of direct joint injection.

How similar studies have performed: Previous domestic and international reports have shown that glucocorticoid injections at myofascial trigger points can reduce pain short-term, but long-term data and head-to-head non-inferiority comparisons with intra-articular injections are limited.

Eligibility criteria

Inclusion Criteria:

* Diagnosis of shoulder osteoarthritis with radiographic evidence of osteoarthritis (Kellgren-Lawrence grade 1-4) confirmed by at least two orthopedic surgeons, pain specialists, or general practitioners, with physical examination confirming at least one myofascial trigger point;
* Disease duration exceeding 3 months;
* Age ≥ 45 years;
* Numerical Rating Scale (NRS) score ≥ 3 points despite prior conservative pharmacological treatment;
* Signed informed consent form.

Exclusion Criteria:

* History of allergy to trial medications such as corticosteroids;
* Alcohol abuse; long-term use of opioids (exceeding 2 weeks or more than 3 days per week for over 1 month); suspected use of sedative or analgesic medications; patients on long-term steroid therapy;
* Severe neurological disorders, significant hepatic or renal dysfunction, heart failure, coagulation abnormalities, gastric ulcer, diabetes, inflammatory rheumatic diseases, etc.;
* Intra-articular injection within the past 6 months or planned joint replacement surgery;
* Inability to use pain assessment scales;
* Presence of local or systemic infection;
* Pregnant or lactating patients.

Where this trial is running

Beijing, Beijing Municipality

• Beijing Tiantan Hospital — Beijing, Beijing Municipality, China (Recruiting)

Study contacts

• Study coordinator: Fang Luo

Conditions Myofascial Trigger Points; Chronic Musculoskeletal Pain; Shoulder Osteoarthritis