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Trigger Point Injections

What is a Trigger Point Injection?

A trigger point injection or TPI is a minimally invasive outpatient procedure employed for the treatment of chronic muscle pain, stiffness, and inflammation caused by trigger points.

Trigger points are tight bands or knots that form when a muscle fails to relax after a contraction. These areas of pain and muscle spasm may develop due to acute trauma, overuse injuries, or chronic muscular disorders. They usually occur in the upper back and shoulder muscles and may irritate adjacent nerves causing pain to radiate to the surrounding regions.

Trigger point injections may contain an anesthetic such as lidocaine, a corticosteroid, or a combination of the two. The injections are administered to relieve pain, stiffness, and inflammation at the trigger points and surrounding areas and improve mobility.

Indications

Chronic and persistent muscle pain can have a considerable impact on an individual’s quality of life and normal functioning. Trigger point injections are indicated when your muscle pain has not responded to other non-surgical treatments such as medications and physical therapy. They can be used for the management of conditions such as:

  • Fibromyalgia
  • Tension headaches
  • Temporomandibular pain
  • Myofascial pain syndrome
  • Neck pain
  • Upper back/low back pain
  • Shoulder pain
  • Arms and legs pain

Procedure for Trigger Point Injections

The trigger points are usually located by palpation but an ultrasound localization technique may also be used. A topical anesthetic may be applied to numb the area and keep you comfortable during the procedure. Then a small injection containing local anesthetic with or without corticosteroid is directly administered to the trigger point making it inactive and relieving pain. You may feel a slight stinging or burning sensation during the injection. After injecting the medication, the needle is removed, and the injection site is covered with a Band-Aid. The procedure usually takes about 15 to 20 minutes and is performed in a doctor’s office. A single injection may be enough to treat trigger points due to trauma or repetitive use injuries. Chronic conditions usually require periodic administration of trigger point injections.

If you are allergic to the anesthetic, your doctor may use a dry-needle technique where a needle is inserted into the trigger point but no medication is used. This can also relieve pain. The procedure takes just a few minutes.

Post-Operative Care and Recovery

Trigger point injections result in less pain and downtime. The majority of patients can return to work right away. You are advised not to engage in any strenuous activities following the injection. However, you may resume all your normal activities the next day. You will experience some numbness at the site for approximately an hour. You may also develop some pain and bruising at the injection site. Hot or cold packs and over the counter pain medication can help relieve these symptoms. Stretching and other physical therapy exercises are usually recommended after trigger point injections.

Risks and complications

Trigger point injection is a relatively safe procedure; however, as with any injection procedure, some risks and complications may occur, such as the following:

  • Pain
  • Bruising
  • Swelling
  • Infection
  • Bleeding
  • Numbness