FAQs on Trigger Point Injection in Nashville TN

A trigger point injection is used to treat painful areas of the muscle, which are characterized by trigger points. A trigger point feels like a tight, taut band of muscle, and it is tender to touch or deep pressure. A trigger point injection (TPI) is a procedure where a needle is inserted into the painful trigger point, and an anesthetic is injected.

Where do trigger points occur?

A trigger point may occur in any body region, but most often develop in the shoulders, neck, and low back. The trigger point can irritate surrounding nerves, causing referred pain (pain felt in another region in close proximity to the original painful area).

What causes painful trigger points?

Trigger points often are the primary muscle problem, or they are secondary to some type of trauma, fibromyalgia, scar tissue formation, surgery, and many other conditions. In addition, myofascial pain syndrome also causes painful trigger points.

What is the purpose of a trigger point injection?

Trigger point injections are given to reduce pain and increase functional ability. They allow the patient to participate in daily activities and physical therapy. Approximately 10% of the U.S. population have some form of chronic musculoskeletal disorder, resulting in disabling muscle pain.

What can I expect before a series of trigger point injections?

The doctor will make the decision for trigger point injections after conducting a medical history and physical examination. To determine the existence of one or more trigger points, he/she will apply pressure along the neck, shoulders, and back. In addition, the doctor may use needle-guided electromyography (EMG) to locate trigger points. Be sure to discuss your medications and allergies with the doctor.

How is the trigger point injection performed?

A TPI is a simple procedure performed in the physician’s office. The doctor examines the patient and identifies the trigger points. The skin is cleansed with an antiseptic solution, and a small needle is entered into the trigger point. The doctor may choose to inject a local anesthetic into the trigger point. Other solutions used include a corticosteroid, sterile water, and Botox. Botulium toxin (Botox) has been found to alleviate painful muscle contractions. The insertion of the needle can cause mild pain or a twitch, which lasts a few seconds.

What can I expect after the trigger point injection?

After the trigger points are injected, expect some mild soreness at the injection sites. We recommend use of an ice pack or massage to relieve the pain. In addition, stretching exercises are recommended following the procedure. The skin numbness from the local anesthetic will last approximately 1 hour. After the injection, you will be observed by a nurse for around 15 minutes to assure you have no problems or medication reactions. To reduce the tenderness, apply an ice pack for 20 minutes 3-4 times a day.

What are the possible complications of the trigger point injection?

TPIs are safe, effective injections, and complications are rare. However, there is a slight risk of lightheadedness, tenderness, bleeding, bruising, infection, allergic reaction, and damage to the organs. People who should not have trigger point injections include anyone with a bleeding disorder, current infection, or pregnant women.

What is the success rate of TPI?

One injection does not work for everyone, so TPIs often need to be repeated. Some patients receive trigger point injections every month, whereas others only need them once a year. The frequency of TPI depends on the patient’s pain, the doctor’s recommendation, and the medication used. Studies indicate that trigger points have an efficacy rate of 98%, and more than half of these patients report complete symptom relief.

Resources

Dhadwal, N, Hangan, MF, Dyo, FM, Zeman, R, & Li, J (2013). Tolerability and efficacy of long-term lidocaine trigger point injections in patients with chronic myofascial pain. International Journal of Physical Medicine and Rehabilitation.

Wong CSM & Wong SHS (2012). A new look at trigger point injections. Anesthes Res & Pract, ID 492452. http://dx.doi.org/10.1155/2012/492452