Procedure: Trigger Point Injection
What is a trigger point?
Trigger points are focal areas of spasm and inflammation in skeletal muscles. The rhomboid and trapezius back muscles, located in the upper back and behind the shoulder areas, are a common site of trigger points. Trigger points in these areas can cause neck pain, shoulder pain, and headaches. In addition to the upper spine, trigger points can also occur on the lower back or less commonly in the extremities.
What is actually injected?
The injection consists of a local anesthetic (like lidocaine and bupivacaine) and Depomedrol.
How is the injection performed?
It is done with the patient lying down or sitting up in the exam table, the exact technique varies. The trigger point(s) are located by manual palpitation and are marked with a skin marker. The injection site is then cleaned with alcohol. The needle is then inserted into the trigger point and the medication is injected.
What should I expect after the injection?
Immediately after the injection, the patient may have mild soreness. If the area is painful, Coastal Bend Pain Management recommends ice, heat, Tylenol, or over the counter non-steroidal anti-inflammatory medication such as Advil or Naproxen can be used.
What should I do after the procedure?
The patient should have a driver take them home. Coastal Bend Pain Management advises patients to take it easy for a day or two after the procedure. The patient may pPerform activities as tolerated by their body. Some patients may go for immediate physical therapy.
How many injections do I need to have?
Optimally, a trigger point resolves after one injection. This may happen when a patient has one isolated trigger point, especially if the cause of the trigger point has been removed. Trigger points caused by chronic conditions such as fibromyalgia or myofascial pain syndrome tend to recur due to the underlying problem. In these cases, trigger point injections may be administered on a regular or as needed basis. The frequency of trigger point injections depend on the medication being injected.
What are the risks and side effects?
A potential complication from the trigger point injection is post-injection pain. This is relatively uncommon, but it can occur. This pain usually resolves by itself after a few days. It is more common when no medication is injected into the trigger point (dry needling).