Trigger Point Injections

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Trigger point injection (TPI) is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.
What Happens During the Procedure?

In the TPI procedure, a health care professional inserts a small needle into the patients trigger point. The injection contains a local anesthetic that sometimes includes a corticosteroid . With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief. Injections are given in a doctors office and usually take just a few minutes. Several sites may be injected in one visit. If a patient has an allergy to a certain medication, a dry-needle technique (involving no medications) can be used.
When Is Trigger Point Injection Used?

TPI is used to treat many muscle groups, especially those in the arms, legs, lower back, and neck. In addition, TPI can be used to treat fibromyalgia and tension headaches. TPI also is used to alleviate myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatments. However, the effectiveness of TPI for treating myofascial pain is still under study.

Trigger point injection (TPI) is used to treat extremely painful areas of muscle. Normal muscle contracts and relaxes when it is active. A trigger point is a knot or tight, ropy band of muscle that forms when muscle fails to relax. The knot often can be felt under the skin and may twitch involuntarily when touched (called a jump sign).

The trigger point can trap or irritate surrounding nerves and cause referred pain — pain felt in another part of the body. Scar tissue, loss of range of motion, and weakness may develop over time.
TPI is used to alleviate myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatment, although there is some debate over its effectiveness. Many muscle groups, especially those in the arms, legs, lower back, and neck, are treated by this method. TPI also can be used to treat Fibromyalgia and tension headaches.
Procedure

Medical specialists such as an orthopedist, physiatrist, pain specialist, or neurologist can administer TPI. Injections are given in the physician’s office and takes approximately 30 minutes. Before performing TPI, the physician may give the patient a nerve block to prevent pain from needle penetration.

Frequently Asked Questions

What is a trigger point?
  • A Trigger Point is a knot of muscle that forms when a muscle does not relax, or is in spasm. Your doctor can usually feel the Trigger Point in order to diagnose.
  • This causes muscle pain and can irritate the nerves around the muscle and can cause referred pain, or pain that travels to another part of the body.
What is a Trigger Point Injection?
  • A Trigger Point Injection is used to inactivate a Trigger Point and relieve pain.
  • A thin needle will be inserted into the Trigger Point and a local anesthetic along with a corticosteroid will be injected.
  • If you have more than one Trigger Point the doctor will repeat this process at each site.
What are some possible side effects of a Trigger Point Injection?
  • Post injection pain can occur in some cases. This pain usually resolves itself in a few days. Ice, heat, or over the counter medications such as acetaminophen, ibuprofen, or naproxen sodium can be used to ease this discomfort.
  • Any time the skin is punctured by a needle there is a risk for bleeding or infection, however this is rare with Trigger Point Injections.
  • When should I expect to feel relief and how long will it last?
  • If the Trigger Point was caused by an isolated incident, the Trigger Point Injection should resolve the issue after one injection.
  • Trigger Points caused by an underlying issue, such as fibromyalgia, tend to be recurrent and the Trigger Point Injection will need to be repeated.
What will happen after the injection?
  • The doctor will have you wait for about 10 minutes after the injection in order to monitor your response to the injection.
  • You will most likely have a hot pack applied to the site of the injection to lower inflammation and irritation.
  • Vital signs may be retaken as a precaution.
  • You will be allowed to drive yourself home from this visit.
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