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Some Frequently Asked Questions on Trigger Points

 

What is a trigger point?

Trigger points are tight spots in the muscle that are unable to relax on their own. This tightness exerts pressure on surrounding tissue including other muscles, tendons, ligaments and the fascia. It is this pressure that can cause a loss of function and range in nearby joints.

What is a trigger point injection?

A trigger point injection (TPI) is an injection that is given directly into the trigger point for pain management. The injection may be an anesthetic such as lidocaine  or bupivicaine, a mixture of anesthetics, or a corticosteroid (cortisone medication) alone or mixed with lidocaine. Sometimes, a needle alone is inserted into the trigger point, and no medication is injected. This may be helpful and is referred to as “dry needling.” With the injection, the trigger point is made inactive and the pain is relieved.

When is a trigger point injection used?

Trigger point injections are used when a patient has a painful trigger point, especially when pain radiates from the trigger point to the surrounding area. Trigger point injections may be used as a treatment for conditions such as fibromyalgia and myofascial pain syndrome.

How is the trigger point injection procedure performed?

The trigger point injection is performed in our office. The trigger point is located by manual palpation. Ultrasound guidance is not generally necessary. The injection site is then cleaned. Alcohol or another skin cleanser such as betadine is commonly used to clean the injection site. A numbing agent may be used to anesthetize the skin and make the actual injection less painful. The needle is then inserted into the trigger point and the medication is injected. After the injection, a simple adhesive bandage may be applied.

What are complications and side effects of trigger point injections

A potential complication from the trigger point injection procedure 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). Cryotherapy is recommended for relief of this minor pain.

If a steroid medication is injected into the trigger point, shrinkage of the fat under the skin can occur, leaving a dent in the skin. This does not occur when only anesthetic is injected without any steroid medication. Other side effects are rare with trigger point injections but can occur anytime a needle punctures the skin, including infection and bleeding.

 

How frequently do trigger point injections need to be administered?

Trigger points often resolve 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 (such as a trigger point caused by a repetitive minor trauma or movement that will no longer be performed). Trigger points caused by chronic conditions such as fibromyalgia and myofascial pain syndrome tend to recur due 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 depends on the medication being injected. If only lidocaine or a mixture of anesthetics is injected, then the injections can be administered as ongoing therapy as frequently as monthly. If a steroid medication is injected, TPIs should be administered much less frequently because of the risk of tissue damage or shrinkage caused by the steroid.

How do I schedule an appointment to see if I would benefit from trigger point injections?

Scheduling an appointment for your consultation is as easy as calling Action Medical at 706-860-3355.

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