Trigger point injections

What is the purpose of it?
Trigger points are painful “knots” in muscles which may feel sharp and may radiate to distant areas. Although generally not considered a serious medical condition, the pain can be disabling. Trigger points are usually injected with local anesthetic medication. Sometimes only needling without medication is performed, which is often done by acupuncturists. When local anesthetic is injected, it will numb the painful areas, and often help to break up the “knots” and allow for stretching the muscle to its normal length.

How long does the injection take?
The actual injection takes only a few minutes.

What is actually injected?
The injection consists of local anesthetic such as lidocaine or bupivacaine.

Will the injection(s) hurt?
The procedure involves inserting a thin needle through skin and into the trigger point of the muscle. When the trigger point is entered, it usually reproduces the typical pain from the trigger point. Therefore, we expect to elicit pain when the needle is correctly placed. Once the local anesthetic begins to work, the area becomes numb.

Will I be “put out” for this procedure?
No. This procedure is generally done in the doctor’s office.

How is the injection performed?
It is done with the patient sitting, standing, or lying down, depending on the area of the body involved and patient and doctor preference.

What should I expect after the injection?
Immediately after the injection, you may feel that your pain may be gone or reduced. This is due to the local anesthetic injected. This will last only for a few hours. Your pain may not return to its usual level, even after the anesthetic wears off. This may due to break-up of the trigger points.

What should I do after the procedure?
You should either apply ice or heat to the affected area, depending on instructions. Attempt stretching of the involved muscles while the area is numb. Perform activities as tolerated.

Can I go to work to work the next day?
Unless there are complications, you should be able to return to your work the same or the next day. The most common thing you may feel soreness at the site of the injection.

How long does the effect of the medication last?
The local anesthetic wears off in about 24 hours. The pain relief may greatly outlast the effect of the anesthetic.

How many injections do I need to have?
If the first injection is effective, we usually recommend repeating them as needed, not usually any more frequently than every two weeks. The injections should be combined with a physical therapy or exercise program to improve the health of the muscles.

Will the Trigger Point Injection help me?
It is very difficult to predict if the injection will indeed help you or not.

What are the risks and side effects?
Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. The most common side effect is pain – which is temporary. The other risks involve damage to surrounding structures, such as puncturing a lung if done in the chest, bleeding, and worsening of symptoms. The local anesthetic is very safe, provided doses are carefully measured, and the drug is not injected into a blood vessel. Should there be an overdose of local anesthetic or direct injection into a blood vessel, a seizure may occur. Fortunately, the serious side effects and complications are uncommon.

Who should not have this injection?
If you are allergic to any of the medications to be injected or if there is an active infection in the area of injection, you should not have the injection.