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Trigger Point Injections

What is a Trigger Point?

Trigger points are tender areas of contracted muscle. They can cause a great deal of pain. Common sites are in the muscles of the neck, shoulder blades, low back, buttocks or calves. They are commonly referred to as “knots.” Pressure tends to flare trigger points and can often radiate pain to other areas of the body.

What Causes Trigger Points?

Trigger points are caused most commonly by poor posture, overuse/misuse of muscles and stress.

How are Trigger Points Treated?

Stretching, myofascial release, massage, regular exercise, and stress reduction can all be useful in treating trigger points. When these strategies don’t work, a Trigger Point Injection may be useful.

How are trigger points injected?

First, the trigger point area must be located. After pushing on a series of places to localize the taut band or “knot,” the skin is marked. After visualizing the anatomy with ultrasound imaging, betadine or another cleaning solution is applied to sterilize the area. Prior to the injection, a cold spray is used to reduce the pain of the needle passing through the skin. At the time of the injection, the muscle may jump or twitch. This is a sign that the trigger point has been reached. The entire procedure takes only a few moments to complete.

What is injected?

Usually, lidocaine is the only thing injected. At times, steroid or botox may be appropriate.

Does it hurt?

All injections cause some degree of pain. Additionally, the muscle twitch that is illicited can sometimes be painful. Post injection soreness for 24-48 hours is common. Ice usually reduces the pain considerably.

Are trigger point injections risky?

These injections are usually quite safe. Whenever a needle is passed through the skin, there is a small risk of bleeding or infection. Every precaution is taken to minimize this risk. For some injections, there is a risk to the underlying organs or tissues. When relevant, this will be explained to you prior to the procedure.

How long will the relief last?

While the treatments don’t always work, when effective, relief can last days, weeks or even months.

How often can the treatments be done?

The treatment schedule will vary depending on the area of the trigger point and the duration of pain. Generally, injections are performed every few weeks or months. Sometimes, an intensive initial treatment schedule is undertaken.

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