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Trigger Point Injections

A trigger point is a sensitive or irritable spot in the body that can be a main or associated source of pain conditions. Most often these spots are found in muscle and its lining (fascia) and are called "myofascial" trigger points. They can also be located in skin, ligament and tendon tissue. Trigger points can be causes for bands of pain radiating quite a distance from the actual trigger spot. Because of this "referred pain," trigger points can even mimic pinched nerves. Trigger points can arise as a result of strain or repetitive use injuries, stress and muscle tension conditions, or specific disorders such as herniated discs, pinched nerves, fractures, and surgical incision healing sites, to name only a few.

Trigger point injections have been found to be very effective in relieving pain, best used in combination with a home exercise, heat, cold and medication program.

The procedure itself can be done in an office setting, or a pain clinic. The injections are limited to what is called the "soft tissue" of the body. They are not given into blood vessels, nerves, joints or the spinal canal.

You may be sitting or lying down in order to be comfortable. This allows the physician to localize areas of maximum tenderness. These areas are cleansed with a sterile solution. The injection is then performed using local anesthetic and sometimes an anti-inflammatory steroid. You may experience some transient burning as the local anesthetic starts to take effect before it numbs the area. Several sites may be injected in one visit. The trigger point injection procedure takes approximately 30 minutes.

Icing for 20 to 30 minutes several times later on the day of the injection is recommended, along with easy stretching exercises. You may return immediately to work or regular activities after the injection. You may drive, although some people feel less nervous if they know they have someone along to drive them home. You should continue any physical therapy sessions already scheduled. At times, the physician will specifically want to perform the injection on a day when you are scheduled for physical therapy.

You may be sore for the first 24 to 48 hours. If any unusual redness or swelling or warmth occurs at the injection site, notify the physician who performed the trigger point injection. You may continue taking all of your regular medications. The doctor may prescribe some new medications to enhance the effectiveness of the injections.