FAQs on Trigger Point Injections in Colorado

 

Trigger point injections (TPIs) are used to treat many types of back, neck, and muscle pain. These injections are done in the pain management specialist’s office, and they provide long-lasting pain relief for many patients.

What medications are used in trigger point injections?

The medications used for trigger point injections include:

  • Anesthetics – Marcaine, bupivacaine, and lidocaine.
  • Corticosteroids – Triamcinolone, betamethasone, and methyl-prednisolone.
  • BOTOX – Botulinum toxin type A.

What are trigger points?

Trigger points, also called muscle knots or trigger sites, are hyperirritable spots in the muscle tissue that are associated with taut bands of muscle fibers. Trigger points are small contraction of tissue that cause pain. Pressing on a trigger point can lead to local pain, referred pain, or a twitch response.

How do trigger point injections work?

Trigger point injections have been used in medicine for over 50 years. Experts believe these injections offer physical and psychological symptom relief. The safety and efficacy of TPIs has been investigated in many clinical studies.

What conditions are associated with trigger points?

Trigger points can occur alone or in combination with other medical conditions. They are associated with:

  • Myofascial pain syndrome
  • Fibromyalgia
  • Chronic neck pain
  • Chronic back pain
  • Cluster headaches
  • Chronic tension-type headaches
  • Chronic migraine
  • Whiplash
  • Chronic shoulder pain

Will I need to prepare for the trigger point injections?

The trigger points are injected in the doctor’s office, and no sedative or local anesthetic is used. The procedure is done with you lying face-down or sitting on the procedure table. Because bleeding can occur, you should notify the doctor if you are taking anything that thins the blood. This include nonsteroidal anti-inflammatory drugs (NSAIDs), aspirin, Coumadin, Plavix, and Ticlid.

How are trigger point injections done?

After you meet with the pain management specialist, the doctor will evaluate you and decide if trigger point injections will help. The nurse will go over procedure risks and benefits, have you sign a consent form, and make you put on a procedure gown. The doctor will clean the skin with an antiseptic and palpate the trigger points. After identifying all the regions, the skin is marked with a skin pen. The doctor then injects the region with a tiny needle, instilling the medication. Small spot band-aids are applied to injection sites.

What can I expect after the TPIs?

After the doctor injects your trigger points, you may experience some mild bruising and tenderness at the multiple injection sites. Over the next few hours and days, you will experience pain relief. If a corticosteroid is used, the anti-inflammatory effects will not be noticed for 2-3 days.

Are trigger point injections effective?

In a study involving 91 patients with myofascial pain, researchers found that TPIs had a 93% success rate. The injections involved use of ultrasound guidance for needle placement, and no medication was injected (dry needling). In a 12-week study involving trigger points in shoulder muscles, researchers found that the therapy reduce pain and improved shoulder function. In a study where patients with fibromyalgia were treated using TPIs, doctors found that the injections improved quality of life and range of motion. In addition, TPIs have been used for chronic tension-type headache, chronic migraine, and cluster headaches with success.

Resources

Calandre EP, Hidalgo J, Garcia-Leiva JM, Rico-Villademoros F, & Delgado-Rodriguez A. (2008). Myofascial trigger points in cluster headache patients: a case series. Head Face Med., 4, 32.

Fernández-de-las-Peñas C, Fernández-Mayoralas DM, Ortega-Santiago R, Ambite-Quesada S, Palacios-Ceña D, Pareja JA. (2011). Referred pain from myofascial trigger points in head and neck-shoulder muscles reproduces head pain features in children with chronic tension type headache.J Headache Pain., 12(1), 35-43.

Fernández-de-Las-Peñas C, Ge HY, Alonso-Blanco C, González-Iglesias J, & Arendt-Nielsen L. (2010). Referred pain areas of active myofascial trigger points in head, neck, and shoulder muscles, in chronic tension type headache. J Bodyw Mov Ther., 14(4), 391-6.

Tough EA, White AR, Richards SH, & Campbell JL. (2010). Myofascial trigger point needling for whiplash associated pain–a feasibility study. Man Ther., 15(6), 529-35.

Venancio Rde A, Alencar FG Jr, Zamperini C. (2009). Botulinum toxin, lidocaine, and dry-needling injections in patients with myofascial pain and headaches. Cranio., 27(1), 46-53.