Trigger Point Injections (TPI) are administered when there is a painful trigger point that spreads the pain to the surrounding area. The injection is given directly into the source – the trigger point of the pain; this makes the trigger point inactive, and thus, the pain is relieved.
Where TPI is Injected
Many muscles, including those in legs, lower back, arms, and neck, are treated with these injections. TPI can also be used to treat tension headaches, myofascial pain syndrome, and fibromyalgia. Sometimes injections may need to be taken in multiple locations in order to get better and lasting relief from the pain.
The injection usually contains an anesthetic like Bupivacaine (Marcaine) or Lidocaine (Xylocaine).The key component can be a cortisone medication (corticosteroid), a mix of anesthetics, or corticosteroids mixed with Lidocaine. Without using any medications, a needle alone can be inserted at the trigger point. This process is called dry needling and is quite helpful in administering the medicine in complex cases.
The injection is usually given in a center for pain relief by a healthcare professional, with the patient either sitting or lying down. The location of the trigger point is marked and then the site is cleaned by rubbing alcohol or any skin cleanser (like Betadine). A numbing medication like Ethyl Chloride is used to reduce the pain of the injection, and a simple bandage can be applied over the injection site afterwards if needed.
Frequency of Injections
In case of a single isolated trigger point, one injection may be enough to relieve the pain. In other cases, the injections are given according to the severity of the condition. The frequency also depends on the type of medication used. Trigger points may recur in case of chronic conditions like myofascial pain syndrome and fibromyalgia, due to some underlying problems. These conditions might require TPI on a regular basis.
Post-injection pain is a potential side effect associated with TPI. Heat, ice, Tylenol, or some anti-inflammatory medications with the recommendation of the healthcare provider can be taken to reduce the pain. Apart from that, a dent may form in the skin due to the shrinkage of fat under the skin when steroid medication is used for injections, but this condition can be avoided by using anesthetics. Other risks and side effects associated with the injection are rare, but bleeding and infection can occur in some cases when the needle punctures the skin.