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Trigger Point Injections

Trigger Point Injections 2017-08-09T17:15:54+00:00

A trigger point injection is an injection of local anesthetic, with or without steroid, into the trigger point in the muscle.  A trigger point is a band of tissue you can feel within a muscle that causes your typical pain when pressed upon.  Trigger point injections are ordered by your doctor to try to help “break up” the tight muscle.  You must be involved in an active stretching and strengthening program to help prevent the trigger points from coming back. In some people (either due to frequency of injections or if steroid is contraindicated) a natural medicine called sarapin is used. Trigger point injections may need to be repeated, especially if you are unable to perform your exercises because of pain or spasm.  Again, exercise is the key to both eliminating and preventing trigger points.

As with most procedures there is a remote risk of bleeding, infection, nerve injury or allergic reaction to the medications used.  If the injections are around your chest or upper to mid- back there is also a small risk of pneumothorax (collapsed lung). Some short-term side effects may occur.  It is possible to get some numbness/weakness beyond the muscle that’s injected if the medication spreads to a nerve.  If this happens the numbness/weakness can last for hours. You may have increased pain for a few days after the local anesthetic wears off.  If steroid is used, diabetics may have a short-term elevation of blood sugars; people prone to fluid retention may have increased fluid retention for 1 – 2 weeks.

The most effective trigger point injections are the injections that reproduce your typical pain on injection.  Therefore, there is temporary discomfort/pain upon injection, but as it is local anesthetic (numbing medicine) being injected the discomfort/pain is short-lived.

After signing a consent form and checking your blood pressure the procedure will usually be done in the sitting position (position may vary depending on area to be injected).  Using a marking pen, the doctor will identify and mark the area(s) to be injected.  The skin is then cleansed with an antiseptic soap or alcohol.  A small needle is advanced through the skin into the muscle until the tight band is felt and/or until your pain is reproduced. The medication is then injected and the needle is removed.  This process will be repeated in each trigger point. Your skin will be cleansed and a bandage will be applied if needed. (The bandage can be removed the next morning). The doctor may massage the area(s) to help the medicine spread throughout the muscle.  Your blood pressure will be checked and you will be discharged to leave after your doctor authorizes your discharge.  You may or may not need a ride depending on the number of areas to be injected as well as the location of areas to be injected. (This should be discussed with your doctor prior to setting up an appointment for trigger point injections).

Your pain may be improved immediately after the injection from the local anesthetic.  The steroid, when used, usually takes two or three days to have an effect in most people and peaks in about two weeks. Some local tenderness may be experienced for a couple of days after the injection.  Using an ice pack three or four times a day will help this.  You may take your usual medication as well after the injection. Having someone massage the area injected to help break up the spasm is helpful.  Gentle stretching exercises of the involved area are also recommended.

You may NOT drive for the remainder of the day after your procedure.  No heat is to be used on the injection area for the remainder of the day.  No tub bath or soaking in water (pools/Jacuzzi, etc) for the remainder of the day.

If you experience severe back pain, new numbness or weakness of your legs, loss of control of your bladder or bowels, or have signs of infection (temperature greater than 99.9º , drainage, redness/heat at insertion site) – call IMMEDIATELY.

ON THE DAY OF YOUR PROCEDURE, PLEASE DO THE FOLLOWING:

♦ Take all blood pressure pills & heart medications prior to the procedure with a sip of water at least 3 hours before your requested arrival time. Your vitals must be stable to have the procedure.

♦ Have a responsible person to take you home.

♦ Arrive at the requested procedure time.  Please do not be late or your procedure may be cancelled. 

ON THE DAY OF YOUR PROCEDURE: 

♦ Do not take ANY of the following 5 days before your procedure:  Coumadin

♦ Do not take ANY of the following 7 days before your procedure:  Plavix

♦ Coumadin must be stopped prior to the injection. You must have a normal INR prior to the injection.  Do not stop the drug by yourself.

♦ Eat or drink 6 hours before the procedure.

NOTE:  YOUR PROCEDURE WILL BE CANCELLED IF
: 

  • You have an active infection, flu, cold, fever, or very high blood pressure.
  • You do not have a responsible driver to take you home, arrive late for your procedure, or unable to follow the medication / fluid restrictions.

Call the office at (513) 860-1039 for procedure related questions.