What is a Trigger Point Injection?

A Trigger Point Injection (TPI) is an injection that will help diagnose and treat certain chronic pain conditions where muscle sensitivity and pain exist.

How long does the injection take?

The actual injection takes only a few minutes for most patients.

What is actually injected?

The injection consists of a mixture of local anesthetic (like lidocaine or bupivacaine) and the steroid medication (methylprednisolone).

Will the injection hurt?

The procedure involves inserting a needle through skin and possibly some deeper tissues (like a “tetanus shot”). So, there is some discomfort involved. However, we numb the skin and tissue with a local anesthetic using a very thin needle prior to inserting the needle into the joint.

Will I be “put out” for this procedure?

No. This procedure is done under local anesthesia.

How is the injection performed?

The procedure includs injecting the skin with a local anesthetic. You may feel a stinging and burning sensation. When the tip of the needle touches the trigger point, you may feel a brief increase in your pain. This pain is a good sign that the medicine is in the correct spot; the pain usually goes away quickly. The actual time it take for your doctor to complete the procedure may be different for each patient.

What should I expect after the injection?

Immediately after the injection, you may feel that your pain may be gone or quite less. This is due to the local anesthetic injected. This will last only for a few hours. Your pain will return and you may have a “sore back” for a day or two. This is due to the mechanical process of needle insertion as well as initial irritation form the steroid itself. You should start noticing pain relief starting the 5th day or so.

What should I do after the procedure?

You should have a ride home. We advise the patients to take it easy for a day or so after the procedure. You may want to apply ice to the affected area. Perform the activities as tolerated by you.

Can I go to work to work the next day?

Unless there are complications, you should be able to return to your work the next day. The most common thing you may feel is some soreness at the affected area.

How long the effect of the medication lasts?

The length of pain relief varies from person to person. In most cases, the pain may be lessened for a few days up to a few months. Your doctor may recommend TPIs as well as other types of pain management as part of your treatment plan.

How many injections do I need to have?

Sometimes your doctor will prescribe a series of injections. These injections are done several weeks apart. After this series, your doctor can determine how the injections are helping you. If the second or third injection does not help, then TPIs most likely will not help your pain

Will the Trigger Point Injection help me?

It is very difficult to predict if the injection will indeed help you or not. Your pain may go away after the injection and never come back. Sometimes the injection only helps to lessen pain for a short time. In this case, a second injection may be helpful. If the second injection does not help, then TPI will most likely not help with your pain for the long-term. A TPI may make it easier for you to exercise and to participate in physical therapy sessions to help improve your condition overall. It is important for you to take an active role in your treatment plan.

What are the risks and side effects?

Generally speaking, this procedure is safe. However, with any procedure there are risks, side effects, and possibility of complications. Very rarely, if the injection is done in the chest wall or low in the neck, the needle may puncture the lung. This would cause chest pain and difficulty breathing. Also, the needle may hit a nerve that could cause pain.

Trigger point injections do have some associated side effects including: the injection area may be sore for several days, bruising in the area of injection, muscle stiffness due to muscle spasm. If this is a problem, you might try acetaminophen (such as Tylenol) or aspirin. Also, try applying a cold pack. If it doesn’t work, try warm, moist heat, and then gently stretch the muscle in the affected area to relieve muscle stiffness.

Who should not have this injection?

You sh0uld not have this injection if you are: thinking of becoming pregnant, or are currently pregnant or breastfeeding. If you have severe allergic reaction to local anesthetics. If you are taking blood thinning medicine like coumadin (Warfarin), clopidogrel (Plavix), aspirin/dipyridamole (Agrrenox), Enoxaparin (Lovenox), Fondaparinux (Arixtra) or heparin. You will need to stop taking them before the procedure. Discuss this with your doctor or cardiologist in order to weigh the risks and benefits of stopping these medicines. It is OK to take Tylenol for other pain like arthritis, pain from previous operations, abdominal pain and headaches.