FAQ’s on Trigger Point Injections (TPI) in Las Vegas

A trigger point injection (TPI) is done in the office setting. These injections effectively treat pain associated with fibromyalgia and myofascial pain syndrome.

What are trigger points?

Localized areas of pain on the body are called trigger points. These areas are associated with muscle spasm and inflammation. Trigger points can occur on the back, neck, buttocks, and shoulders. Two common muscles that are affected are the trapezius of the shoulder region and the rhomboid of the upper back.

What are the types of trigger points?

Trigger points can be latent or active. Latent trigger points do not cause pain during rest, but will hurt with movement. These areas can cause decreased range of motion of the affected body muscle. Active trigger points are painful during rest, and when palpated, produce pain. The pain may spread (radiate) to other body parts.

How are trigger points diagnosed?

The doctor will take a detailed medical history and ask you questions about your pain. During the physical examination, the doctor will notice a lump or “knot” where the trigger point is located. When pressure is applied, the trigger points will produce referred or localized pain.

What conditions can be treated using trigger point injections?

Trigger point injections will treat:

  • Neck pain – Related to whiplash, degenerative disc disease, spinal arthritis, and spinal stenosis.
  • Low back pain – Related to herniated discs, facet joint syndrome, degenerative disc disease, and spinal stenosis.
  • Fibromyalgia – A disorder characterized by muscle pain that is widespread, and involving multiple trigger points. Patients with this disorder also have headaches, depression, and anxiety.
  • Headaches – The most common type of head pain is tension headache. The pain of this headache begins in the back of the neck, and moves up the head. Patients often report a band-like sensation around the head.
  • Myofascial pain syndrome – This is a chronic condition involving tender muscle areas, deep aching pain, and trouble sleeping.
  • Temporomandibular joint disorder – With this condition, the jaw joint develops arthritis, and is easily injured. The muscles on the side of the face spasm and contract, causing pain.

What medication is used in this injection?

A local anesthetic is often used, such as bupivicaine or lidocaine. Depending on the severity of the condition, a corticosteroid may be added to the anesthetic, such as dexamethasone or triamcinolone. Botox (botulinum toxin A) has been proven effective for relieving many trigger points and myofascial pain syndromes.

How is the trigger point injection given?

The trigger points are first identified and marked by the doctor. The doctor usually performs multiple trigger point injections during one session. First, the patient is positioned sitting or lying, depending on the location of the trigger points. Then, the skin is cleaned with an antiseptic solution, and a topical anesthetic may be applied to the injection sites. After the areas are injected, a small Band-Aid is applied.

Do trigger point injections work?

In one recent clinical study, the success rate for trigger point injections was noted at 100%. Of the study participants, almost 60% reported complete symptom relief.

What side effects are associated with the trigger point injection procedure?

The injection sites are tender for 1-2 days following the TPIs. We recommend using an ice pack for 20-minute intervals a few times each day, along with taking a mild anti-inflammatory pain reliever. Side effects depend on the medication used and include:

  • Botox – Pain at the injection site, muscle paralysis, and soreness.
  • Lidocaine – Itching, prolonged numbing, and rash.
  • Corticosteroid – Weight gain, mood swings, and irritability.

Resources

Cheng J, Abdi S. Complications of joint, tendon, and muscle injections. Tech Reg Anesth Pain Manag. 2007;11(3):141-147.

Karadas O, Gui HL, Inan LE. Lidocaine injection of pericranial myofascial trigger point in the treatment of frequent episodic tension-type headache. The Journal of Headache and Pain. 2013;14:44.

Saeidian SR, Pipelzadeh MR, Rasras S, Zeinali M. Effect of trigger point injection on lumbosacral radiculopathy source. Anesthesiology and Pain Medicine. 2014;4(4):e15500.

Wong CSM, Wong SHS. A new look at trigger point injections. Anesthesiology Research and Practice. 2012;article ID 492452: 5 pages.