Trigger Point Injection

  • Medical Author:
    Catherine Burt Driver, MD

    Catherine Burt Driver, MD, is board certified in internal medicine and rheumatology by the American Board of Internal Medicine. Dr. Driver is a member of the American College of Rheumatology. She currently is in active practice in the field of rheumatology in Mission Viejo, Calif., where she is a partner in Mission Internal Medical Group.

  • Medical Editor: William C. Shiel Jr., MD, FACP, FACR
    William C. Shiel Jr., MD, FACP, FACR

    William C. Shiel Jr., MD, FACP, FACR

    Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.

Surprising Reasons You're in Pain Slideshow

When is a trigger point injection used?

Trigger point injection is used when a patient has a painful trigger point, especially when pain radiates from the trigger point to the surrounding area. Trigger point injections may be used as a treatment for conditions such as fibromyalgia and myofascial pain syndrome. However, the trigger points commonly recur with chronic pain syndromes.

What are complications and side effects of trigger point injections?

A potential complication from the trigger point injection procedure is post-injection pain. This is relatively uncommon, but it can occur. This pain usually resolves by itself after a few days. It is more common when no medication is injected into the trigger point (dry needling). Ice, heat, or over-the-counter medications such as acetaminophen, ibuprofen, or naproxen sodium may be useful for post-injection pain.

If a steroid medication is injected into the trigger point, shrinkage of the fat under the skin can occur, leaving a dent in the skin. This does not occur when only anesthetic is injected without any steroid medication. Other side effects are rare with trigger point injections but can occur anytime a needle punctures the skin, including infection and bleeding.

How frequently do trigger point injections need to be administered?

Optimally, a trigger point resolves after one injection. This may happen when a patient has one isolated trigger point, especially if the cause of the trigger point has been removed (such as a trigger point caused by a repetitive minor trauma or movement that will no longer be performed). Trigger points caused by chronic conditions such as fibromyalgia and myofascial pain syndrome tend to recur due the underlying problem. In these cases, trigger point injections may be administered on a regular or as needed basis. The frequency of trigger point injections depends on the medication being injected. If only lidocaine or a mixture of anesthetics is injected, then the injections can be administered as ongoing therapy as frequently as monthly. If a steroid medication is injected, TPIs should be administered much less frequently, at the discretion of the treating health-care professional, because of the risk of tissue damage or shrinkage from the steroid medication.

Medically reviewed by Aimee V. HachigianGould, MD; American Board of Orthopaedic Surgery

REFERENCE:

Alvarez, David J., et al. "Trigger Points: Diagnosis and Management." American Family Physician 65.4 Feb. 15, 2002:653-661.

Medically Reviewed by a Doctor on 2/18/2015
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