What is it?
A trigger point injection is an outpatient procedure used to relieve pain by treating areas of muscle that contain trigger points (contracted knots of muscle that form when the muscles do not relax). Often these knots can be felt under the skin.
When stressed through repetitive activity or an injury, muscles often form these trigger points, which can cause significant pain and tightness in the nerves around them. They can also cause a condition known as “referred pain,” which means that the pain is not felt in the knotted area, but rather another part of the body.
Trigger point injections can be used to treat many muscle groups and are especially helpful in reducing or eliminating pain in the arms, legs, lower back and neck. They are also used to treat syndromes and conditions such as tension headaches, fibromyalgia, myofascial pain syndrome (a type of chronic pain involving the tissue surrounding a muscle) and chronic pelvic pain syndrome and are often beneficial when other treatments have failed. Trigger point injections are considered one of the most effective pain treatments available.
Preparing for Trigger Point Injections
Avoid eating solid foods at least four hours before the procedure is scheduled. Clear liquids such as water, coffee, tea or soda are allowed up to two hours before the procedure (if the patient wishes to have mild sedation). Patients should inform their physician of any medications they are currently taking. Bathe or take a shower the morning of the procedure and wear comfortable, loose clothing.
Patients should arrange to have a family member or friend to take them home after the procedure (if they are being sedated). It may be helpful to keep in mind that although the injection may cause discomfort, it is only for a brief time, and the result should be significantly reduced or eliminated pain.
What Happens During Trigger Point Injections?
Prior to the injection, a physician will exert gentle pressure on the trigger point area to observe how the muscles react and evaluate the patient’s pain. Patients need to remain still during the injection since movement can make administering the injection difficult.
Once the painful area has been identified, a physician will sterilize the area and then insert a small needle containing anesthetic into the trigger point. The physician will use a topical agent on the skin that will cool the nerves so the patient will not feel the sharpness of the needle. The injection may also include saline or a steroid. If a patient has several trigger points, they may be injected in one visit.
The procedure itself only takes 5-10 minutes, but you may be observed for 30-60 minutes after the procedure.
What Happens After Trigger Point Injections?
Most often you can go home in about 30-60 minutes. Written instructions will be sent home with you. You will need someone to drive you home and care for you for the first few hours after the procedure.
The injection site may be sore for several days and may have some bruising. Icing the area or taking an over-the-counter pain reliever can alleviate any discomfort.
For a few hours after the procedure, patients should rest or limit their activity but then can resume regular activity unless a physician has told them otherwise. If there is increased pain or a patient begins to experience fever, chills, or bleeding at the site, or anything that seems unusual, contact a physician.
With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief. Several sites may be injected in one visit. If a patient has an allergy to a certain medication, a dry-needle technique (involving no medication) can be used.
What to expect the day of your procedure
You are expected to arrive at the surgery center at least one hour before your procedure is scheduled. Bring a responsible adult driver with you because you may be receiving medications that could impair your ability to drive. Unless you are certain you will not be receiving sedation, do not eat anything for 6 hours prior to your procedure; you may have modest amounts of clear liquids (liquids you can see through) up to 4 hours beforehand. Please take your regularly scheduled blood pressure and heart medications with a sip of water as you normally would. If you have diabetes, take half of your normal dosage and bring your insulin with you.
After you arrive, you will be asked to sign-in and complete any paperwork as needed. You will then be taken to the preoperative area. At this time, a nurse will ask you some medical questions and have you sign your consent forms. It is imperative that you, the patient, inform the assistant of any changes in your history and/or physical, such as recent flu or any health problems that might affect your procedure. Inform the staff of any allergies, especially to Betadine or Iodine.
You will be asked to change into a gown. An assistant will take your blood pressure, heart rate, temperature, and oxygen saturation.
The anesthesiologist, physician, or nurse will talk to you before your procedure. You will then be positioned and the injection site will be cleaned. The pain management physician will perform the procedure. Afterward, the cleaning solution will be washed off and bandages will be applied as needed.
You will be transported to the recovery room area where you will be monitored anywhere from 20 minutes to an hour. Lastly, your caregiver will be given discharge instructions for your care at home.