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 within a muscle that, when pressed, causes your typical pain. 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. Trigger point injections may need to be repeated, especially if you are unable to perform your exercises. Again, exercise is the key to both eliminating and preventing trigger points. Please note: This procedure cannot be performed if you have an active infection, flu, fever, extremely high blood pressure, or if you are on blood thinners other than aspirin. For your safety, please inform us if any of these conditions exists.
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, as well. It is possible to get some numbness or weakness beyond the muscle that is injected if the medication spreads to a nerve. If this happens, the numbness or weakness can last for a few hours. If you get weakness that interferes with your ability to walk, you must remain in the Pain Management Center until this resolves. You may have increased pain for a few days after the local anesthetic wears off. It usually takes the steroid two or three days to take effect. If a steroid is used, diabetics may have a short-term elevation of blood sugars. People prone to fluid retention may have increased fluid retention for one or two weeks.
After you sign a consent form and your vital signs are checked, the procedure will be done, usually in the sitting position. Using a marking pen, the doctor will identify the area(s) to be injected. The skin is then cleansed with iodine or alcohol. A small needle is advanced through the skin into the muscle until the tight band is felt and/or until your pain in reproduced. The medication is then injected, and the needle is removed. This process will be repeated in each trigger point. The doctor may massage the area(s) to help the medicine spread throughout the muscle. Your skin will be cleansed and a Band-Aid(s) will be applied, if necessary. The Band-Aid(s) may be removed the following day. Your pain may improve immediately after the injection, due to 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.
Your vital signs will be taken, and you will be discharged within 5 to 15 minutes. If you experience local tenderness from the needle(s), ice may help relieve the discomfort. You can also resume taking your normal pain medications, if necessary. You may or may not need a ride home, depending on the number of areas to be injected as well as the location of the injections. This should be discussed with your doctor prior to setting up an appointment for trigger point injections. Having someone massage the injected area to help break up the spasm is helpful. Gentle stretching exercises of the involved area are also highly recommended.
You are not allowed to drive for the remainder of the day, unless your doctor has lifted this restriction based upon the amount of medicine that was injected and the location of the injections. No heat is to be used on the injected area for the remainder of the day.
You should call us immediately at 781-744-5090 if you experience either of the following: