Trigger point injections
What conditions do they treat?
Trigger points are commonly located in the neck, upper back and shoulder areas and are focal areas of muscle spasm. Trigger point injections can be used to target any muscle groups. Other sites include the lower back, buttocks and outer hip area. The injections administer medication directly into a specific trigger point and are used to treat several conditions including tension headache, myofascial pain syndrome and in some rare cases fibromyalgia. When used to relieve myofascial pain, the myofascial trigger point is typically found inside a taut band of skeletal muscle, or alternatively in the muscle fascia.
Where are the injections performed in the body?
Procedures can vary but typically involve locating the trigger point via manual palpation and then marking the site. After the injection site is cleaned, some local anaesthetic is used to make the injection less painful before the needle is inserted into the trigger point. A small needle in the back of your hand can be used to administer sedation or in case of an emergency. Ice packs or painkillers can be used to treat any post-procedural flare-ups which may cause pain due to local reactions in the one or two days following the injection.
Patients are then monitored in a recovery area before transfer to the ward and discharge home. Patients may experience a numb feeling for a few hours. Pain at the injection site may increase for four or more days. It is advisable to rest for 24 hours and resume stretches and exercises when the pain eases. This window of pain relief should be utilised for performance of strengthening exercises and rehabilitation physiotherapy.
Complications
There is a variable response to injection treatment. It is important to discuss both the benefits and risks of the procedure with your doctor before any agreement to undergo the procedure is reached. Trigger point injections are typically very safe. Although the chance of any complications is generally low, as with all surgical procedures, there is an element of risk involved including failure to get benefit or pain aggravation. Ice packs and painkillers can be used to treat these post-procedural flare-ups. Possible complications, as with all interventional procedures, include bleeding, bruising, infection and nerve injury. There may be an allergic reaction to the steroid or any of the medications.