Trigger point injection (TPI) facts
What is a trigger point?
A trigger point describes a taut band of skeletal muscle located within a larger muscle group. Trigger points are tender to the touch and can refer pain to distant parts of the body. Patients may have regional, persistent pain resulting in a decreased range of motion in the affected area muscles.
Often there is a palpable nodule in the muscle where the trigger point is located. The area is tender, and frequently when pushed, pain travels from the trigger point itself to an area distant from the trigger point. Trigger points commonly accompany chronic musculoskeletal disorders such as fibromyalgia, myofascial pain syndrome, neck pain, and low back pain. They cause migraine, tension headaches and temporomandibular pain. Acute trauma or repetitive minor injury can lead to the development of trigger points.
Trigger Point Injections for Pain Management
Peripheral Nerve Pain
Peripheral nerve pain, or neuropathy, can be debilitating. It can respond well to simple treatments such a trigger-point-injections accompanied with anesthetic medicines, cortisone, stretching and PiezoWave II massage. Examples of peripheral nerve pain include scalene contractions, SCM contractions, intercostal neuralgia, ilioinguinal neuroma, hypogastric neuroma, lateral femoral cutaneous nerve entrapment, interdigital neuroma, and related nerve entrapments.
What is a trigger point injection? What medications may be in a trigger point injection?
A trigger point injection (TPI) is an injection that is given directly into the trigger point for pain relieve and muscle reactivation. The injection may be an anesthetic such as lidocaine (Xylocaine) or bupivacaine (Marcaine), a mixture of anesthetics, and/or a corticosteroid (cortisone medication) alone or mixed with lidocaine. With the injection, the trigger point is made inactive, the pain is relieved, and strength returns to the muscle.
What types of doctors administer trigger point injections?
Trigger point injections are frequently administered physical medicine and rehabilitation doctors. Some internists, family practice doctors, generalists, and neurologists also perform trigger point injections.
How do health care providers perform trigger point injections? What technique to physicians use to administer a trigger point injection?
The trigger point injection is performed in Indy Myopain Relief Clinic, usually with the patient either lying on the exam table on the stomach or sitting on the exam table. The exact technique varies. The Myofascial Trigger Point Therapist locates the trigger point by manual palpation combined with Piezowave II and marks the site. Ultrasound guidance is not generally necessary. Our physicians then clean the injection sites with alcohol or another skin cleanser such as betadine. Frequently, a numbing spray such as ethyl chloride is used to anesthetize the skin and make the actual injection less painful. The needle is then inserted into the trigger point and the medication is injected. After the injection, a simple adhesive bandage may be applied. The muscle is gently massaged, stretched and PiezoWave II is used to assure medication reaches the targeted are and the proper results are obtained. If the area is painful after the injection, ice, heat, acetaminophen (Tylenol), or over-the-counter nonsteroidal anti-inflammatory medications such as ibuprofen (Advil) or naproxen sodium may be used.