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All about trigger point injections

What are trigger points?

Trigger points are very tender areas within muscles, muscle linings or tendon junctions. They feel like firm knots or bands and can irritate nerves in the area. When pressure is applied to a trigger point, the pain may be felt far from the site. Trigger points may occur due to excessive or repetitive physical activity, fatigue or trauma. Once they develop, they can recur with exertion or inactivity of the muscle, overstretching, exposure to cold or damp weather, or psychologically stressful situations.

What are trigger point injections?

Local anesthetic, often combined with an anti-inflammatory steroid, is injected directly into the muscle where the trigger point is located. These medicines reduce pain, relieve irritation of surrounding nerves and help break the cycle of pain. The injections may be augmented by massage using an ice spray to relax and stretch the muscle.

Most people describe the procedure as somewhat uncomfortable. A very fine needle is used and the area is numbed during the procedure. You will be fully awake during the injection; however, some physicians will offer sedation before the procedure, if needed.

How long will it take?

You can expect to be at the clinic for one to 1½ hours. When you arrive, the nurse will briefly review some information with you, provide you with a gown to change into, and attach monitors to check your heart rate, blood pressure and blood oxygen level. An intravenous catheter may also be placed in your vein so that sedation or other medications can be given. The procedure itself takes only five to 15 minutes and may involve one to five injections. You will then be taken to recovery for continued monitoring, while the nurse gives you some discharge instructions.

Are there any restrictions afterward?

You will not be permitted to drive yourself home, because the medicines used can cause drowsiness, dizziness, slow response and reduced coordination. Therefore, you must make arrangements for someone to take you home. Otherwise, you are free to eat, drink or move normally, though you should avoid excessive use of the affected muscle.

How effective are these injections?

Every person is different, but most people report pain relief and increased mobility after treatment. Often the doctor will recommend combining other treatments with these injections to improve pain relief and reduce the risk of recurrence. Application of cold or heat, massage, exercise, relaxation training, biofeedback or TENS therapy may be suggested or prescribed.

For more information about trigger point injections, call Baptist Health Louisville's Center for Pain Management at (502) 896-7246.