Disease: Trigger Point Injection

    Trigger point injection (TPI) facts

    • Trigger points are focal areas of muscle spasm, often located in the upper back and shoulder areas.
    • A trigger point injection involves the injection of medication directly into the trigger point.
    • Trigger point injections can be used to treat a number of conditions including fibromyalgia, tension headache, and myofascial pain syndrome.

    What is a trigger point?

    Trigger points are focal areas of spasm and inflammation in skeletal muscle. The rhomboid and trapezius back muscles, located in the upper back and shoulder areas, are a common site of trigger points. In addition to the upper spine, trigger points can also occur in the low back or less commonly in the extremities.

    Often there is a palpable nodule in the muscle where the trigger point is located. The area is tender, and frequently when pushed, pain radiates from the trigger point itself to an area around the trigger point. Trigger points commonly accompany chronic musculoskeletal disorders such as fibromyalgia, myofascial pain syndrome, neck pain, and low back pain. They may also occur with tension headache and temporomandibular pain. Acute trauma or repetitive minor injury can lead to the development of trigger points.

    What's a trigger point injection?

    A trigger point injection (TPI) is an injection that is given directly into the trigger point for pain management. The injection may be an anesthetic such as lidocaine (Xylocaine) or bupivicaine (Marcaine), a mixture of anesthetics, or a corticosteroid (cortisone medication) alone or mixed with lidocaine. Sometimes, a needle alone is inserted into the trigger point, and no medication is injected. This may be helpful and is referred to as "dry needling." With the injection, the trigger point is made inactive and the pain is relieved.

    How is the trigger point injection procedure performed?

    The trigger point injection is performed in the health-care professional's office, usually with the patient either lying on the exam table on the stomach or sitting on the exam table. The exact protocol varies. The health-care professional performing the procedure locates the trigger point by manual palpation and marks the site. Ultrasound guidance is not generally necessary. The injection site is then cleaned. Alcohol or another skin cleanser such as betadine is commonly used to clean the injection site. 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. 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.

    What's a trigger point injection?

    A trigger point injection (TPI) is an injection that is given directly into the trigger point for pain management. The injection may be an anesthetic such as lidocaine (Xylocaine) or bupivicaine (Marcaine), a mixture of anesthetics, or a corticosteroid (cortisone medication) alone or mixed with lidocaine. Sometimes, a needle alone is inserted into the trigger point, and no medication is injected. This may be helpful and is referred to as "dry needling." With the injection, the trigger point is made inactive and the pain is relieved.

    How is the trigger point injection procedure performed?

    The trigger point injection is performed in the health-care professional's office, usually with the patient either lying on the exam table on the stomach or sitting on the exam table. The exact protocol varies. The health-care professional performing the procedure locates the trigger point by manual palpation and marks the site. Ultrasound guidance is not generally necessary. The injection site is then cleaned. Alcohol or another skin cleanser such as betadine is commonly used to clean the injection site. 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. 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.

    Source: http://www.rxlist.com

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