Musculoskeletal pain is a common complaint that many primary care providers and pain professionals regularly diagnose and treat. To provide safe and effective results for patients, it is important to take a multimodal approach to treating pain. Trigger Point Injections (TPI) can be an effective primary or complementary therapy for reducing pain in the musculoskeletal system. Trigger points are knots that form in the muscle fibers after acute trauma or from repetitive microtrauma, causing tension in the muscle fibers.
These knots can cause pain in the neck, shoulders, arms, legs, and lower back. Trigger point injections involve injecting an anesthetic and steroid medication directly into the trigger points to relax the muscles and relieve pain. The procedure begins with marking each trigger point with a skin marker or with the tip of a pen retracted as a guide. The doctor then inserts the needle connected to the 5 or 10 ml syringe at an angle of 30 degrees at the activation point and rhythmically taps the area by inserting and retracting the needle repeatedly without completely removing it from the muscle.
After treatment with Trigger Point Injection, patients can use the treated muscle, but are asked to refrain from strenuous activities for a few days. If the procedure was effective, the injections may need to be repeated over several sessions, one to two weeks apart, until the trigger points are deactivated and the pain goes away or is no longer severe. Common side effects that occur after an injection at the trigger point include numbness or pain at the site of the injection. Taking steps such as reducing stress levels, improving posture, and participating in an exercise program can often ease pain in trigger points. Trigger point injections can be a valuable adjunct to treating chronic pain conditions affecting the musculoskeletal system.
Communication with the patient throughout the procedure is essential to ensure that the treatment addresses an active trigger point.