Trigger Point Injections

What are trigger points?

Trigger points are knots in a tight band of muscle. They can occur in any muscle but in patients with headaches or neck pain the most common muscle affected is the trapezius (a large muscle that covers the upper back and neck).

Why do they occur?

There are many potential causes for trigger points. Some of the most common include trauma or injury, heavy or repetitive lifting or use of the upper body, and stress.

What symptoms do they cause?

Some of the most common symptoms caused by trigger points include headaches, pain, tension, tightness, muscle spasm or a burning sensation.

What are trigger point injections?

Trigger point injections are a special technique used to release the trigger point or knot. It involves injecting a solution of lidocaine (a local anesthetic) and depo-medrol (a steroid) into the muscle using a small, thin needle. The lidocaine is used to help numb the area and the depo-medrol is used to help reduce the inflammation.

How many injections are needed?

The number of injections needed depends on the size of the trigger point and how the body responds to each injection. If the trigger point is small, 90-95% of people will only need one injection to release the knot. If the trigger point is large, several injections over a series of weeks may be needed.

Are there any restrictions after the injections?

For 3-4 days after the injections any heavy lifting or strenuous physical exertion should be avoided. After this point, any other therapeutic modalities such as physical therapy, massage therapy, chiropractic, etc. may be resumed.

Are there any activities that should be done after the injections?

There are a series of stretching and range of motion exercises that you will be given by your provider. It is also helpful to apply heat to the muscle that was injected. Ice should not be used for at least 4 days after the injections.

Who should not have trigger point injections?

Please inform your provider if you have a history of bleeding or blood clotting disorders, take aspirin or blood thinners daily (Coumadin, Heparin, Lovenox, Plavix, Aggrenox, Ticlid), have an allergy to local anesthetics (Lidocaine, Novacaine) or steroids, have a cold or infection, have been injured recently, or are pregnant.