After careful analysis to determine the underlying cause of your pain, your pain management team will develop a personalized treatment plan for you, which may include trigger point injections (TPI). Trigger points are tight knots of muscle that form when a muscle fails to relax. TPIs are used to relax the muscle and relieve pain. Relaxing the muscle can also make movement easier. You may then be able to exercise to strengthen the muscle and help it heal.

During the exam—what to expect

• Injections are administered by an anesthesiologist and takes approximately 30 minutes
• A small needle is inserted into the trigger point using X-ray-guidance (fluoroscopy), and a local anesthetic (numbing medication) with or without a steroid (anti-inflammatory) is injected
• Injection of medication numbs the trigger point and thus alleviates pain
• Sustained relief is usually achieved with a brief course of treatment. The injection may cause a twitch or pain that lasts a few seconds to a few minutes

After the exam—what to expect

• Numbness from the anesthetic may last about an hour and a bruise may form at the injection site
• Pain can be relieved by alternately applying moist heat and ice for a day or two

In most cases, stretching exercises and physical therapy are performed following TPI

Possible side effects

• Steroid medications may cause facial flushing, occasional low-grade fevers, hiccups, insomnia, headaches, water retention, increased appetite, increased heart rate, and abdominal cramping or bloating.
• These side effects are bothersome in only about 5 percent of patients and commonly disappear within one to three days after the injection.