Trigger Point Injection
Trigger points are focal areas of spasm and inflammation in skeletal muscle. The rhomboid and trapezius back muscles, located in the upper back and behind the shoulder areas, are a common site of trigger points. Trigger points in these areas can cause neck pain, shoulder pain, and headache. In addition to the upper spine, trigger points can also occur in the low back or less commonly in the extremities.
Trigger Point Injections involve the insertion of a hypodermic needle into trigger points and fascia (the membrane that envelops muscles). Trigger Point Injections have been proven to be an effective method of releasing the tension to reduce pain as well as nourish the muscles and tendons in the surrounding area.
The solutions injected include
• 0.9% saline, which has the same concentration as your blood and helps the muscle contract and relax
• Procaine, a quick acting anesthetic which will interrupt the pain cycle
• B12, methocobalamine, added to help nourish the nervous tissue
Some solutions may also include Traumeel or Zeel, both homeopathic remedies for trauma and pain.
Trigger points should not be injected in the presence of systemic or local infection. Injection of patients with bleeding disorders or patients on anticoagulation must be done with proper medical evaluation and control. Although bleeding may be increased in these patients, the risk of harmful bleeding remains very low.
Avoid injections in the pregnant patient or patients who feel or appear to be ill. Use precautions in patients who are at high risk for infection, including debilitated patients, patients with diabetes mellitus, or patients on steroids.
Other contraindications include allergy to anesthetic agents, acute muscle trauma, and extreme fear of needles.