Trigger point injection (TPI) for pain management

Trigger point injection (TPI) may be a treatment option to manage pain in some people. TPI is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.

What happens during trigger point injection?

In the TPI procedure, a doctor inserts a small needle into the patient's trigger point. The injection contains a local anaesthetic that sometimes includes a corticosteroid. With the injection, the trigger point is made inactive and the pain is alleviated. Usually, a brief course of treatment will result in sustained relief. Injections can be given as an outpatient visit or in a GP’s surgery and usually take just a few minutes. Several sites may be injected in one visit. If a patient has an allergy to a certain medication, a dry-needle technique (involving no medications) can be used.

The procedure may be done with X-ray guidance, so make sure you tell the doctors or nurses if you may be pregnant beforehand.

When is trigger point injection used?

TPI is used to treat many muscle groups, especially those in the arms, legs, lower back, and neck. In addition, TPI can be used to treat fibromyalgia and tension headaches. TPI also is used to alleviate myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatments. However, the effectiveness of TPI for treating myofascial pain is still being studied.