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A trigger point injection is an outpatient procedure designed to reduce or relieve the back pain caused by trigger points.
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.
The trigger point injection is performed in the health-care professional’s office, usually with the patient either lying on the exam table on the stomach or sitting on the exam table. The exact technique varies. The health-care professional performing the procedure locates the trigger point by manual palpation and marks the site. Ultrasound guidance is not generally necessary. The injection site is then cleaned. Alcohol or another skin cleanser such as betadine is commonly used to clean the injection site. Frequently, a numbing spray such as ethyl chloride is used to anesthetize the skin and make the actual injection less painful. The needle is then inserted into the trigger point and the medication is injected. After the injection, a simple adhesive bandage may be applied.
The local anesthetic will numb the area for 1 to 3 hours. The corticosteroids remain in the tissue in active form for about one month. The major benefit of trigger point injections is to allow the patient to more effectively participate in a rehabilitative program.