Trigger Point Injections

Appasamy, Malathy; Lam, Christopher M; Alm, John; Chadwick, Andrea

doi:10.1016/j.pmr.2022.01.011

Cited by 22 publications

(11 citation statements)

References 103 publications

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“…Trigger points are hyperirritable points located within a taut band of skeletal muscle that can either be active, spontaneously inducing pain, or latent. These areas can cause local tenderness, referred pain, and autonomic changes when compressed (40). Trigger points are common and often related to poor body mechanics, postural abnormalities, and chronic strain from repetitive microtrauma seen especially with sedentary, office-based lifestyles (41).…”

Section: Physical Examinationmentioning

confidence: 99%

“…They may respond well to various techniques of myofascial release, including trigger point injections done with dry needling or injectate such as a local anesthetic. In combination with a physical therapy program, trigger point injections can provide long-term relief (40). Muscle relaxants have also been shown to help muscle spasm, but their exact mechanisms in FM are unknown (43).…”

Section: Physical Examinationmentioning

confidence: 99%

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Identifying and Managing Nociplastic Pain in Individuals With Rheumatic Diseases: A Narrative Review

Murphy

Minhas

Clauw

et al. 2023

Arthritis Care & Research

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Chronic pain is a burdensome and prevalent symptom in individuals with rheumatic disease. The International Association for the Study of Pain classifies pain into 3 descriptive categories: nociceptive, neuropathic, and nociplastic. These categories are intended to provide information about the mechanisms underlying the pain, which can then serve as targets for drug or non‐drug treatments. This review describes the 3 types of pain as they relate to patients seen by rheumatology health care providers. The focus is on identifying individuals with nociplastic pain, which can either occur in isolation as in fibromyalgia, or as a comorbidity in individuals with primary autoimmune conditions, such as rheumatoid arthritis and systemic lupus erythematosus. Practical information about how rheumatology health care providers can approach and manage chronic pain is also provided.

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Section: Physical Examinationmentioning

confidence: 99%

Section: Physical Examinationmentioning

confidence: 99%

Identifying and Managing Nociplastic Pain in Individuals With Rheumatic Diseases: A Narrative Review

Murphy

Minhas

Clauw

et al. 2023

Arthritis Care & Research

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“…The injections, at minimum, involve dry needling to help break the paintension cycle in the muscle. Use of ultrasound scan technology can be used for soft tissue imaging of trigger points to decrease complications from blind injection (Appasamy et al, 2022). Injections may include medications such as steroids or local anesthetics to calm the taut muscle and inactivate the trigger point.…”

Section: Trigger Point Injectionsmentioning

confidence: 99%

Physiatry for Treating Hip, Knee, and Back Pain

Mohammadi,

Sedlak

2024

Orthopaedic Nursing

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Physical Medicine and Rehabilitation (PM&R) is a rapidly expanding field. Physicians who practice PM&R are known as physiatrists and provide care primarily for patients who have disabilities or physical impairments affecting the musculoskeletal system, brain, and spinal cord. Physiatrists may work in an inpatient or outpatient setting, with outpatient physiatrists being an invaluable resource in treating patients experiencing pain. It is worthwhile to refer patients experiencing hip, knee, or back pain to a PM&R specialist because of their skill in making specific and accurate diagnoses, as well as providing a wide range of modalities to treat pain and augment function such as management of pain medications, osteopathic manipulative therapy, trigger point injections, intra-articular steroid injections, orthobiologic therapy, and interventional spinal procedures. Emphasis is on the use of the least invasive modality before employing more invasive treatments. The need for physiatrists to help individuals maximize function and enhance quality of life is increasing with the aging population, expanding workforce of older adults, and a growing population of people with a disability, especially since the COVID-19 pandemic.

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“…TPI should be performed as part of a multimodal treatment approach that incorporates muscle stretching, physical therapy, and/or other therapies. In patients with increased pain that is inhibiting their ability to fully participate in a prescribed therapy program, TPIs may help to reduce pain to the point that their tolerance of therapy and stretching is improved 20…”

Section: Treatment Optionsmentioning

confidence: 99%

“…In patients with increased pain that is inhibiting their ability to fully participate in a prescribed therapy program, TPIs may help to reduce pain to the point that their tolerance of therapy and stretching is improved. 20 Although TPIs are generally considered low risk, the primary care NP should be fully aware of possible contraindications and adverse reactions prior to performing this procedure. Absolute contraindications include cellulitis at the injection site or inaccessibility of the MTrP by needle.…”

Section: Tpismentioning

confidence: 99%

An overview of myofascial pain syndrome with a focus on trigger point injection

Bodine

2023

The Nurse Practitioner

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Myofascial pain syndrome (MPS) is a very common condition, with an estimated lifetime prevalence of 85% in the general population. MPS is commonly underdiagnosed or misdiagnosed due to the lack of standardized diagnostic criteria and the symptoms' overlap with those of other musculoskeletal pain conditions. The most notable and bothersome feature of MPS is the presence of myofascial trigger points (MTrPs), hypersensitive areas of muscle commonly characterized as knots, nodules, or bumps that cause strain and pain with and oftentimes without stimulation. A low-risk, low-cost procedure, trigger point injection (TPI) is the gold standard for MPS treatment, and NPs can perform the procedure in an outpatient practice setting. Through administration of TPIs and use of other treatment modalities, primary care NPs can significantly impact the quality of life for those patients affected by acute and chronic MPS. This article aims to educate primary care NPs on MPS diagnosis and provide an overview of treatment options, with a focus on TPI use and administration for MPS relief.

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Trigger Point Injections

Cited by 22 publications

References 103 publications

Identifying and Managing Nociplastic Pain in Individuals With Rheumatic Diseases: A Narrative Review

Identifying and Managing Nociplastic Pain in Individuals With Rheumatic Diseases: A Narrative Review

Physiatry for Treating Hip, Knee, and Back Pain

An overview of myofascial pain syndrome with a focus on trigger point injection

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