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Pain Management
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Trigger point injections (TPI) are used to treat extremely painful areas of a muscle. Normal muscle contracts and relaxes when it is active. A trigger point is a knot or tight, ropy band of muscle that forms when muscle fails to relax. The knot often can be felt under the skin and may twitch involuntarily when touched. It usually causes tension and pain that can be acute or chronic.
The trigger point can trap or irritate surrounding nerves and cause referred pain to another part of the body. Scar tissue, loss of range of motion, and weakness may develop over time. TPI treatment is used to alleviate myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatment. Many muscle groups, especially those in the arms, legs, neck and lower back, are treated by this method. TPI also can be used to treat Fibromyalgia and tension headaches.
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Procedure Overview
The procedure itself can be done in an office setting.
The injections are limited to what is called "soft tissue" of the body.
They are not given into blood vessels, nerves, joints or the spinal canal.
The patient may be sitting or lying down in order to be comfortable.
This allows the physician to localize areas of maximum tenderness.
These areas are cleansed with a stile solution.
The injection is then performed using local anesthetic and sometimes an anti-inflammatory steroid.
You may experience some transient burning as the local anesthetic starts to take effect before it numbs the area. Injection of this medication inactivates the trigger point and thus alleviates pain. Sustained relief usually is achieved with a brief course of treatment. Several sites may be injected in one visit. Trigger Point Therapy includes injections containing Lidocaine (short acting numbing agent), Marcaine (long acting numbing agent) and Depo Medrol (mild steroid/anti-inflammatory). The injection effects last from 1-5 days and each subsequent injection can decrease pain and inflammation.
The patient will not be asleep for this procedure; however, the patient will receive enough medication for comfort. Normally, a trigger point injection takes no more than 15 minutes. The Session could take longer if the patient is having more than one injection. It is very important to be aware if the patient has had an allergic reaction to trigger point injections in the past.
After the procedure
Icing for 20 to 30 minutes several times later on the day of the injection is recommended, along with easy stretching exercise. The patient may return immediately to work or regular activities after the injection. The patient may drive, although some people feel less nervous if they know they have someone along to drive them home. The patient should continue any chiropractic treatments or physical therapy sessions already scheduled. The patient may be sore for the first 24 to 48 hours. If any unusual redness or swelling or warmth occurs at the injection site, the patient should notify the physician who performed the trigger point injection. The patient may continue taking all of the regular medications
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