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Review
. 2022 May;33(2):307-333.
doi: 10.1016/j.pmr.2022.01.011.

Trigger Point Injections

Malathy Appasamy  1 , Christopher Lam  2 , John Alm  3 , Andrea L Chadwick  4
Affiliations
Review

Trigger Point Injections

Malathy Appasamy et al. Phys Med Rehabil Clin N Am. 2022 May.

Abstract

Myofascial pain and myofascial pain syndromes are among some of the most common acute and chronic pain conditions. Many interventional procedures can be performed in both an acute and chronic pain setting to address myofascial pain syndromes. Trigger point injections can be performed with or without imaging guidance such as fluoroscopy and ultrasound; however, the use of imaging in years past has been recommended to improve patient outcome and safety. Injections can be performed using no injectate (dry needling), or can involve the administration of local anesthetics, botulinum toxin, or corticosteroids.

Keywords: Botulinum toxin; Corticosteroid; Local anesthetic; Myofascial pain; Piriformis syndrome; Trigger point injection.

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Figures

Fig. 1.
Fig. 1.
Schematic of the anatomy of a taut band and trigger point.
Fig. 2.
Fig. 2.
Fluoroscopic-guided piriformis muscle injection.
Fig. 3.
Fig. 3.
(A) Longitudinal US view of the piriformis during needle placement using a medial-to-lateral approach parallel to the long axis of the transducer. The proximal end of the needle has been digitally enhanced to highlight the needle trajectory. (B) Postinjection tenogram at the level of the greater sciatic foramen. Anechoic injectate (FLUID) within the piriformis tendon sheath lies superficial and deep to the hyperechoic tendon. RT PIR LG, right side, piriformis, longitudinal view; TIP, needle tip. (Reproduced with permission from Archives of Physical Medicine and Rehabilitation, Authors Jay Smith, Mark-Friedrich Hurdle, Adam J. Locketz, Steven J. Wisniewski. December 2006. Copyright © 2006 American Congress of Rehabilitation Medicine and the American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved. (PERMISSIONS HAVE BEEN OBTAINED BY ALC).)
See this image and copyright information in PMC

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