Trigger point injection
A trigger point injection directs liquid anesthetic directly to the “trigger point”.The liquid anesthetic (lidocaine) is administered for immediate pain relief and diagnostic evaluation. Steroid is also administered when necessary. This injection procedure is used for focal soft issue pain typically low neck, upper back or low back pain related to muscle spasm.
Pre-procedure instructions
An NMH nurse will contact you prior to your procedure date to discuss the following:- Confirm your appointment date and time
- Inform you of your arrival time and parking instructions
- Prior imaging: please bring any prior spine imaging including film, CD and reports. Prior imaging includes CT, MRI and X-Ray.
- Current medications, especially blood thinners
- Allergies
- Your questions
Hospital arrival
Arrive on-time or better yet, early. If you are driving from a distance or inclement weather is forecasted, please leave extra time for your trip. When you arrive, come to the 4th floor of the Feinberg Pavilion and “check-in” at the desk. You are now in the “waiting room”. Shortly after check-in, a support staff will take you to the “holding room”. In the holding room, you will meet a holding room nurse who will perform a pre-procedure check-list and help you change into a hospital gown. A physician will then meet with you to discuss your procedure, answer your questions and obtain informed consent.
Team and Quality
Quality, safety and precision guide our practice. Each procedure is staffed by a nurse, a radiology technologist and a staff physician. The nurse is responsible for monitoring your vital signs, providing procedural medications, making you comfortable and supporting the physician. The procedure technologist is responsible for positioning you on the procedure table, obtaining the appropriate instruments, documenting the procedure with imaging and assisting the physician. The staff physician is responsible for knowing your history, performing the procedure and providing you with follow-up instructions.
Procedure
You are brought to the procedure room by the nurse, transferred to the procedure table and sterilely prepped and draped. Before proceeding, a pre-procedure “Time-out” to confirm your identity, the planned procedure and any relevant details such as allergies is performed. This is strictly for your safety. Using sterile technique, universal precautions and local anesthetic, a thin needle is advanced through the skin into the target soft tissues. The target soft tissues are precisely localized by palpation combined with image guidance. When the location is confirmed the medication administered. The needle is removed, skin cleaned and a standard band-aid applied.
Post-procedure
You are monitored in the holding room for 15 minutes: the vast majority of patients are discharged in 15 minutes. You may have immediate relief from the numbing medication. When this wears off, your symptoms may return to baseline. You will be monitored and discharged when safe.
Follow-up
If steroids are administered, they will take effect in ~48 hours and can last from days to months. If your pain returns, another steroid injection is often helpful and can be directly scheduled through us. Depending upon your situation, you can have 3-6 injections per calendar year.
Potential side effects
Side effects are extremely uncommon. The vast majority of patients (>99%) do not experience side effects form facet injections.