What's a trigger point injection?
A trigger point injection (TPI) is an injection that is given directly into the trigger point for pain management. The injection may be an anesthetic such as lidocaine (Xylocaine) or bupivicaine (Marcaine), a mixture of anesthetics, or a corticosteroid (cortisone medication) alone or mixed with lidocaine. Sometimes, a needle alone is inserted into the trigger point, and no medication is injected. This may be helpful and is referred to as "dry needling." With the injection, the trigger point is made inactive and the pain is relieved.
How is the trigger point injection procedure performed?
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 protocol varies. The health-care professional performing the procedure locates the trigger point by manual palpation and marks the site. Ultrasound guidance may be necessary at times. 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. If the area is painful after the injection, ice, heat, acetaminophen (Tylenol), or over-the-counter nonsteroidal anti-inflammatory medications such as ibuprofen (Advil) or naproxen sodium may be used.
What are Knee Injections? How do they Work?
- First, your doctor will give you a shot of anesthetic to numb your knee.
- Next, your doctor may use a needle to draw out any extra fluid that's in your knee.
- After that, you'll get the pain-relieving injection, usually just below your kneecap. The shot shouldn't hurt, and the drug will work throughout the joint.
Different treatments have side effects that you should discuss with your doctor beforehand. The two most common types of knee injection for OA are corticosteroids and hyaluronic acid.
Injectable Medications for Knee Osteoarthritis
If you have knee osteoarthritis, doctors can offer a variety of treatments to relieve your symptoms. One option is to inject medication into your knee.
There are different types of injections, and they're an important part of treating knee osteoarthritis for many people. Injections can be especially helpful for people who haven’t gotten relief from NSAIDs like ibuprofen, or people who can’t take those drugs due to side effects.
Osteoarthritis (OA) is a common form of arthritis that often affects the knees. It develops when the cartilage -- the smooth covering that protects the bones in the joint -- breaks down. The surface of the bones becomes damaged, causing pain, swelling, stiffness, and disability.
Reduce Inflammation With Steroids
Corticosteroid injections are useful for treating flare-ups of OA pain and swelling with fluid buildup in the knee, Richmond says.
These injections help relieve symptoms by reducing inflammation in the joint. But they’re not a perfect solution in every case. If you're considering this treatment, keep this in mind:
They work quickly. These injections offer “very rapid” relief, usually within 24 to 48 hours.
The benefit is short-term. On average, the pain relief lasts from 6 to12 weeks, Richmond says. Often, that’s long enough to get you through a flare-up of osteoarthritis until your symptoms subside.
You shouldn’t use them frequently. A corticosteroid shot often works best the first time, Altman says. After that, they tend to give less relief.
In most cases, Richmond tells his patients they can use these shots two to three times a year. Using them too often may damage cells in the knee that make cartilage.
Treating knee pain in patients with osteoarthritis who have not received relief from other treatments. Euflexxa is a hyaluronic acid derivative. It works by increasing the effectiveness of the fluid within the knee joint to act as a lubricant and shock absorber