Trigger Point Injections Can Cause Adverse Reactions

Trigger point injections are commonly used to relieve pain in individuals with fibromyalgia and myofascial pain. These soft tissue injections are gaining popularity among patients for the almost instant pain relief which results from the injection of a local anesthetic. Trigger point injections are gaining popularity among health care practitioners as well due to the fact that they are quick and easy to perform, often provide considerable pain relief to patients, and are considered a reimbursable procedure by most insurance companies.

In light of the increasing popularity of trigger point injections, health care practitioners and patients should keep in mind that there are potential adverse reactions to trigger point injections. Additionally, there are some medical conditions in which trigger point injections are contraindicated, or are done only with extreme caution.

Some of the conditions that are considered a contraindication to the use of trigger point injections include:

-Infection at the site the needle would pierce the skin to administer the lidococaine or bupivicaine. This may introduce infection deeper into the tissue.

-Current use of an anticoagulant may make individuals receiving trigger point injections prone to bleeding

-Individuals with a hemorrhagic (bleeding) disorder should also not receive trigger point injections with out due caution.

-Severe psychiatric disturbance is a general contraindication to trigger point injections, though physicians will obviously have to use proper judgement.

-Those with many widespread trigger points present in the setting of an untreated endocrine imbalance should not get trigger point injections. The endocrine imbalance may include hypothyroidism, estrogen deficiency, hypoparathyroidism, hyperparathyroidism, pituitary disorders and Cushing's disease.

An individual who is a good candidate for trigger point injections is still at risk for adverse reactions to either the injected medication or the action of receiving the injection itself. Some individuals have a vasovagal response to needle injections and may feel lightheaded or actually faint.

In addition, some people who receive trigger point injections can react to the local anesthetic. There should be almost immediate pain relief after the lidocaine or bupivicaine is administered. However, symptoms such as slurring of speech, drowsiness, numbness of one or more extremities indicates an adverse reaction to trigger point injections.

After the very first trigger point injection, a patient should be observed for signs of an adverse reaction as discussed above. Some unfortunate individuals may even experience seizure activity following a trigger point injection.

If an adverse reaction occurs, or the individual is aware of an allergy to local anesthetic prior to injection of the trigger points, there are alternative injections. Sterile saline appears to work as well as lidocaine in several studies. Additionally, some individuals seem to respond particularly well to the injection of a steroid into the trigger point.

Trigger points are often quite effective in relieving the pain associated with fibromyalgia, myofascial pain, and other pain disorders of the musculoskeletal system. However, trigger point injections are associated with contraindications and adverse reactions that must be taken into consideration prior to the first injection.