Trigger point injection

[organdonor]

Do you guys do them in clinic? Refer to pain management? lido/steroid or both? Were you taught in residency or did you do some CME type thing?

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[Bacchus]

I haven't. But, don't forget that you can use sterile water if you don't want to use localized anesthetics or steroids.

 

[styphon]

I was taught in residency how to do them. I use a combination of lido/steroid if there is no allergies/contraindications. I have done it with lido alone. I believe there is a *large* placebo effect with these - but its better than adding or increasing opiates. Having done a few hundred, I think my success rate for pain relief is around 66%

 

[deleted87716]

I do them. I learned to do them in residency. Usually xylocaine+CS.

 

[cabinbuilder]

Do you guys do them in clinic? Refer to pain management? lido/steroid or both? Were you taught in residency or did you do some CME type thing?

I do them all day every day. You can use steroid every 3 months. I do steroid + marcaine for initial. Do not refer that to pain management. It takes 10 seconds in the office. Just find the tender spot of the muscle (ususally the back) and put a needle in. Use the 5/8 in so you don't go too deep. Super easy, fast, and you can bill for them.

I learned them in residency. Started do them out in the wilds more and more because patient's like a "quick fix" and they go about their day.

 

[Doctor4Life1769]

They aren't hard.
Dry needling is as effective, but I also use combo lido and steroid.

 

[primadonna22274]

I do them too. Very very easy. I will say though that I've successfully avoided injecting some trigger points just by simple OMT--in the few seconds it takes me to find the trigger point I've successfully released it manually. Once in the ED I had to go get the supplies and when I came back to the room the patient said "hey, it's all better now, I think I'll skip the needle" 🙂

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[Bacchus]

I do them all day every day. You can use steroid every 3 months. I do steroid + marcaine for initial. Do not refer that to pain management. It takes 10 seconds in the office. Just find the tender spot of the muscle (ususally the back) and put a needle in. Use the 5/8 in so you don't go too deep. Super easy, fast, and you can bill for them.

I learned them in residency. Started do them out in the wilds more and more because patient's like a "quick fix" and they go about their day.

Remind me, without getting us in trouble by providing medical advice 😉, but is it a SQ or IM administration that's being done?

(If you get any beef for answering I'll take the flak 😛)

 

[VA Hopeful Dr]

Remind me, without getting us in trouble by providing medical advice 😉, but is it a SQ or IM administration that's being done?

(If you get any beef for answering I'll take the flak 😛)

Technically I think its IM but its not an exact science.

 

[cabinbuilder]

Remind me, without getting us in trouble by providing medical advice 😉, but is it a SQ or IM administration that's being done?

(If you get any beef for answering I'll take the flak 😛)

I think it's more IM since I target the muscle that is in spasm.

 

[primadonna22274]

Superficial IM 🙂

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[Bacchus]

Technically I think its IM but its not an exact science.

That's how I remember it from when I saw it done. I mean, as long as you aspirate and don't inject near any neurovascular bundles anyone could do it. 😉

 

[VA Hopeful Dr]

That's how I remember it from when I saw it done. I mean, as long as you aspirate and don't inject near any neurovascular bundles anyone could do it. 😉

That's pretty much the truth of it. Its fairly idiot proof and yet works quite well - I love it.

 

[Hamhock]

I do them too. Very very easy. I will say though that I've successfully avoided injecting some trigger points just by simple OMT--in the few seconds it takes me to find the trigger point I've successfully released it manually. Once in the ED I had to go get the supplies and when I came back to the room the patient said "hey, it's all better now, I think I'll skip the needle" 🙂

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Great satire.

HH

 

[Doctor4Life1769]

Remind me, without getting us in trouble by providing medical advice 😉, but is it a SQ or IM administration that's being done?

(If you get any beef for answering I'll take the flak 😛)

you're injecting into the muscle.

woops, I see it's been answered.

I need to relearn OMT.