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Encyclopedia of Health and Medicine

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trigger-point injection 385<br />

be painful, there is no risk for electrical shock<br />

from TENS. It is important to keep the electrode<br />

pads covered with gel. The main SIDE EFFECT with<br />

TENS is irritation to the skin from the adhesive<br />

that holds the electrodes in place or from using<br />

the electrodes without adequate gel. People who<br />

have an implanted PACEMAKER or IMPLANTABLE CAR-<br />

DIOVERTER DEFIBRILLATORS (ICD) cannot use TENS<br />

because the electrical current <strong>of</strong> the TENS interferes<br />

with the pacing signals.<br />

See ACUPUNCTURE; DERMATOME; MALDYNIA; NERVE;<br />

NEURON; NOCICEPTOR; TRIGGER-POINT INJECTION.<br />

trigger-point injection An injection <strong>of</strong> local<br />

anesthetic into an area <strong>of</strong> MUSCLE that has tightened<br />

into a knot that constricts or pressures a<br />

NERVE, causing severe PAIN. Trigger points are<br />

highly sensitive to touch or other stimuli <strong>and</strong> may<br />

form after musculoskeletal injuries <strong>and</strong> in CHRONIC<br />

PAIN conditions such as my<strong>of</strong>ascial pain syndrome<br />

<strong>and</strong> FIBROMYALGIA.<br />

Typically a pain specialist, <strong>of</strong>ten an orthopedic<br />

surgeon (specialist in musculoskeletal conditions)<br />

or a neurologist (specialist in conditions that affect<br />

the NERVOUS SYSTEM), administers the trigger-point<br />

injection. Depending on the cause <strong>of</strong> the damage,<br />

the injection may combine a local anesthetic with<br />

a corticosteroid medication to directly target<br />

INFLAMMATION in the area. The injection is an <strong>of</strong>fice<br />

procedure that causes brief discomfort from the<br />

insertion <strong>of</strong> the needle. Complete relief from pain<br />

immediately follows as the anesthetic numbs the<br />

nerves. After the numbness wears <strong>of</strong>f pain relief<br />

<strong>of</strong>ten lasts several months <strong>and</strong> for some people is<br />

permanent.<br />

The main risks <strong>of</strong> trigger-point injection are discomfort<br />

at the time <strong>of</strong> injection <strong>and</strong> bruising at the<br />

site that may cause superficial (surface) tenderness<br />

for several days. Ice to the site lessens the risk for<br />

bruising <strong>and</strong> relieves its discomfort. Other specific<br />

risks depend on the injection site.<br />

See also ANESTHESIA; CORTICOSTEROID MEDICATIONS.

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