Ultrasound-guided trigger point injections

Abstract

Myofascial trigger point injections are frequently indicated for myofascial pain syndrome and are performed as blind procedures. Although these injections are usually safe and effective, complications resulting in pneumothorax, epidural abscess, skeletal muscle toxicity, and intrathecal injection been reported. Avoiding the risk of radiation, ultrasonography provides real-time visualization of soft tissue, bone, cartilage, and foreign body, and may be used to guide injections. The clinical manifestation of myofascial pain syndrome and trigger points will be presented. A review of the etiology and identification of trigger point will be introduced. This paper presents the technique of ultrasound (US)-guided trigger point injections. It will also discuss the advantages of US guidance over the blind technique, including minimizing risks. The technical challenges and their solutions for needle visualization and guidance will be presented. © 2009 Elsevier Inc. All rights reserved.