Myofascial trigger points

As described by Travell and Rinzler 7 a trigger point is characterised by:

• circumscribed local tenderness

• localised twitching with stimulation of juxtaposed muscle

• pain referred elsewhere when subjected to pressure

Trigger spots also tend to correspond to the acupuncture points for pain relief. Treatment

Local injection is relatively easy and may give excellent results. Identify the maximal point of pain and inject 5-8 mL of local anaesthetic, e.g. lignocaine/lidocaine 1% into the painful point (Fig 34.9). Postinjection massage or exercises should be performed. Don't: use large volumes of LA; use corticosteroids; cause bleeding Do: use a moderate amount of LA (only)

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