Chapter 51 Trigger Point Injection
Common indications
Painful trigger points of the low back can be easily injected with a combination of local anesthetics and steroids to obtain immediate and long-term pain relief. Trigger points are commonly found over the sacroiliac joint region where the small ligaments and muscles of the sacrum cross over the iliac crest (Figure 51-1).
Equipment
For this injection, prepare a 3-cc syringe with 1 cc of bupivacaine, 1.5 cc of lidocaine, and the equivalent of 25 mg of hydrocortisone or 10 mg of triamcinolone. Use an 18-gauge needle to draw up the solutions, but inject with a 25- or 27-gauge needle only (Figure 51-2).
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