How is the trigger point located prior to injection?

Updated: Nov 03, 2020
  • Author: Stephen Kishner, MD, MHA; Chief Editor: Erik D Schraga, MD  more...
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Palpation of muscles for trigger points may exhibit a palpable taut band or cord of tense muscle fibers approximately 1-4 mm in diameter. The examiner should palpate along this band to locate the point of maximum tenderness, which is the area identified as the trigger point. Pressure is held firmly to elicit the referred pain pattern.

Palpation of an active trigger point often elicits a “jump sign” or local twitch response. A jump sign is a jump or involuntary reflex–like movement of the patient that is disproportionate to the amount of pressure exerted, is reproducible, and may correspond to the degree of irritability of the trigger point. [5]

Localized twitch response refers to a localized twitch of part of the muscle when the trigger point is rolled under the fingers or a needle is inserted into the trigger area. This twitch may be intense enough to cause a notable jerk or contraction of the muscle fibers in the taut band, lasting up to 1 second. [5]

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