Trigger Point Injections for the Low Back

back pain sucks

Unfortunately, I have had low back and major sciatic pain issues all my life as an athlete. That’s what lead me to massage. A few months ago I had trigger point injections at a pain management center here in Santa Barbara. These injections did not work for me and I just made an appointment for the next level of injections after I discuss the next phase with my physician. This will be a different treatment.


We live in the age of computers, laptops, cell phones, iPads, and tablets. Who doesn’t use any of these devices on a given day? A better question is how many hours a day does a person spend on one of these devices? Ask yourself:

  • Do I have neck pain/stiffness?
  • Do I have migraines?
  • Do I have recurrent headaches?
  • Do I have upper back pain/stiffness?
  • Do I have lower back pain/stiffness?
  • Do I have a lot of mental stress?
  • Do I have a lot of physical stress?
  • My on the computer/laptop/tablet/cellphone for more than 25% of my day.
  • Have I been to chiropractors or massage therapists and been unable to resolve my muscle tension or stiffness?
  • Do I always have a heavy load on my shoulders?

It is guaranteed that 99% of people will have neck pain, upper back pain, or lower back pain which can be linked to the posture that is held during the use of these devices.

In my first round of trigger point injection treatment, I was injected with the following 3 mixtures:

1. Lidocaine Injection – Lidocaine is a local anesthetic (numbing medication) that is used to numb an area of your body to help reduce pain or discomfort caused by invasive medical procedures such as surgery, needle punctures, or insertion of a catheter or breathing tube.

The use of trigger point injection therapy uses ingredients in this trigger point injection solution including an anesthetic such as lidocaine which blocks the above vicious circle which is medically known as the neuro-somatic signal to pain.

Define Neuro-Somatic Signal – What Does Neurosomatic Mean? If we break down the term “Neurosomatic,” “Neuro” refers to the brain and nervous system while “somatic” refers to the body. Neurosomatic Therapy simply examines the ways in which the relationship between your mind and body manifests in your posture.

Can lidocaine be injected for pain?
Lidocaine is an anesthetic injection that a healthcare provider will give to you in a hospital or healthcare setting. It prevents and treats pain caused by some procedures. When you receive this injection, you’ll lose feeling in your skin or other tissues.
How long does a lidocaine injection last?
Lidocaine is a fast-acting drug, but the effects wear off within about two hours. That is why lidocaine is used more often as a diagnostic tool rather than a long-lasting pain reliever. Bupivacaine (also known as Marcaine) is another type of anesthetic that can be used. The cream may stay on for 1 hour and will keep working for another hour after it comes off. You can keep the tube of numbing cream to use again.
What does lidocaine injection treat?
Descriptions. Lidocaine injection is used to cause numbness or loss of feeling for patients having certain medical procedures (by blocking certain nerves using the brachial plexus, intercostal, lumbar, or epidural blocking techniques). Lidocaine is a local anesthetic.
What kind of pain is lidocaine good for?
Intravenous lidocaine is used broadly in the management of neuropathic pain, postoperative pain, postherpetic neuralgia, centrally mediated pain, headache, and infiltrative malignant neurological lesions  Lidocaine is a relatively safe drug, which can be used at low doses without any notable safety concerns.
How long does it take for a lidocaine injection to work?
When injected, the numbing effects of Lidocaine can begin working very quickly. It is in as little as four minutes and can last from 30 minutes up to three hours. However, other factors can play a role in how long the drug’s effects last. It’s a fast-acting local anesthetic.
Neck and Back Trigger Points
What kind of pain is lidocaine good for?
Intravenous lidocaine is used broadly in the management of neuropathic pain, postoperative pain, postherpetic neuralgia, centrally mediated pain, headache, and infiltrative malignant neurological lesions (8). Lidocaine is a relatively safe drug, which can be used at low doses without any notable safety concerns.
Is lidocaine A Narcotic?
It numbs nerve signals by blocking the nerve endings in the skin only around where it is applied. It is not a general anesthetic and has no addictive properties. It also does not fall under the five controlled classes of drugs: depressants, stimulants, narcotics, hallucinogens, and anabolic steroids.
How many shots of lidocaine is safe?
Single doses of Lidocaine (for anesthesia other than spinal) should not exceed 4.5 mg/kg (or 200 mg) in adults or children 12 – 18 years of age. Lidocaine by local infiltration for children under the age of 12 years should not exceed 3mg/kg, repeated not more often than every 4 hours.
Is lidocaine good for nerve pain?
Lidocaine skin patch is used to relieve nerve pain caused by herpes zoster or shingles (postherpetic neuralgia). Lidocaine belongs to the family of medicines called local anesthetics. This medicine prevents pain by blocking the signals at the nerve endings in the skin.

What are the side effects of lidocaine?
Side Effects
  • Bluish-colored lips, fingernails, or palms blurred or double vision.
  • chest pain or discomfort.
  • cold, clammy, pale skin.
  • continuing ringing or buzzing or other unexplained noise in the ears.
  • difficulty breathing.
  • difficulty swallowing.
  • dizziness or lightheadedness.
Who Cannot use lidocaine?
Lidocaine skin creams such as EMLA, Denela, and Nulbia may not be suitable for people with porphyria, methemoglobinemia, or G6PD deficiency because they contain a combination of local anesthetics.
Is lidocaine stronger than tramadol?
In an in vitro study found that tramadol has a LA effect similar to lidocaine, but it was relatively weaker and that tramadol may have a mechanism different from lidocaine for producing conduction blockade.
Are lidocaine injections safe?
Applied either by injection, inhalation or as a topical agent to provide anesthesia, lidocaine has a good safety margin before reaching toxic blood levels. Since it can be applied in various forms to the same patients, however, care must be taken to keep track of the total dose given to minimize its systemic toxicity.
What are the side effects of lidocaine injections?
Common side effects of lidocaine injection may include:

nausea, vomiting; feeling hot or cold; confusion, ringing in your ears, blurred vision, double vision; or. numbness in places where the medicine is accidentally applied.
How often can you have lidocaine injections?
Most physicians recommend one injection every eight weeks for six months for maximum pain relief. How often do you need trigger point injections? How often you need the injections depends on your level of pain and medical condition. Sometimes, a trigger point only requires one injection for the pain to subside.
How much does a lidocaine injection cost?
Brand names for lidocaine include Xylocaine-MPF, and Xylocaine HCl. The cost for lidocaine injectable solution (1% preservative-free) is around $11 for a supply of 20 milliliters, depending on the pharmacy you visit. Quoted prices are for cash-paying customers and are not valid with insurance plans.
Can you drive after lidocaine injection?
Lidocaine injection can cause side effects that may impair your thinking or reactions. Unless absolutely necessary, do not drive after receiving this medicine. Avoid eating or chewing within 1 hour after lidocaine injection is used to numb your mouth or throat.
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2. Bupiuicaine Injection – 

It is a local anesthetic. Bupivacaine injection causes a loss of feeling and prevents pain by blocking signals at the nerve endings. It does not cause loss of consciousness. This medicine is to be given only by or under the direct supervision of your doctor.

Bupivacaine injection is used to numb an area of your body during or after surgery or other procedures, childbirth, or dental work. This medicine is also used to numb your shoulder after surgery for up to 72 hours. It is a local anesthetic.

Bupivacaine injection causes a loss of feeling and prevents pain by blocking signals at the nerve endings. It does not cause loss of consciousness.

This medicine is to be given only by or under the direct supervision of your doctor.

Is bupivacaine an epidural?
Epidural administration of amide local anesthetics in combination with opioids is widely used for pain relief in labor because of the dose minimizing and side effects reducing benefits. Bupivacaine is the most widely used long-acting amide local anesthetic.
How long does bupivacaine nerve block last?
In dentistry, bupivacaine hydrochloride administered as a nerve block in adult humans has a duration of action of 6 to 8-hours, and 5 to 7-hours as a local infiltration. On the other hand, Bupivacaine, has a slower onset of action (about 5-10 minutes after injection) but its effects last much longer, for about 4-8 hours. The delay in onset of action makes it a less popular option as a primary source of local anesthesia in outpatient hand surgery.


















3. Tonudol Injection – 

What is Toradol injections used for?
Ketorolac is used to relieve moderately severe pain in adults, usually after surgery. Ketorolac is in a class of medications called NSAIDs. It works by stopping the body’s production of a substance that causes pain, fever, and inflammation.
Is a Toradol shot good for back pain?
Toradol can also be injected in the muscle if someone is in severe pain, such as back pain and has been used for years in emergency rooms for the treatment of pain from kidney stones and on orthopedic hospital floors for the treatment of postop pain.
Is Toradol injection narcotic?
Is Toradol a narcotic? No, Toradol is not a narcotic, opioid, or controlled substance. Rather, Toradol is an NSAID and a non-habit forming alternative to treat moderate-to-severe pain that requires opioid levels of pain relief.
How long does a Toradol injection last?
You’ll feel the effects of a Toradol shot within minutes after the injection, especially compared to a pill or tablet. This makes it an effective pain reliever. It usually takes about six hours for Toradol to wear off.
What happens after Toradol shot?
Pain at the injection site, dizziness, drowsiness, headache, or upset stomach may occur. If any of these effects last or get worse, tell your doctor or pharmacist promptly. Remember that this medication has been prescribed because your doctor has judged that the benefit to you is greater than the risk of side effects.
Is Toradol just strong ibuprofen?
Both Toradol (ketorolac tromethamine) and ibuprofen are nonsteroidal anti-inflammatory drugs (NSAIDs) used to treat pain. Toradol is more effective than ibuprofen. Toradol is used to treat moderately severe inflammation. Ibuprofen, on the other hand, is used to relieve mild to moderate pain.
Does Toradol make you sleepy?
You should know that this medication may make you drowsy or dizzy. Do not drive a car or operate machinery until you know how this medication affects you. talk to your doctor about the safe use of alcohol while taking this medication. Alcohol can make the side effects of ketorolac worse,
How strong of a painkiller is Toradol?
Toradol is a nonsteroidal non-inflammatory drug (NSAID). It’s not a narcotic. Toradol (generic name: ketorolac) is not addictive, but it’s a very strong NSAID and can lead to serious side effects. You also shouldn’t take it for long periods of time,
What kind of pain does Toradol treat?
Ketorolac is used for the short-term treatment of moderate to severe pain in adults. It is usually used before or after medical procedures or after surgery. Reducing pain helps you recover more comfortably so that you can return to your normal daily activities.
What is the strongest anti-inflammatory injection?
Toradol (ketorolac tromethamine) is a powerful prescription non-steroidal anti-inflammatory drug (NSAID), often given by injection.
How many shots of Toradol can you get?
TORADOL is given as an injection, into a muscle by a doctor or trained nurse. The usual dose for healthy adults is 10 mg to 30 mg every 4 to 6 hours, up to a maximum daily dose of 90 mg.
Can Toradol and Tylenol be taken together?

No interactions were found between Toradol and Tylenol. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Ketorolac injection is used for the short-term relief of moderately severe pain in people who are at least 17 years of age. Ketorolac injection should not be used for longer than 5 days, for mild pain, or for pain from chronic (long-term) conditions. You will receive your first doses of ketorolac by intravenous (into a vein) or intramuscular (into a muscle) injection in a hospital or medical office. After that, your doctor may choose to continue your treatment with oral ketorolac. You must stop taking oral ketorolac and using ketorolac injection on the fifth day after you received your first dose of ketorolac injection. Talk to your doctor if you still have pain after 5 days or if your pain is not controlled with this medication. Ketorolac may cause serious side effects.

People who are treated with nonsteroidal anti-inflammatory drugs (NSAIDs) (other than aspirin) such as ketorolac may have a higher risk of having a heart attack or a stroke than people who are not treated with these medications. These events may happen without warning and may cause death. This risk may be higher for people who are treated with NSAIDs for a long time. Tell your doctor if you or anyone in your family has or has ever had heart disease, a heart attack, or a stroke or ‘ministroke;’ and if you have or have ever had high blood pressure. Get emergency medical help right away if you experience any of the following symptoms: chest pain, shortness of breath, weakness in one part or side of the body, or slurred speech.

Receiving ketorolac injection increases the risk that you will experience severe or uncontrolled bleeding. Tell your doctor if you have or have ever had a bleeding or clotting problem. Your doctor will probably not give you ketorolac injection.

If you are having surgery, including dental surgery, tell the doctor or dentist that you are using ketorolac injection. If you will be undergoing a coronary artery bypass graft (CABG; a type of heart surgery), you should not use ketorolac injection right before or right after the surgery.

NSAIDs such as ketorolac may cause ulcers, bleeding, or holes in the stomach or intestine. These problems may develop at any time during treatment, may happen without warning symptoms, and may cause death. The risk may be higher for people who take NSAIDs for a long time, are older in age, have poor health, smoke cigarettes, or drink alcohol while using ketorolac injection. Tell your doctor if you take any of the following medications: anticoagulants (‘blood thinners’) such as warfarin (Coumadin, Jantoven); aspirin; or oral steroids such as dexamethasone (Decadron, Dexpak), methylprednisolone (Medrol), and prednisone (Deltasone). Do not take aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) and naproxen (Aleve, Naprosyn) while you are using ketorolac. Also tell your doctor if you have or have ever had ulcers, holes, or bleeding in your stomach or intestine, or a disease that causes inflammation of the bowels such as Crohn’s disease (a condition in which the body attacks the lining of the digestive tract, causing pain, diarrhea, weight loss, and fever) or ulcerative colitis (a condition which causes swelling and sores in the lining of the colon [large intestine] and rectum). If you experience any of the following symptoms, stop using ketorolac injection and call your doctor: stomach pain, heartburn, vomit that is bloody or looks like coffee grounds, blood in the stool, or black and tarry stools.

Ketorolac may cause kidney failure. Tell your doctor if you have kidney or liver disease, if you have had severe vomiting or diarrhea or think you may be dehydrated, and if you are taking angiotensin-converting enzyme (ACE) inhibitors such as benazepril (Lotensin), captopril (Capoten), enalapril (Vasotec), fosinopril, lisinopril (Prinivil, Zestril), moexipril (Univasc), perindopril (Aceon), quinapril (Accupril), ramipril (Altace), and trandolapril (Mavik); or diuretics (‘water pills’). If you experience any of the following symptoms, stop using ketorolac injection and call your doctor: unexplained weight gain; swelling of the hands, arms, feet, ankles, or lower legs; confusion; or seizures.

Some people have severe allergic reactions to ketorolac injection. Tell your doctor if you are allergic to ketorolac, aspirin or other NSAIDs such as ibuprofen (Advil, Motrin) or naproxen (Aleve, Naprosyn), any other medications, or any of the ingredients in ketorolac injection. Also tell your doctor if you have or have ever had asthma, especially if you also have frequent stuffed or runny nose or nasal polyps (swelling of the lining of the nose). If you experience any of the following symptoms, stop using ketorolac injection and call your doctor right away: rash; fever; peeling or blistering skin; hives; itching; swelling of the eyes, face, throat, tongue, lips; difficulty breathing or swallowing; or hoarseness.

You should not receive ketorolac injection during labor or while you are giving birth.

Do not breast-feed while you are using ketorolac injection.

Tell your doctor if you are 65 years of age or older or if you weigh less than 110 lb (50 kg). Your doctor will need to prescribe a lower dose of medication. If you are an older adult, you should know that ketorolac injection is not as safe as other medications that can be used to treat your condition. Your doctor may choose to prescribe a different medication that is safer for use in older adults.



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*Disclaimer: This information is not intended to be a substitute for professional medical advice. You should not use this information to diagnose or treat a health problem or disease without consulting with a qualified healthcare provider. Please consult your healthcare provider with any questions or concerns you may have regarding your condition. The information provided is for educational purposes only and is not intended as a diagnosis, treatment, or prescription of any kind. The decision to use, or not to use, any information is the sole responsibility of the reader. These statements are not expressions of legal opinion relative to the scope of practice, medical diagnosis, or medical advice, nor do they represent an endorsement of any product, company, or specific massage therapy technique, modality, or approach. All trademarks, registered trademarks, brand names, registered brand names, logos, and company logos referenced in this post are the property of their owners.

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