Injection techniques in the management of local pain.

Area of Science:

• Musculoskeletal pain management
• Injection techniques
• Pain relief strategies

Background:

• Local anesthetic (LA) injections and infiltrations are used for musculoskeletal pain.
• New techniques are needed to improve patient comfort and treatment efficacy.

Purpose of the Study:

• To review local anesthetic injections combined with needling for musculoskeletal pain.
• To describe pre-injection blocks (PIBs) as a method to prevent pain during injections.
• To evaluate the efficacy of needling and infiltration (N and I) after PIB.

Main Methods:

• A review of LA injections and infiltrations combined with needling.
• Description of pre-injection blocks (PIBs) to block sensory input before injections.
• Needling and infiltration (N and I) with 1% lidocaine performed after PIB in 179 tender spots, trigger points, and muscle spasms in 123 patients.

Main Results:

• N and I over abnormal muscle fibers provided effective pain relief and functional improvement.
• Successful treatment observed in conditions like sports injuries, sprains, overuse syndromes, and local inflammations.
• Pre-injection blocks enabled pain-free N and I of tender areas.

Conclusions:

• Needling and infiltration of trigger areas and tender spots is an effective treatment for several musculoskeletal conditions.
• Pre-injection blocks enhance the tolerability of N and I procedures by preventing pain.
• This combined approach offers a promising strategy for managing local musculoskeletal pain and promoting healing.