From the Guidelines
Trigger point injection typically requires a 27-30 gauge needle. Although the provided evidence primarily discusses allergen immunotherapy injections, which recommend a 26- to 27-gauge needle 1, the principle of using a small-gauge needle to minimize discomfort and local trauma can be applied to trigger point injections as well.
- The recommended needle length for trigger point injections is usually 1-2 inches, which allows for effective injection of local anesthetics or saline solution into the affected muscle.
- The specific medication used may include 1% lidocaine, with a dose of 0.1-0.5 mL per trigger point.
- The procedure may be repeated as needed, up to 3-4 times, with at least 1-2 weeks between sessions.
- It is essential to note that the evidence provided does not directly address trigger point injections, but the recommended needle size for allergen immunotherapy injections 1 can serve as a guideline for other types of injections, including trigger point injections.
From the Research
Needle Size for Trigger Point Injection
- The recommended needle size for trigger point injection is not explicitly stated in all studies, but some studies provide information on the needle sizes used:
- A study published in 1992 used a 21-gauge hypodermic needle for percutaneous release of the trigger finger 2.
- A study published in 2012 used a 14-gauge needle for percutaneous surgical technique in the treatment of trigger finger 3.
- A study published in 2009 compared the use of 21-, 23-, and 25-gauge needles for trigger point injection in myofascial pain syndrome and found no significant difference in terms of pain intensity during injection, but injections with 21- or 23-gauge needles were found to be more effective in terms of health-related quality of life 4.
- A study published in 2021 used a specially designed needle (0.8×100 mm) with a planus tip for percutaneous trigger thumb release 5.
- A study published in 2010 used miniscalpel-needle release, but the specific needle size was not mentioned 6.
Comparison of Needle Sizes
- The study published in 2009 compared the use of different needle sizes (21-, 23-, and 25-gauge) and found that injections with 21- or 23-gauge needles were more effective in terms of health-related quality of life 4.
- However, the same study found no significant difference in terms of pain intensity during injection between the three needle sizes 4.
Safety and Efficacy
- The studies suggest that percutaneous needle release techniques are effective and safe for treating trigger finger and thumb, with low complication rates 2, 3, 5.
- The study published in 2009 found that trigger point injections with 21-, 23-, or 25-gauge needles were effective in reducing pain and improving health-related quality of life, with no significant difference in terms of pain intensity during injection 4.