What is the recommended needle size for trigger point (myofascial trigger point) injection?

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Last updated: February 19, 2025View editorial policy

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From the Guidelines

Trigger point injection typically requires a 27-30 gauge, 1-2 inch needle to minimize discomfort and local trauma while allowing for effective injection of local anesthetics or saline solution to help relax the muscle and relieve pain 1. This size needle is small enough to reduce the risk of complications and is suitable for injecting 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's essential to note that the specific medication and dosage may vary depending on the individual patient's needs and the practitioner's professional judgment.

  • Key considerations for trigger point injection include:
    • Using a small-gauge needle to minimize discomfort and local trauma
    • Injecting local anesthetics or saline solution to help relax the muscle and relieve pain
    • Repeating the procedure as needed, with adequate time between sessions
    • Monitoring patient response and adjusting treatment accordingly
  • The evidence suggests that a 27-30 gauge needle is a suitable size for trigger point injection, as it balances the need for effective injection with the need to minimize discomfort and complications 1. However, it's crucial to consider individual patient factors and adjust treatment accordingly.

From the Research

Trigger Point Injection Needle Size

The recommended needle size for trigger point (myofascial trigger point) injection can vary depending on the specific study and location of the injection.

  • A study published in 2009 compared the efficacy of 21-, 23-, and 25-gauge needles for trigger point injection in the upper- and middle-trapezius muscle, and found that all three needle sizes were effective in reducing pain and improving function 2.
  • Another study published in 1992 used a 21-gauge hypodermic needle for percutaneous release of the trigger finger, and reported a high success rate with minimal complications 3.
  • A 2012 study used a 14-gauge needle for percutaneous surgical technique in the treatment of trigger finger, and found it to be an effective and safe method with a low complication rate 4.
  • A 2021 study used a specially designed needle (0.8×100 mm) with a planus tip for percutaneous trigger thumb release, and reported significant improvements in pain and function with high patient satisfaction 5.
  • There is no direct comparison of these studies to determine the optimal needle size for trigger point injection, but they suggest that a range of needle sizes can be effective depending on the specific location and technique used.

Key Findings

  • The choice of needle size may depend on the specific location and technique used for trigger point injection.
  • Studies have used a range of needle sizes, including 14-gauge, 21-gauge, 23-gauge, and 25-gauge, with varying degrees of success.
  • The use of a specially designed needle with a planus tip may be effective for percutaneous trigger thumb release 5.
  • Further research is needed to determine the optimal needle size and technique for trigger point injection in different locations and patient populations.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Percutaneous surgery: a safe procedure for trigger finger?

North American journal of medical sciences, 2012

Research

Use of a Percutaneous Needle Release Technique for Trigger Thumb: A Retrospective Study of 11 Patients from a Single Center.

Medical science monitor : international medical journal of experimental and clinical research, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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