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 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

Trigger Point Injection Needle Size

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

  • A study comparing 3 needle sizes (21-, 23-, and 25-gauge) for trigger point injection in myofascial pain syndrome found that injections with 21- or 23-gauge needles were more effective in terms of health-related quality of life 2.
  • Another study used a 20-gauge hypodermic needle for percutaneous trigger finger release and found the technique to be effective and safe with a low complication rate 3.
  • A study using a 25-gauge hypodermic needle with corticosteroid infiltration for percutaneous trigger digit release also reported favorable results with a low recurrence rate 4.
  • A study using a specially designed needle (0.8×100 mm) with a planus tip for percutaneous trigger thumb release found the technique to be effective, less time-consuming, and safe 5.
  • A study using a 14-gauge needle for percutaneous surgical technique in the treatment of trigger finger found the method to be effective, convenient, and cost-effective with a low complication rate 6.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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

Research

Percutaneous surgery: a safe procedure for trigger finger?

North American journal of medical sciences, 2012

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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