Ultrasound-Guided External Trigger Point Injections for Female Patients With Myofascial Pelvic Pain: A Report of Two Cases.

Trigger point injections (TPIs) are used to relieve myofascial pain via injection with local anesthetics. External TPIs are commonly used to treat surface muscle groups such as the trapezius, while internal transvaginal or external pelvic TPIs may be used for pelvic pain in female patients. This case series discusses two female patients with histories of myofascial pelvic pain due to high-tone pelvic floor disorder (HTPFD) who received ultrasound-guided external TPIs for pain relief. Patient 1 had previously received internal TPIs with no relief, while Patient 2 had previously tried botulinum toxin injections and a pudendal nerve block with some relief. In both cases, ultrasound-guided external TPIs provided pain relief for a period of time and were repeated. This case highlights the importance of ultrasound-guided external TPIs as part of the arsenal of treatment options for pelvic floor dysfunction treatment.