Musculoskeletal pain is a common ED presentation and emergency providers can often manage it with NSAIDs alone.1 On the other hand, when patients present with small localized areas of intense muscle spasm called trigger points, NSAIDs won’t cut it. A trigger point injection (TPI), however, is a safe and easy way to treat the underlying cause of trigger point pain, and requires only basic equipment already available in most the EDs.
Pain management in the ED has become a balancing act. EPs must continually balance adequate pain management with the risks of opioids prescribing. As providers reach into their pain management toolbox it is always nice to have as many options as possible because one size does not fit all. Specifically for the management of acute renal colic, IV preservative-free (cardiac) lidocaine has been gaining popularity as a potential alternative when opioids are unable to get job done or are contraindicated due to co-morbidities or a history of addiction. Is it safe? Does it work?