Letters to the Editor

Why Is Aspirin a Contraindication for Trigger-Point Injections?


Am Fam Physician. 2003 Jan 1;67(1):32.

to the editor: In the article entitled, “Trigger Points: Diagnosis and Management,”1 Table 3 lists aspirin therapy as a contraindication to trigger-point injections. Given the current recommendations for aspirin therapy to prevent coronary artery disease events, large portions of the adult population in the United States are currently taking or should be taking aspirin on a regular basis. If aspirin therapy is truly a contraindication to trigger-point injections, then trigger-point injections would be off limits to a large percentage of the adult population.

The only information presented in the article to support this contraindication is the citation of two textbook chapters.2,3 What evidence, if any, indicates that trigger-point injections are dangerous to patients taking aspirin?


1. Alvarez DJ, Rockwell PG. Trigger points: diagnosis and management. Am Fam Physician. 2002;65:653–60.

2. Simons DG, Travell JG, Simons LS. Travell & Simons' Myofascial pain and dysfunction: the trigger point manual. 2d ed. Baltimore: Williams and Wilkins, 1999:94–173.

3. Ruoff GE. Technique of trigger point injection. In: Pfenninger JL, Fowler GC, eds. Procedures for primary care physicians. St. Louis: Mosby, 1994:164–7.

editor's note:A copy of this letter was sent to the author of “Trigger Points: Diagnosis and Management,” who declined to reply.


Send letters to afplet@aafp.org, or 11400 Tomahawk Creek Pkwy., Leawood, KS 66211-2680. Include your complete address, e-mail address, and telephone number. Letters should be fewer than 400 words and limited to six references, one table or figure, and three authors.

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This series is coordinated by Kenny Lin, MD, MPH, Associate Deputy Editor for AFP Online.



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