The main hypothesis of this study is that anti-inflammatory medications (ketorolac or
dexamethasone) will provide longer-lasting and greater pain relief than just lidocaine in
trigger point injections where a local twitch response is evoked at the time of the
The primary objective of this study is to compare the efficacy of three substances used in
TPIs with a LTR identified at the time of the injection: a CS (dexamethasone), a NSAID
(ketorolac), or only a local anesthetic (lidocaine).