Trigger Point Injection Therapy for Chronic Pain
Trigger point injection therapy is used for pain relief caused by trigger points. These points represent dense knots of muscles that are sensitive to pressure, touch and irritate surrounding nerves.
Understanding Trigger Points
Referred pain radiates to another area of the body. The trigger points are very tight muscle areas and form for a variety of reasons:
- traumatic injury,
- muscle tension,
- pinched spinal nerves,
- muscle over-exertion,
- muscle spasms,
- muscle inflammation,
- past surgery,
- inflamed or injured tendons or ligaments or muscle fascia,
- poor posture,
- muscle overuse involving repetitive movements.
Weakened, inflamed or overstretched muscles heal in a way that leads to tight, twisted or knotted ones. The knotted fibers restrict blood flow to the muscles, and it keeps them tight and stiff, causing pain and a restricted range of motion. Trigger points impact the muscle’s willingness to stretch or contract, making movement painful.
The Trigger Point Injection
Trigger point injections can be used to treat:
- muscle pain in the neck, lower back, leg, and arms;
- fibromyalgia pain;
- myofascial pain syndrome;
- tension headaches;
- temporomandibular pain.
Understanding the Injection Process
Trigger point injections are usually not used as a treatment until other treatments, like medications and exercises, have been tried for four to six weeks. If the pain does not improve, trigger point injections may provide the pain relief sought.
The trigger point injection does not take long to complete. Who gives trigger point injections? Injections are made by a physician in the Spine and pain clinic. Typically, it is general practitioners, neurologists, rheumatologists, pain-management specialists and rehabilitation doctors who give the injections.
How is the procedure performed?
- Patient sits or lies down.
- Physician locates the trigger point targeted for injection via manual palpitation.
- A numbing solution may or may not be applied before the injection.
- A small needle is inserted into the trigger point.
- An injection of an anesthetic or mixture of anesthetics, with a corticosteroid added sometimes, is made directly into the trigger point via the needle.
- Sometimes a needle is inserted without medication, or only a saline solution is administered, with the goal to make the trigger point inactive.
- More than one trigger point can be injected
The anesthetic and steroid medicine provide fast relief, relaxing the tight muscles. People who experience chronic pain may have trigger point recurrence. In this case, the patient will get the trigger point injections regularly, but no more than three times to the same trigger point to avoid scarring and muscle damage.
If only the anesthetic is applied, the injection can be administered once a month. If the corticosteroid is used, the trigger point injection cannot be given so often. Steroids used over the long term can cause tissue damage.
What to Expect after Trigger Point Injections
Do trigger point injections hurt? Usually, the only complication is swelling or soreness at the injection site. Application of heat or ice, and taking over-the-counter NSAIDs, may be helpful. Infrequently, patients experience muscle spasms or balance problems due to changes in the muscles.
If the patients got the trigger point injections into the leg or arm, they are not allowed to drive.
For the first 24 hours after the procedure, patients should do mild stretching exercises to help stretch tissues in the treated area. The physician will give the patient all necessary instructions.