If you’re suffering from muscle spasms and inflammation in one localized area, you may be suffering from trigger points. Trigger points can occur in various regions of the body. Common sites for these tender points include the rhomboid and trapezius muscles, which are located in the upper back and shoulder regions. They’re also common in the lower back and extremity musculature. Trigger point injections (TPI) can help provide pain relief in these areas. The goal of the treatment is to inactivate the trigger point, thereby reducing pain.
To determine if you have these tender areas of muscle pain, a doctor can palpate that area. If you do have them, they’ll often feel a nodule or lump. When someone compresses these, they can produce localized, as well as referred pain. You may also see a localized twitch when palpating the area.
Trigger points are classified as being either active or latent. Active ones cause pain at rest. They are also tender to palpation and produce a referred pain pattern. You may feel this as radiating or spreading pain. Conversely, a latent trigger point does not cause immediate pain, but may restrict movement and cause muscle weakness. Patients with trigger points commonly present with regional, persistent pain that often results in decreased range of motion of the affected muscle.
Repetitive minor injuries or acute traumatic events can lead to the development of trigger points.
What Are Trigger Point Injections?
A trigger point injection is a minimally invasive procedure for treating these tender points. It involves injecting medicine directly into the trigger point to provide pain relief.
A trigger point injection may be made up of a variety of medicines. These include: :
Single local anesthetic
Combination of local anesthetics
Combination of an anesthetic and corticosteroid
The anesthetic medication can help block pain receptors within the nerves that surround the muscle, which helps to reduce pain signal transmission to the brain. When a corticosteroid is also injected, it helps to reduce inflammation and swelling of the tissue surrounding the nerve. This may help to decrease a patient’s pain.
The pain relief experienced following these injections varies among patients. Some physicians may recommend a series of injections for some patients. Your doctor will schedule these several weeks apart in order to provide optimal relief.
How Are Trigger Point Injections Performed?
Trigger point injections are performed in an outpatient setting. You’ll lie or sit on the exam table depending on the location of the painful area. Your physician will find this point by palpating the area.Ultrasound may also be used to identify the location. They’ll then clearly mark the site.
Next, they’ll clean the skin with an antiseptic solution to help reduce the risk of infection. A local anesthetic may be applied to numb the area prior to the injection to make the procedure more comfortable for you. They’ll then insert the needle into the trigger point and inject the medication. A bandage may be applied to the injection site after the procedure, if necessary.
Trigger point injections side effects and recovery
After a trigger point injection, the area may be tender. Patients can apply ice or heat to the tender area to help. You may also want to take acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs), if needed for pain control.
Your doctor will likely encourage you to remain active after the procedure in an effort to put the affected muscle through its’ full range of motion in the week after the injection. However, do refrain from strenuous activity, particularly for the first three to four days after the injection.
Trigger point injections side effects are rare, but include infection and bleeding. When cortisone is injected, fat shrinkage under the skin may also occur.
Conditions Related To Trigger Point Injections
These injections can be used to treat a variety of conditions that affect the musculoskeletal system, including:
Fibromyalgia (when myofasical trigger points are present)
Myofascial pain syndrome
Lower back pain
Fibromyalgia is a disorder that is characterized by widespread musculoskeletal pain that is often accompanied by fatigue, memory, sleep, and mood issues. Further, patients with fibromyalgia often experience:
Temporomandibular disorders (TMJ)
Irritable bowel syndrome
When patients with fibromyalgia have myofascial tender points that are contributing to their pain symptoms, these injections may help to relieve some of their pain symptoms. The following video talks about fibromyalgia in more detail.
Tension headaches are the most common type of headache. Tension headache pain may impact the whole head; however, the pain commonly begins in the back of the head or above the eyebrow. Some patients may also report a band-like sensation around their head, while others report muscle tension in their neck or shoulders.
While the pain associated with tension headaches is usually short-lived, some patients experience these headaches frequently. Lidocaine injections into the myofascial tender points located in the pericranial muscles may help to provide pain and headache relief to patients who frequently suffer from these.
Myofascial pain syndrome is a chronic pain condition. Patients with this condition have trigger points that cause radiating pain when they are compressed. Signs and symptoms of myofascial pain syndrome include:
A deep aching type pain in a muscle
Pain that increases at night
A tender nodule in the muscle
Difficulty sleeping due to pain
Tender areas can be the result of injury or overuse of a muscle. Injections into the tender areas associated with this condition can help to relieve pain.
Tender areas in the surrounding musculature can also lead to neck or lower back pain. Trigger point injections into these areas can help to provide pain relief.
A trigger point injection is a minimally invasive treatment. Healthcare professionals can use it to treat a variety of chronic pain conditions that involve myofascial trigger points. These include: