Simple Pain & Stress Relief

If you’re suffering from muscle spasms, tendonitis, headaches, and inflammation you may be suffering from trigger points. Tcan 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 along with other areas that may be affected. The goal of the treatment is to inactivate the trigger point, thereby reducing pain and increasing blood and nerve flow to surround organs and tissue.

To determine if you have these tender areas of muscle pain, a doctor can palpate that area and will do muscle testing regarding nervous system function. 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. Muscle testing is also a way to figure out if there is long standing nervous system dysfunction which can also be cleared up by injections into nerve bundles that are associated with different organs and muscles.

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 can be from underling inflammation or trauama that is creating nerve stress and can reflex out 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.

Trigger points accompany not just chronic musculoskeletal disorders but chronic inflammatory diseases including:

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: :

The anesthetic medication can help block and reset pain receptors within the nerves that surround the muscle, which helps to reduce pain signal transmission to the brain. When homeopathic medicine  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, while increasing nervous system function.

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. 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 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.

Conclusion

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:

This procedure is relatively safe, with the most common trigger point injections side effect being injection site tenderness. This is an injection so there is always a slight risk of allergy, bruising, and temporary nerve pain or numbness.

Patients suffering from chronic pain condition should speak with their physicians to determine if trigger point injections are an effective treatment option for their condition.

References

  1. Alvarex DJ, Rockwell PG. Trigger points: diagnosis and management. American Family Physician. 2002;65(4):653-661.
  2. Cheng J, Abdi S. Complications of joint, tendon, and muscle injections. Tech Reg Anesth Pain Manag. 2007;11(3):141-147.
  3. Karadas O, Gui HL, Inan LE. Lidocaine injection of pericranial myofascial trigger point in the treatment of frequent episodic tension-type headache. The Journal of Headache and Pain. 2013;14:44.
  4. Saeidian SR, Pipelzadeh MR, Rasras S, Zeinali M. Effect of trigger point injection on lumbosacral radiculopathy source. Anesthesiology and Pain Medicine. 2014;4(4):e15500.
  5. Wong CSM, Wong SHS. A new look at trigger point injections. Anesthesiology Research and Practice. 2012;article ID 492452: 5 pages.

 

Author
Cynthia Preston, ND

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