Trigger Point Injections

Trigger point injections can be administered in the office, and often help release spots of tension or muscle soreness.

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Are Trigger Point Injections Right For You?

What is a Trigger Point Injection?

In a trigger point injection procedure,  a health care professional inserts a small needle into the patient’s trigger point with administer one of four treatments:

  • Anesthetic injection (e.g., lidocaine)
  • Corticosteroid (cortisone) injection, alone or mixed with lidocaine
  • Acupuncture
  • Dry-needling, a needle used without any medication. This can be a good option for trigger points that produce a twitch when you apply pressure and create referred pain

Most trigger points go away after one injection but may come back, depending on what caused them. That is especially true for trigger points from chronic pain conditions or repetitive motion. For recurring trigger points, you may need additional injections.

Once a trigger point has been located and the overlying skin has been cleansed with alcohol, the clinician isolates that point with a pinch between the thumb and index finger or between the index and middle finger, whichever is most comfortable.

Using sterile technique, the needle is then inserted 1 to 2 cm away from the trigger point so that the needle may be advanced into the trigger point at an acute angle of 30 degrees to the skin. The stabilizing fingers apply pressure on either side of the injection site, ensuring adequate tension of the muscle fibers to allow penetration of the trigger point but preventing it from rolling away from the advancing needle.10 The application of pressure also helps to prevent bleeding within the subcutaneous tissues and the subsequent irritation to the muscle that the bleeding may produce.

Who Is This Procedure For?

See if Trigger Point Injections are Right for Your Pain
  • Trigger points are discrete, focal, hyperirritable spots located in a taut band of skeletal muscle. They produce pain locally and in a referred pattern and often accompany chronic musculoskeletal disorders.
  • The spots are painful on compression and can produce referred pain, referred tenderness, motor dysfunction, and autonomic phenomena. Physician’s sense of feel and patient expressions of pain upon palpation are the most commonly used method to localize a trigger point. The most common physical finding is palpation of a hypersensitive bundle or nodule of muscle fibre of harder than normal consistency. The palpation will elicit pain over the palpated muscle and/or cause radiation of pain towards the zone of reference in addition to a twitch response

When areas of muscle that have become tight and inflamed, often a tender knot or tight band forms at the spot.

Trigger points can be caused by a variety of conditions, including the following:

    • Back pain, which typically occurs after a fall, injury or heavy lifting, and is chronic, persisting for three months or longer
    • Neck pain
    • Chronic tension from stress
    • Fibromyalgia
    • Myofascial pain syndrome, (also called chronic myofascial pain) is a condition in which connective tissue called fascia tightens and contracts; this is usually from an injury or overuse (repetitive motion)
    • Poor posture
    • Migraine or tension headaches
    • Traumatic or overuse (repetitive motion) sports or other injury
  • Trigger points are classified as being active or latent, depending on their clinical characteristics. An active trigger point causes pain at rest. It is tender to palpation with a referred pain pattern that is similar to the patient’s pain complaint. This referred pain is felt not at the site of the trigger-point origin, but remote from it. The pain is often described as spreading or radiating. Referred pain is an important characteristic of a trigger point. It differentiates a trigger point from a tender point, which is associated with pain at the site of palpation only.
  • A latent trigger point does not cause spontaneous pain, but may restrict movement or cause muscle weakness. The patient presenting with muscle restrictions or weakness may become aware of pain originating from a latent trigger point only when pressure is applied directly over the point
  • Patients who have trigger points often report regional, persistent pain that usually results in a decreased range of motion of the muscle in question. Often, the muscles used to maintain body posture are affected, namely the muscles in the neck, shoulders, and pelvic girdle, including the upper trapezius, scalene, sternocleidomastoid, levator scapulae, and quadratus lumborum.
Why Get Treatment?
  • When left untreated, trigger point disfunction can induce a chronic pain state. This often manifests in headaches, muscle aches, morning stiffness, TMJ syndrome, tinnitus, or other painful syndromes, sometimes located away from the active trigger point site.
  • Over time, patients may also experience increased muscle weakness or imbalance, altered motor recruitment, in either the affected muscle or in functionally related muscles, Changes in Range of Motion (ROM), or Postural abnormalities.

Is a Trigger Point Injection Right For You?

If you suffer from muscle tightness or tension in your middle to upper back, or neck and shoulders, please take our online diagnostic to see if trigger points are right for you
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