Trigger Point Injections

Trigger points are hyperirritable contraction knots found in tight bands of muscles resulting in what we call myofascial pain syndromes. These points can refer pain. These are found by physical exam.

Trigger points can cause chronic debilitating myofascial pain with loss in muscle function, strength and coordination. We can treat trigger points with injections, acupuncture, and dry needling.

Trigger point injections can be used to treat fibromyalgia, neck and low back pain, and tension headaches. The technique is also used to alleviate myofascial pain syndrome (chronic pain involving tissue that surrounds muscle) that does not respond to other treatments.

We palpate the sore muscle looking for the tight, painful band of muscle. Once we find the trigger point, we insert a small needle into the patient’s trigger point. The injection contains a local anesthetic or saline, and may include a corticosteroid. With the injection, the trigger point is made inactive and the pain is alleviated. Often, a brief course of treatment will result in sustained relief. Injections usually take just a few minutes. Several sites may be injected in one visit. If a patient has an allergy to a certain drug or is pregnant, a dry-needle technique (involving no medications) can be used.

What are the risks?

The risk of complication from a trigger point injection is very low. Complications such as bleeding and infection at the injection site are uncommon. However, you may have temporary soreness or numbness at the injection site.
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Postprocedural Care

Exercise

Active exercise is a critical part of the treatment program and will determine whether trigger point injection treatment is effective. Exercises can be designed to target stretching, strengthening, or conditioning of muscles.

Exercise designed for stretching the involved muscles is the key to the relief of myofascial pain. Improved conditioning and increased strength reduces the likelihood of developing trigger points. As the trigger points are inactivated and any rest pain resolves, a carefully graded exercise program begins to increase endurance.

Stretching

Stretching after trigger point injection is an integral part of treatment. The patient should perform full active range of motion of the muscle several times to relieve residual stiffness, evaluate the effectiveness of the procedure, and reestablish awareness of normal muscle function.

Strenuous activities should be avoided for at least the period of post injection muscle soreness. However, the patient is encouraged to use the muscle with full range of motion.

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