Certain patients may benefit from trigger point injections (TPI). When you do not relax your muscles, trigger points, or knots of skeletal muscle, form, causing pain. During a TPI, the knots are treated. These knots are often noticeable under the skin. Inflammation of the nerves around trigger points can result in referred pain, or pain felt in another part of the body.

When you have muscle pain, especially in your arms, legs, lower back, and neck, a trigger point injection can help. As well as fibromyalgia, tension headaches, and myofascial pain, it can be used to treat these conditions.

In order to describe trigger points, you would use the term “knots”. These occur when muscles are unable to relax. Sometimes you may find that rubbing your muscles triggers them.

Injecting small amounts of anesthetic and steroids into the trigger point can help alleviate the pain.

Among the possible trigger points for injection are:

It blocks the pain receptors in muscles with a local anesthetic such as lidocaine

Inflammatory conditions are reduced through corticosteroid treatment of the surrounding nerve and muscle tissue

Inhibits nerve signaling pathways for muscle contractions with botulinum toxin A (Botox)

An injection of medication is administered to a myofascial trigger point using a small needle inserted by the doctor.

A stinging sensation may be experienced by people with tense muscles as the doctor inserts the needle. Typically, this sensation disappears once their muscles relax.

Uses

These conditions affect the nervous system and the musculoskeletal system, which trigger point injections could help relieve.

Myofascial pain syndrome

Myofascial pain syndrome affects the muscles and surrounding tissue, and trigger point injections may help treat its symptoms.

It has been proven that trigger points are activated in parts of the body that are seemingly unrelated to each other. Referred pain is the name given to this phenomenon.

By relaxing muscles affected by referred pain, trigger point injections interrupt nerve signals that cause referred pain.

Trigger points may develop from a variety of causes, including:

  •         psychological stress
  •         repetitive motions
  •         poor posture
  •         injury or trauma to a muscle

Myofascial pain may also be accompanied by the following symptoms:

  •         muscle stiffness or weakness
  •         a limited range of motion
  •         pain that intensifies when the person moves or stretches the affected muscle
  •         pain in specific parts of a muscle

What Happens During a Trigger Point Injection?

During TPI, a small needle is inserted into the trigger point of the patient. There are either local anesthetics or saline in the injection, and they may include corticosteroids. When the trigger point is injected, the pain is reduced because the trigger point is made inactive.

Treatment that is short-term will usually produce sustained relief. It typically takes only a few minutes for a doctor to inject you. The doctor may inject multiple sites at once. The dry-needle technique is an option for patients who cannot tolerate a particular medication.

When Is Trigger Point Injection Used?

Many muscle groups can be treated with TPI, including the arms, legs, back, and neck. Aside from treating fibromyalgia, TPI is effective for reducing tension headaches. In addition to relieving myofascial pain, this technique is also applied to chronic pain resulting from surrounding muscle tissue that doesn’t respond to other therapies. In spite of this, TPI remains under investigation for its effectiveness in treating myofascial pain.

How is a trigger point injection done?

The procedure will be performed while you are seated or lying down. It is important to tell your doctor where the pain is coming from by pressing on the muscle. A small needle will be inserted into the area, then an injection of anesthetic and steroids will be administered.

A single visit to the doctor can involve the injection of multiple trigger points. Each treatment is relatively quick.

What are the risks?

Having trigger point injections performs very little risk of complications. The injection site is not prone to complications like bleeding or infection. The injection site may feel sore or numb for a few days following the procedure.

What happens after the procedure?

You can use your muscles afterward after receiving trigger point injections. During the first few days, you should not do anything strenuous.

Is trigger point injection right for you?

You might be a candidate for trigger point injection if other options, such as pain medication and physical therapy, haven’t helped reduce your muscle pain.

How frequently will patients need trigger point injections?

A trigger point should resolve following one injection in the ideal scenario. The symptom may occur when the patient has a trigger point that has been removed by removing its cause (for example, trauma or movement caused by repetitive motion that will no longer be performed). Chronic conditions such as fibromyalgia and myofascial pain syndrome can cause trigger points to recur because of the underlying issue. A trigger point injection will be administered on a regular basis or only when necessary in these instances. Depending on the medication, the frequency of the injection will vary. The injections can be scheduled on a regular basis as long as lidocaine or a mixture of anesthetics is used as an ongoing therapy. Since steroid medications may damage or shrink tissue when injected, TPIs should not be given frequently when steroid medications are injected, at the discretion of the treating healthcare professional.

What to Expect

First, the trigger point must be identified by a doctor. A doctor examines the muscles to determine if they are knotted as part of a physical examination. A trigger point can be diagnosed without imaging since it cannot be seen on X-rays or MRIs. In the case of an underlying condition, however, these tests may be of some help.

It typically takes 15 minutes to receive a trigger point injection. Following your initial injections, you will usually only have one session every two months, after which you may receive several more.

There should be no negative side effects to trigger point injections. Taking physical therapy can greatly improve your performance and efficiency. Trigger point injections have been shown to benefit these programs.

Summary

Trigger point injections are safe and effective in treating chronic pain, including myofascial pain syndrome, fibromyalgia, and tension headaches. Injections are administered directly into the affected muscle by a physician or other healthcare provider.  Local anesthetics, corticosteroids, and botulinum toxin A are commonly used. Certain people may benefit from trigger point injections right away, while others may not receive any pain relief. This treatment is best discussed with a physician in order to get a better understanding of the risks and benefits.