Procedures

Trigger Point Injections

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What are Trigger Point Injections? 

Trigger point injection (TPI) may be an option in treating pain for some patients. TPI is a procedure used to treat painful areas of muscle that contain trigger points or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.

Occasionally, a specific muscle may generate pain due to sustained contraction and subsequent localized ischemia. While this type of pain is usually secondary to another problem, it can occur primarily. These areas of muscle pain are called trigger points and can be treated with injection of small amounts of local anesthetic solution with or without steroid, usually in concert with specific physical therapy treatments.  If the primary source of the muscle pain such as an arthritic zygapophysial joint is identified, then it is important to treat this primary pain source as well. Trigger point injections are usually performed in the office.  Some deep muscle injections such as the piriformis and iliopsoas muscles are performed under fluoroscopy

Trigger point injections can help with chronic headaches, muscle tension, and muscle pain! 

During a trigger point injection a small amount of medication into the painful muscle to provide pain relief and relaxation. The relief will be in that painful muscle and any referred pain!  

Trigger point injection is used to treat especially painful areas of a muscle, characterized by the presence of trigger points. Often caused by trauma or repetitive injuries, trigger points are areas of skeletal muscles that become inflamed or knotted. They are most common on the upper back muscles, but can occur in the lower back and neck as well. 

Trigger points will often take the form of a knot on the muscle, which will be extremely tender to the touch. They can also go along with chronic musculoskeletal disorders like lower back pain, fibromyalgia, and tension headaches. Trigger points can irritate the nerves around them, which causes the pain to be referred somewhere else on the body.

What is a trigger point injection?

Used for pain management, trigger point injections are injections aimed directly into the trigger point. The injection can be an anesthetic for pain relief, a corticosteroid for anti-inflammatory purposes, or a mixture of both. Occasionally, a needle will be inserted into the trigger point with just saline inside (dry needle technique). 

Before the injection, your doctor will locate the trigger point manually, as ultrasound or X-ray guidance is not usually necessary. Before the injection, the skin around the trigger point will be numbed, and then a small amount of anesthetic and/or anti-inflammatory will be injected into the muscle. If the patient is allergic to any of the medications typically injected, the dry needle technique can be used instead to relieve the pain. After the injection, the trigger point should be rendered inactive, and therefore, not cause you anymore pain.

How will they help me?

Trigger point injections can be used to treat muscle areas in the neck, lower back, arms, and legs. They have also been successful in treating the symptoms of fibromyalgia and tension headaches. Symptoms associated with myofascial pain syndrome, or chronic pain in the tissues around the muscles, have also been alleviated with trigger point injections. 

These injections are usually more successful in treating pain compared to oral medications, since the medicine is injected directly into the problem area. Depending on what medications were used during your trigger point injections, your pain relief may be temporary, or long lasting.

This nonsurgical method is typically utilized if physical therapy, exercise, or medications have not been successful in treating pain, and the patient does not want surgery. Your doctor can also use trigger point injections to accurately locate the source of your pain. Commonly, they will be used to diagnose facet or SI joint pain, in combination with imaging studies and a physical exam.
Please see a spine care specialist at Integrated Pain Management and discuss whether you are a candidate for a trigger point injection.

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