Trigger points are focal areas of spasm and inflammation in skeletal muscle. The rhomboid and trapezius back muscles, located in the upper back and behind the shoulder areas, are a common site of trigger points. Trigger points in these areas can cause neck pain, shoulder pain, and headache. In addition to the upper spine, trigger points can also occur in the low back or less commonly in the extremities.
Often there is a palpable nodule in the muscle where the trigger point is located. The area is tender, and frequently when pushed, pain radiates from the trigger point itself to an area around the trigger point. Trigger points commonly accompany chronic musculoskeletal disorders such as fibromyalgia, myofascial pain syndrome, neck pain, and low back pain. They may also occur with tension headaches and temporomandibular pain. Acute trauma or repetitive minor injury can lead to the development of trigger points.
Trigger point injections may treat chronic muscle pain related to myofascial trigger points, which are highly sensitive bundles of fibers in tight bands of muscle. The treatment involves injecting medication directly into myofascial trigger points. The doctor will determine the best type of medicine based on the severity and underlying cause of the pain.
When Is Trigger Point Injection Used?
TPI is used to treat many muscle groups, especially those in the arms, legs, lower back, and neck. In addition, TPI can be used to treat fibromyalgia 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. However, the effectiveness of TPI for treating myofascial pain is still under study.
What Happens During a Trigger Point Injection?
In the TPI procedure, a health care professional inserts 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 are given in a doctor's office and usually take just a few minutes. Several sites may be injected in one visit. If a patient has an allergy to a certain drug, a dry-needle technique (involving no medications) can be used.
Is trigger point injection right for me?
Trigger point injection may be right for you if your muscle pain has not improved with other treatment, including pain medication and physical therapy.
Trigger point injection can be a great help if you have a painful trigger point, especially when pain radiates from the trigger point to the surrounding area. Trigger point injections may be used as a treatment for conditions such as fibromyalgia and myofascial pain syndrome. However, the trigger points commonly recur with chronic pain syndromes.