A trigger point injection is a simple office procedure. The doctor performs this treatment to alleviate the pain associated with painful conditions such as myofascial pain syndrome and fibromyalgia.
Trigger points are localized painful body areas that are associated with inflammation and muscle spasm. Trigger points occur on the neck, back, shoulders, and buttocks. The two common muscles are the rhomboid of the upper back and the trapezius of the shoulder region.
The doctor will ask you questions about your pain, and take a detailed medical history. During the physical examination, the doctor can feel a “knot” or lump where the trigger point is located. When compressed, these points often produce localized and referred pain.
Trigger points are either active or latent. Active trigger points are painful even at rest, and they are tender to palpation. Pain associated with active trigger points often radiates (spreads) to other areas of the body. Latent trigger points are not painful at rest, but produce pain with movement. These often lead to decreased range of motion of the affected muscle.
Trigger point injections are used to treat:
Neck pain – This can be related to degenerative disc disease, whiplash, spinal stenosis, and spinal arthritis.
Low back pain – This can be related to a herniate disc, degenerative disc disease, facet joint syndrome, and spinal stenosis.
Myofascial pain syndrome – This chronic condition involves tender muscle nodules, difficulty sleeping, and a deep aching pain.
Fibromyalgia – This is a disorder characterized by widespread muscle pain and multiple trigger points. Patients with this condition also suffer from depression, anxiety, and headaches.
Headaches – Tension headache is the most common type of head pain. The pain begins in the back of the neck and moves up the head. Patients report a band-like sensation around the head.
Temporomandibular joint disorder – The jaw joint develops arthritis or can be injured. With this pain, the muscles on the side of the face contract and spasm.
Depending on the condition, the doctor can use an anesthetic (lidocaine or bupivicaine), a corticosteroid (triamcinolone or dexamethasone), or Botox (botulinum toxin A). The goal of treatment is to reduce pain, and a combination of medicines may be required.
The trigger point injection involves insetting a needle directly into the trigger point. It is not uncommon for several trigger points to be injected during a treatment session. The doctor will first use an antiseptic to clean the skin. Ultrasound guidance is often used to located the trigger point. The procedure is done with the patient lying or sitting. Before the injection, the skin may be first numbed with a topical agent. The needle is inserted, and the medication is injected. A small band-aid is then applied to the injection site.
After a trigger point injection, the site will be tender and a little sore for 1-2 days. You can use ice packs a few times each day or take acetaminophen for the pain. Depending on which medication is used, side effects include:
Lidocaine – Prolonged numbing, itching, and rash.
Corticosteroid – Weight gain, mood swings, and irritability.
Botox – Muscle paralysis, pain at the site, and soreness.
In a recent clinical study, 100% of patients reported some form of pain relief following trigger point injection. Of these participants, 58% reported complete pain relief.