Chronic muscle pain can develop for various reasons – from sleeping in the wrong to tearing muscles during weightlifting sessions. Although most types of muscle pain subside within a few days of rest, persistent muscle pain usually requires medical treatment since it can significantly impact a person’s ability to function and overall quality of life. Dr. Mandeep Walia-Bhatia uses trigger point injections to treat myofascial pain.
What are trigger point injections?
Trigger point injections are a pain management treatment for myofascial trigger points. This therapeutic modality involves injecting the local anesthetic, sometimes in combination with a steroid medication, into a trigger point to relieve pain. Trigger points are focal knots located in a band of skeletal muscle. They can form from stress on muscle fibers due to acute trauma or repeated micro-trauma.
Trigger points are usually palpable and produce referred pain upon touch. These points also cause pain in the area where they have developed and, occasionally, a local twitch response. Other possible symptoms of trigger points include stiffness and reduced motion range; these points are sometimes associated with chronic disorders of the musculoskeletal system.
While many use trigger points and tender points interchangeably, these two are not synonymous. Unlike trigger points which cause referred pain, tender points denote a focal nodule that produces pain directly under the area of palpitation. You can have more than one trigger point throughout your musculoskeletal system.
When would I need trigger point injections?
Your healthcare provider may recommend this pain management treatment if your trigger point pain has not improved with other treatments such as non-prescription pain medicines, massage therapy, heat therapy, myofascial release, and physical therapy. Trigger point injections are often a wonderful adjunctive alongside physical therapy and stretching exercises. Combining trigger point injections with physical therapy is especially beneficial for individuals who initially couldn’t do physical therapy or stretch due to severe pain.
However, before your doctor recommends this treatment, they will need to perform a thorough physical exam and rule out other possible causes of your pain. For example, trigger point pain can be mistaken for muscle strain, radiculopathy, or issues with your spinal column, like spinal stenosis, herniated disk, or degenerative arthritis.
How do I need to prepare for a trigger point injection?
There are no special preparations before a trigger point injection, but as with any other treatment, you want to consult your doctor. An initial consultation is critical to discuss your current medications, symptoms, and health status.
A trigger point injection procedure
Depending on the trigger point location, you may sit or lie on an exam table. Next, your healthcare provider will use an alcohol pad to cleanse your skin before identifying the trigger point and marking it with a skin marker. After identifying the trigger point and palpitating it, your provider pinches the point between their fingers to stabilize the tissue; you may feel pain or discomfort.
The doctor inserts a thin needle attached to a syringe into the trigger point and rhythmically inserts and retracts the needle without withdrawing it from your muscle or skin. Once the muscle twitching has stopped, the doctor injects local anesthesia, with or without corticosteroid.
Once the treatment is done, you can go home and immediately use the affected muscle, but you want to avoid strenuous activities for the first few days.
If you have muscle pain, consult your provider at Gain Wellness Center to know if you can benefit from trigger point injections.