1. What are Trigger Points?

If you’re suffering from muscle spasms and inflammation in a localized area, you may be suffering from trigger points. Trigger points can occur in various regions of the body. Common sites for these tender points include the upper back and shoulder regions. They are common in the lower back, neck and extremities. Trigger point injections can help provide pain relief in these areas by inactivating the trigger point (relaxing the muscle, reducing inflammation, desensitizing the nerves), thereby reducing pain. Similar to massage therapy on a specific site of pain, or acupuncture treatment.

Trigger points are usually associated with a nodule or lump at the site of pain, which is a localized area of inflammatory tissue or build up scar tissue. With direct pressure, these trigger points are painful and can sometimes limit function. Trigger points are classified as being either active or latent. Active ones cause pain at rest. They are also tender to palpation and produce a referred pain pattern. You may feel this as radiating or spreading pain to others areas of your body. Conversely, a latent trigger point does not cause immediate pain, but may restrict movement and cause muscle weakness over time. Patients with trigger points commonly present with regional, persistent pain that often results in decreased range of motion of the affected muscle.

Trigger points are commonly associated with chronic pain disorders, low back pain, neck pain, fibromyalgia, myofascial pain syndrome, headaches and extremity deformities. Repetitive minor injuries or acute traumatic events can lead to the development of trigger points.

2. What are Trigger Point Injections?

A trigger point injection involves a precise injection of a particular agent directly into and around the trigger point. At our clinic we utilize numerous agents, such as local anaesthetic (Xylocaine, Bupivicane), corticosteroids, biological agents (PRP, Stem Cell), Botulism Toxin A, and various prolotherapy agents.

The anesthetic medication can help block pain receptors within the nerves that surround the muscle, which helps to reduce pain signal transmission to the brain. When a corticosteroid is also injected, it helps to reduce inflammation and swelling of the tissue surrounding the nerve. The pain relief experienced following these injections varies among patients. Sometimes it is recommended to receive a series of injections.

3. How are Trigger Point injections performed?

Trigger point injections are performed in an outpatient setting with universal sterile precautions, and the trigger points are localized using palpation and/or ultrasound guidance.. The patient may also indicate where there pain may be originating from. The desired agent is injected in and around the trigger point site with image guidance as needed. The procedure is generally less than 10 minutes to perform. The patient is required to rest after the injection prior to leaving the clinic and will schedule a regular follow up appointment.

4. How do I prepare for the injections?

Before you receive a trigger point injection, it is beneficial to stretch the involved muscle groups. After the injections, you should immediately perform the exercises once per hour for the remainder of the day. Moist heat can help reduce the pain and loosen the muscle to help with the stretching.

5. How long do the benefits of the injections last?

Trigger point injections are just one component of your overall treatment program, which may also include physical therapy and regular home exercise. If those regimens are faithfully followed, a single series of injections is more likely to provide long-lasting benefit. Some people may require additional injections.

6. Trigger point injections side effects and recovery

After a trigger point injection, the area may be tender. Patients can apply ice or heat to the tender area to help. You may also want to take acetaminophen or non-steroidal anti-inflammatory drugs (NSAIDs), if needed for pain control.

It is encouraged to remain active after the procedure in an effort to put the affected muscle through its full range of motion in the week after the injection. However, do refrain from strenuous activity, particularly for the first three to four days after the injection.
Trigger point injections side effects are rare, but include infection and bleeding. Depending on the agent used, specific side effects may occur, please speak to our health care team about your treatment.