Perhaps you have heard of trigger point injections (TPI) as a way to address chronic muscle pain and have been curious as to how the process works. Trigger point injections are utilized to manage myofascial pain syndrome. This is a painful musculoskeletal disorder that causes small tight knots (trigger points) to develop in the fascia tissues or muscles, most commonly present in the neck, shoulders, scapula, or lumbar spine. Occasionally pain can be experienced in various other areas of the body (this is described as “referred pain”). They can even mimic nerve pain occasionally.
At EmergeOrtho-Triangle Region, our Interventional Pain Management Team physicians provide an injection for muscle pain called trigger point injections. Additionally, our Physical Therapy Team provides a similar variation of a TPI injection called “dry needling,” which we will explore in more detail later.
When other conservative approaches have failed to alleviate chronic pain, such as heat, physical therapy, and muscle relaxant medications, trigger point injections can be a promising solution. Learn more about this process and how it might help to relieve your myofascial pain.
What Are Trigger Point Injections?
Pain resulting from myofascial trigger points ranges from a 30% to 93% prevalence rate among patients. As we mentioned earlier, trigger points consist of small knots of skeletal muscle fibers. When compressed, these knots can cause referred pain and poor range of motion in the body. Some of the potential ways that trigger points develop include:
- Repetitive stress to the muscle
- Leg-length inequality
- Joint disorders
- Vitamin deficiency
- Posture problems
- Extensive inactivity
- Sleeping issues
- Muscle-tissue injuries (post-viral syndrome or whiplash, as examples)
Your pain management physician may recommend trigger point injections to relieve pain when other conservative treatments have failed. To perform this procedure, your doctor may:
- Locate the trigger point by physical touch
- Utilize ultrasound guidance to avoid complications from nearby structures
Finally, they will cleanse and disinfect the treatment site and then insert the needle into the affected areas of the muscle. Trigger point injections are often performed in the clinic as an outpatient procedure, typically only taking minutes to complete.
What is in a Trigger Point Injection?
Your doctor can tell you exactly what is in your injection. Some of the typical ingredients include:
- Saline solution
- Local anesthetic
- Corticosteroids
- Botulinum toxin (BOTOX)
However, a common misconception about trigger point injections is that the injectate is what is therapeutic. Rather, it is the manual needling and “breaking up” the taut bands of muscle is what restores blood flow and decreases inflammation and pain at the trigger point.
Is Dry Needling the Same Thing as a Trigger Point Injection?
Dry needling is considered an adaptive type of trigger point injection. A thin filiform needle is used to stimulate trigger points to release tension in the muscle, fascia, and connective tissue. Unlike a TPI, it does not inject any substance into your body but can still help with pain relief.
Because of the use of the thin needle, people can tend to link dry needling and acupuncture together. However, acupuncture’s focus is releasing and promoting the flow of energy, unlike dry needling, which focuses on reducing muscle pain.
What to Expect After Trigger Point Injections
After receiving your trigger point injections, your doctor will likely recommend physical therapy exercises and stretches to help maximize the results of your injection and further ease your pain and discomfort.
It is normal to have some bruising, tenderness, soreness, and pain while you heal from the treatment.
The main muscle groups that benefit from trigger point injections include:
- Neck
- Shoulders
- Thoracic back / periscapular
- Lower back
Are Trigger Point Injections Right for You?
The best way to know if an injection could help with your trigger point pain is to have a consultation with one of our board-certified, EmergeOrtho-Triangle Region pain specialists or physical therapists (for dry needling). To learn more, self-schedule an appointment now. Or, call us any time at (919) 220-5255.
