Trigger Point Injections
What Is A Trigger Point?
Trigger points are painful areas of muscle that are tender and may feel like tight bands or knots when pressed. Pressing on the trigger point will “trigger” pain at the area of pressure and often in other areas. For example, pressing on a trigger point at the top of the shoulder may send pain down the arm or up into the neck.
Trigger points are overactive muscle areas that can come from stress, using the muscle too much, or problems with the spine or with posture. They are most often treated by improved posture, reduced stress, and exercise. Sometimes, these treatments will not correct a painful trigger point, and your doctorr may want to treat the problem with a trigger point injection.
How Are Trigger Points Injected?
When doing this treatment, your doctor will mark the skin over the point, clean the skin, and insert a fine needle through the skin into the trigger point area, causing a small “twitch”. You may be able to feel this twitch. It tells us that the trigger point has been reached.
Most doctors will then inject a small amount of medicine to numb the trigger area, and you may feel some burning at this time. This step is not required for the trigger point treatment, but will make you feel better during the rest of the treatment. The action of the needle itself is what causes the trigger point to relax.
Once the numbing medicine is given, your doctor will move the needle gently in and out of the trigger point area, changing direction many times to make sure it is all treated. If you feel a lot of pain or if a twitch occurs again, the doctor may numb the area before going on.
Most trigger point treatments take 1-2 minutes. When finished, a small amount of pressure will be applied to stop any bleeding, and a bandage or other dressing may be applied. Your provider may also spray your skin with a cooling spray to reduce any pain on the top of the skin. He may ask you to stretch the treated muscle.
What Are The Risks Of Trigger Point Injection?
The risks of this treatment depend a lot on what part of the body will be treated. The risk is very small – about the same as it would be for any injection. Some patients have had bleeding or infection. Some patients are allergic to the medicines used. The doctor should be told of these allergies before any treatment takes place.. For some injections, puncture of the lung or other organs with the needle can occur, but is very rare.
How Will I Feel Afterward?
You should feel relief right away after the trigger point treatment, as the medicine will numb any pain from the shot. This relief will last 4-12 hours or until the medicine wears off. You may then feel some soreness, as you might after a flu shot. You can stretch the muscle, use ice or cold packs, or take pain medicine to treat this soreness. Ask your provider what you can safely use.
Within 1-2 days, the soreness should fade, but the trigger point relief should last. There should be less pain than before the treatment. While these treatments do not always work, most patients get relief for days, weeks, and sometimes months.
These treatments may be done every few weeks to months, if needed, but scars may form if treatment is done too often.
What Else Should I Do After The Injection?
When you are pain free, use the time to stretch the treated muscle, perform your exercise program, and take any other steps that will keep the trigger point from coming back.
What About Injecting Other Medicines?
Some doctors use other medicines, such as steroids, during trigger point treatment. None of these medicines has been shown to work better than a needle alone or a needle with local numbing medicine. Botulinum toxin has been tried for use in trigger point treatment to make the relief last longer. While this seems to be safe, it is not clear how well this drug works on trigger points.
Please ask your doctor or other provider for more advice about trigger point injection.
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 06/21/2010
Copyright © 06/21/2010 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#6370
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