Trigger Point Injections
What Causes Trigger Points?
Trigger points may develop as a result of muscular injuries, strains, and trauma. When muscle fibers, fascia, ligaments, or tendons become weakened, overstretched, or inflamed, the soft tissue can develop tiny tears. As the tissue heals, it contracts and becomes twisted and knotted. These knotted fibers restrict blood supply to the muscle cells. In addition, the muscle fibers may shorten to protect from further injury.
Other factors leading to the formation of trigger points include structural imbalances, improper body mechanics, poor nutrition, and mental or emotional stress. In effect, the muscle learns to avoid pain and protect itself by limiting movement. This results in a loss of range of motion of the joint and increases the risk of developing trigger points in the muscle and surrounding structures.
Who is a Candidate For Trigger Point Injections?
Patients experiencing the following symptoms of fibromyalgia, tension headaches, or myofascial pain syndrome may benefit from trigger point injections:
Deep, aching pain in a muscle
Pain that persists or worsens
A tender knot in a muscle
Difficulty sleeping due to pain
Feeling of tightness or pressure across the forehead or on the sides and back of the head
Tenderness in the scalp, neck, and shoulder muscles
Dull, aching head pain
How to Prepare For Trigger Point Injections
The physician will provide detailed instructions to follow before the procedure. Patients should plan to:
Have someone drive them home after the injection.
Tell their provider about all medications they are taking, including pain medicine, blood thinners, and muscle relaxers.
Pause taking certain medicine for the injection, according to physician instructions.
Tell their provider about all allergies, including allergies to any pain medicine.
What to Expect During Trigger Point Injections
The patient will sit or lie down for the procedure. The physician will then press on the muscle to locate the area in pain and insert a small needle into the area through which a mixture of anesthetic and steroid will be injected.
A bandage will be placed over the injection site to prevent bleeding or an infection.
Several trigger points may be injected during one visit to the doctor’s office. The procedure typically only takes a few minutes.
After The Procedure
Some patients may feel pain relief right away, while others may have pain start again two hours later. An ice pack or over-the-counter pain medicine can help ease pain. Patients may also experience temporary soreness in the injection site for a few days.
The physician will provide specific activity instructions to follow at home or recommend physical therapy to aid recovery. Patients may actively use the treated muscle after the procedure but should avoid strenuous activity for a few days.
Additional injections are not recommended if the patient still has trigger point pain after two or three injections.
Risks of Trigger Point Injections
Side effects from a trigger point injection may include temporary soreness or numbness at the injection site, pain, and bruising. Other more serious and rare complications may include bleeding and infection at the injection site.
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