Trigger Point Injections - Indications and Benefits

Introduction:

Trigger point injections are commonly used. These injections use local anesthesia to relieve the pain of the muscles. These points are palpated on the skin and are the knots of muscle that are contracted and cause pain. Thus they relieve myofascial pain. ‘Myo’ means muscle, and ‘fascia’ means skin layers. The patient will feel pain-free as the local anesthesia starts its effects within 24 hours. The muscle is relaxed. The patient can even go home on the same day of the procedure. But should avoid heavy exercise and work. This article explains trigger points, trigger point injections, their indications, procedures, risks, benefits, and precautions.

What Are Trigger Points or Muscle Knots?

Trigger points are the knots of muscle formed when muscles do not relax. These knots are felt under the skin. These trigger points are painful and sensitive to touch. These knots or trigger points are formed on injury or trauma of the muscle. The trauma can cause stress and contract the muscles, further creating pain in the area. Trigger points also reflect their pain on different sites. Any muscle can form a trigger point for the injury. It can involve muscles of the face, neck, shoulders, and legs. Some of the common trigger points are:

• Masseter Muscle - Masseter muscle is the muscle of the jaw.

• Temporalis - It is the muscle on the side of the head.

• Levator Scapulae - Levator scapulae is the muscle of the neck.

• Trapezius Muscle - Trapezius muscle is the muscle on the back of the neck and shoulder.

• Sternocleidomastoid - It is the muscle on the front of the neck.

• Gluteus Medius - Gluteus medius is the muscle in the hips.

What Are Trigger Point Injections?

The injections delivered to control the pain over the trigger points are the trigger point injections. They are used in myofascial pains, and local anesthesia inhibits the pain in trigger point injections. It is delivered to the muscles. One or two trigger points can cause severe pain, which is difficult to control with oral pills. Thus an injection can be successful in these cases.

What Are the Indications for the Trigger Point Injections?

The trigger point injections are indicated in the following:

• Fibromyalgia - It is a chronic pain condition similar to arthritis but affects soft tissues instead of joints.

• Tension Headaches - Trigger points in the shoulders, neck, and head can cause migraine or tension-type headaches.

• Myofascial Pain Syndromes - Myofascial pain syndrome is a chronic pain condition that affects the muscles and the surrounding tissues.

In cases where any muscle pain treatments, like massage therapy or heat therapy, do not work.

What Are the Points to Note Before the Procedure?

The points to note before the procedure include the following:

• The patient should not have any allergy to the anesthetic drugs.

• The medications that the patient takes regularly.

• The patient should not be on anticoagulant before the procedure.

What Is the Procedure for Trigger Point Injection?

The procedures of the trigger point injections are:

• The doctor can recommend the patient sit or lie depending on the site of the trigger points.

• The skin over the injection site is cleaned with an antiseptic solution.

• The doctor locates the trigger points, and further, marks the skin with a skin marker.

• The doctor will pinch the trigger points with their fingers.

• The needle containing anesthesia is prepared and made to be inserted into the trigger points.

• The doctor repeats the insertion and withdraws the process with the needle without completely removing the needle.

• The doctor continues proceeding the same in different directions.

• The doctor does it until the muscle gets relaxed.

• The needle is removed afterward.

• The patient's pain gets relieved within 24 to 72 hours of use. But once the effect is started, it can last about a month. Sometimes, the doctor can repeat the procedure for better outcomes, but only with local anesthesia.

What Are the Benefits and Risks Related to Trigger Point Injections?

The benefits of trigger point injections are:

• It overcomes the intolerable pain.

• It provides movement over the area which was earlier inhibited by pain.

• The function of the muscle is regained.

Risks related to trigger points are:

• Swollen area.

• Pain over the injection site.

• Bleeding.

• Bruising.

• Infections.

• Allergy to the local anesthesia used.

• Blood vessel injury.

• Dizziness.

What Is the Medication Used in Trigger Point Injections?

Local anesthesia is used in trigger point injections. Lidocaine is a commonly used anesthetic agent. Sometimes, steroids can be used to reduce the inflammation in the muscle and Botulinum toxin A (botox), which prevents muscle contractions.

What Are the Precautions Taken After the Procedure?

The precautions include the following:

• The patient should take complete rest for two to three days.

• The patient should avoid any heat or cold therapy at the injection sites.

• The patient should avoid any heavy work or exercises for a few days.

It is a painful procedure as the trigger points are already sore. Locating and inserting the medication can cause temporary pain. In addition, the needle can cause uncomforted during the process. The doctor should keep the patient as the procedure responds better to pain. The medication can provide a burning sensation also.

Is the Trigger Point Injection Procedure Safe?

Trigger point injections are an entirely safe procedure. It is very commonly performed nowadays to control the chronic pain initiated. Its repeat injections are also performed to control the pain, but without steroids, only local anesthesia is used due to the steroid effect on excessive use. The patient can return home on the same day as the procedure is for a short period and does not require medical attention after performing.

Conclusion:

Trigger point injections are injections delivered on the trigger points to control chronic pain. This procedure mainly eliminates muscle pain. Trigger points are the knots of muscles formed by injury. Therefore, a doctor uses trigger point injections, containing local anesthesia and sometimes a steroid and a Botulinum toxin for better outcomes.