What Are Trigger Point Injections?
Trigger points are so-called knots in the muscles that cause pain. They are not literally knots—rather, they’re thought to be contracted areas of a muscle (as opposed to a muscle that is wholly contracted, which is a cramp). The spreading of trigger points is known as myofascial pain syndrome.
Trigger point injection is a term for various forms of trigger-point treatment. Trigger points are identified, and needles—with or without certain medications—are inserted into them. The goal is to either get the muscle to relax or to relieve the pain caused by trigger points with medication.
Common Reasons for Trigger Point Injections
Trigger point injections can be used to treat a variety of painful conditions. Some of these include:
- Back pain
- Cervical radiculopathy
- Lumbosacral radiculopathy
- Hip pain
- Myofascial pain syndrome
- Migraines and tension headaches
- Neck pain
Candidates for Trigger Point Injections
Trigger point injections are not usually the first line of treatment. Generally, a patient will have tried other options first for their condition(s), such as:
- Heat or ice therapy
- Over-the-counter pain relievers
- Physical therapy
- Resting the painful body part
For some conditions, trigger point injections can be an intermediate step between conservative treatment and surgery. People with active infections should not undergo trigger point injection therapy, and those with bleeding or clotting disorders, or who take anticoagulant medications, should be evaluated and approved before having trigger point injections performed.
There are multiple variations of trigger point therapy, but all involve inserting a needle into a trigger point. Trigger point injections are usually either some form of anesthetic such as lidocaine, a corticosteroid or a mix of an anesthetic and a steroid.
In some cases, a needle is inserted into the trigger point but no injection is used. This is known as dry needling. While scientific studies on the effectiveness of dry needling have been mixed, overall the weight of the evidence suggests that dry needling is more effective than a placebo. Researchers are not entirely sure why dry needling may work but believe the needle insertion may disrupt painful muscle or nerve action.
The process, whether for dry needling or injection (no matter the substance being injected) is similar for all types of trigger point injection therapy. The patient will sit or lie down. The skin will be cleaned with an antimicrobial solution, then the healthcare provider will insert the needle into the tender area. The procedure is usually very quick, with minimal pain.
There is no significant recovery time related to trigger point injections. The procedure is done in an office setting, as opposed to a hospital or surgical center. Side effects can include bruising and irritation at the injection site or muscle stiffness.
Relief from the pain caused by trigger points can last anywhere from a few days to a few months. The results of trigger point therapy can be difficult to predict and often vary from patient to patient.
Trigger point injection effectiveness can depend on:
- The overall health of the patient
- How long he or she has had a trigger point causing pain
- How well the patient tolerates any medication injected
- Whether trigger points are part of a more overarching health concern