Trigger Point Injections

While chronic pain can be devastating enough to deal with, not knowing the exact source or location of pain is another headache that some patients have to deal with. Sometimes pain can be pinpointed to a particular muscle, while other times it can originate from a muscle but can be felt in other parts of the body. For these instances, trigger point injections could finally provide the relief the patient is looking for. The California Pain Consultants team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas is well equipped to help those dealing with chronic pain by providing accurate diagnosis and treatment. 

What is a Trigger Point Injection?

First, what is a trigger point? A trigger point is a localized, tender spot within the muscle that most people describe as feeling like a tight knot. They may form due to an isolated traumatic event, or from repeated smaller, stressful events, such as heavy weightlifting. 

Trigger points can be minor and resolve on their own. However, if they don’t go away, they could possibly multiply, complicate other medical conditions, and confuse your pain diagnosis. 

They are very sensitive to touch and pressure, and can even be felt when the muscle is rubbed. The reason why trigger points are so painful is because they involve the body’s fascia. 

Fascia is a thin casing of connective tissue that completely surrounds every organ, blood vessel, bone, nerve fiber and muscle and holds it in place, providing internal structure. Due to the fact that this tissue is highly sensitive, when it becomes stressed, it tightens up or becomes constricted. This particular spot is known as the trigger point. Not only can this particular point cause pain in the immediate area, it can also cause referred pain, meaning that it can lead to pain being felt in other areas of the body. This is because a tightness in one muscle, for example, will lead to the person overcompensating in another muscle to make up for the restricted movement where the trigger point is located. 

A trigger point injection (TPI) can help relieve myofascial pain (chronic pain that stems from one area of the body but is felt in other non-related areas), especially in your neck, shoulder, arms, legs and lower back. The goal of the trigger point injection is to help provide pain relief into one particular, targeted muscle or area of the fascia where the person is experiencing pain and lack of movement or normal functioning, as well as any other referred areas. 

While trigger points can occur in any muscle, the most common muscles are those in the jaw, side of the neck, hip, low back, neck/shoulders and side of the head. In fact, more than eight out of 10 people can expect to experience painful trigger points at some point in their life. Treatment includes stretching and physical therapy exercises, as well as possibly trigger point injections. 

The procedure itself is the injection of an anesthetic, usually lidocaine or procaine, with or without a corticosteroid, directly into the trigger point. Some providers might opt for multiple injections in the same area to provide complete coverage. 

What Do Trigger Point Injections Treat?

The most common reason for a patient receiving a trigger point injection is to find relief from myofascial pain syndrome. Myofascial pain syndrome is a chronic pain disorder that occurs when pressure is applied on trigger points but is felt elsewhere in the body. Those who suffer from this syndrome report feeling deep and aching pain in a muscle that persists or worsens with time, a tender knot in the muscle that hurts when touched, as well as difficulty sleeping due to the pain. While the exact cause of myofascial pain syndrome isn’t fully understood, potential causes include autoimmune conditions, cancer and cancer treatment that possibly leaves damaged health fascia, muscles or tightened muscle tissue. 

Trigger points can also be linked to a range of other conditions and health factors, including: 

• Muscular trauma
• Muscular fatigue
• Sudden muscle overload
• Decrease in temperature in the particular muscle affected
• Emotional distress
• Gall bladder diseases
• Arthritis
• Fibromyalgia
• Nerve damage (radiculopathy) in the back that leads to tension
• Herniated disc
• Spinal stenosis

What Does a Trigger Point Procedure Involve?

A trigger point procedure is a minimally-invasive and quick procedure that is performed in your doctor’s office. Depending on the location of the trigger point, the patient will either sit or lie down. With the help of an ultrasound, the provider will accurately pinpoint the exact location of the trigger point before applying a topical anesthetic to the skin above the targeted area. Then the injection of an anesthetic and possibly a corticosteroid will be administered into the muscle or area where the trigger point is located. While single injections are common, there are instances where multiple injections are needed to completely treat the entire area of the trigger point. Depending on the amount of injections, the entire procedure could take up to an hour. 

Most patients experience pain relief within 24 hours or it could take up to three days to feel the full effects of the injection. It’s recommended to rest for the first day, and do light stretching exercises the following day, which help to achieve a better result. Pain relief generally lasts for about a month, but if pain is still felt after this time, additional injections might be needed for long-term relief. 

Risks are minimal and include bleeding or infection around the injection site. There is also the possibility for temporary muscle spasms or pain when the injection is first administered. The effects of the medication itself can include numbness, temporary headache, and sensory issues. 

If you are suffering with painful trigger points in your muscle(s) that are causing chronic low back and neck pain, please reach out to the California Pain Care team in the Escondido, El Centro, La Mesa, San Diego, Chula Vista areas and schedule an appointment today. Not only can our team expertly treat your trigger points, we can also properly diagnose any underlying medical conditions that could be causing your trigger points.