Trigger Points

Trigger points are sensitive areas that are present in muscles, which when overstimulated, leads to pain or discomfort. They are small knots that feel like a taut band and when extra pressure is applied to these trigger points, the muscles become painful and irritated. Trigger points can also affect the areas surrounding the muscle; this kind of pain is known as referred pain. Trigger points can develop on any part of the body but most often, they occur in the lower back, neck and shoulders.

There are two types of trigger points – active and latent. Active trigger points cause pain when the patient is at rest and are tender when pressed with enough pressure. Latent trigger points don't lead to continuous pain, but can cause the muscle to feel weak. They are discovered only when direct pressure is applied to the trigger point.

How do Trigger Point Injections work?

During the procedure of a Trigger Point Injection, the patient is injected with an anesthetic, a combination of anesthetics or a corticosteroid directly into a trigger point. Often, physicians inject only the needle without any medication, a procedure which is known as dry needling. Either way, it deactivates the trigger point and alleviates the pain.

The procedure is quite simple. The patient is first examined by the physician, who determines the painful trigger points and makes a physical mark to identify them. He/she then cleanses the area with an anesthetic and inserts the needle, injecting the trigger point with the medication, if any. The patient may feel a slight discomfort due to the injection, which will not last for more than a few minutes. A small bandage can then be applied to the area. Trigger Point Injections usually resolve the problem after one procedure but in certain cases, when the patient has conditions like fibromyalgia or myofascial pain, then the frequency of the injections need to be increased as required.

After-effects and complications

While remote, Trigger Point Injections do have a few potential complications and if they arise, the physician should be informed immediately. Some of them include:

• It is possible that the patient may experience pain post-injection. The pain disappears by itself after a few days, but to help the process go faster, the patient can use an ice pack, a hot water bottle, get a massage or use mild pain medication like Ibuprofen. This occurs more often after dry needling.

• If corticosteroids are injected into the skin, the steroids in the medication can reduce the fat in the skin, leading to a mild dent.

• Bleeding or infections can also occur, but these are very rare and hardly take place.