Trigger point Injections

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What are trigger point injections?

Myofascial trigger points are tender points in muscles, which involve the muscle and fascia (the connective tissue around the muscle) and feel like a nodule, a knot, or a band under the skin.

The exact causes of trigger points are not well understood, but in some cases, they can be explained by an infection or local trauma. Trigger points may develop from acute muscle overload or strain, surrounding joint arthritis, emotional distress leading to tension, fibromyalgia, muscular trauma, and fatigue. This pain also called as myofascial pain may cause significant discomfort and suffering. Consequently, myofascial trigger-point injections can provide relief from muscular pain. Furthermore, treatment of myofascial trigger points may help alleviate tension headaches associated with specific trigger points or may help alleviate some of the pain associated with fibromyalgia.

How are trigger-point injections performed?

During a trigger point injection, you will work with your physician to find the areas of maximal tenderness. For this process, you will be positioned in a way that allows your physician to feel your trigger points best. Then your physician will clean the affected area with an antiseptic and explore the area until a trigger point is identified that corresponds to your pain. A small needle will then be inserted into that trigger point.

A combination of local anesthetic and steroids can then be injected.  Steroids (mostly it is cortisone) are potent anti-inflammatories which can provide a substantial reduction in pain.  The needle will be removed, and a sterile dressing applied.

Trigger point injections side effects

Pain after trigger point injections. A potential complication from the trigger point injection procedure is a post-injection pain. This is relatively uncommon, but it can occur. This pain usually resolves after a few days. Ice, heat, or over-the-counter medications such as acetaminophen, ibuprofen, or naproxen may be helpful for post-injection pain.

Shrinkage of the fat under the skin. If a steroid medication is injected into the trigger point, there is a risk of shrinkage of the fat under the skin, leaving a dent in the skin. This does not occur when the only anesthetic is injected without any steroid medication. Other side effects are rare and associated with complications of all needle punctures, including infection and bleeding.