The pain relief provided by Trigger Point Injections can last for several weeks or longer.
Knots in muscles, referred to as “trigger points,” sometimes irritate nearby nerves and cause pain that’s felt elsewhere (referred pain). A trigger point injection (TPI) is a pain management technique that may provide relief for patients.
- Best for pain likely caused by knotted muscles that don’t relax
- Often recommended when other attempts for treatment aren’t providing relief
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How They Work
Trigger point injections work by delivering a mixture of a corticosteroid (medication that helps minimize tissue swelling) with saline or a local anesthetic. The injection deactivates the trigger point and provides relief where the pain is felt, not at the site of the injection. The procedure only takes a few minutes. Multiple trigger points in different muscles may be treated.
How Trigger Points are Identified
Before injections can be given, specific trigger points within muscles need to be identified. Diagnosis of trigger points includes a physical examination to feel for tender areas of tight bands and knots in tissues. Images tests aren’t helpful in identifying trigger points, but they may be used to determine if there are underlying issues affecting tissues and nerves.
What Happens During and After Injections
During the procedure, a small needle is inserted into a trigger point that has already been identified. A dry needle may be used if a patient has an allergy to the medications normally used with a TPI. There may be some initial soreness after the injection for a few days. The application of heat and stretching exercises may soothe and relax muscles and ease discomfort until the medication from injection takes effect, which may take a few days. Risks are minimal and potential side effects are mild.
Immediate relief is sometimes experienced and lasts for a few hours because of the numbing effects of the local anesthetic. Corticosteroids may remain in tissues for several weeks or a month or more.
TPIs may provide relief for patients with chronic pain related to irritation of nerves from the inflammation of muscle tissues. Individuals with tension headaches, pain from fibromyalgia, and discomfort related to myofascial pain syndrome affecting tissues around muscles may also benefit from a trigger point injection.
If trigger point injections aren’t effective, other pain management techniques may be recommended. Another examination might be done to determine if there are additional sources of nerve pain other than trigger points causing referred pain. Related treatments that may provide relief include electrical stimulation with TENS units, radiofrequency ablation (RFA), and nerve blocks.
A study involving whiplash sufferers found that many of them reported improved cervical range of motion after receiving trigger point injections. Different studies suggest similar results for patients with other types of muscle-related nerve pain. Individual results will vary with TPIs, although some patients are able to benefit more from other pain management treatments because of the injections and actively participate in physical therapy exercises.