Skeletal muscles can sometimes develop tight or knotted spots that cause pain in the absence of any other type of damage. Strain or overuse of muscles can cause these, as well as emotional stress. In other cases, they might arise as a symptom of a different pain condition, such as fibromyalgia or whiplash. A better understanding of the injections commonly used to treat these will help you make decisions for your own pain management.
Injections are often combined with other treatments:Particularly when these points appear in patients with conditions such as headache disorders, injections may be used as one element of a treatment plan. For example, manual therapy to stretch the muscles, or other types of physical therapy, may be used as well.
They can be given dry, with no medication: The injections may contain saline, local anesthetics, or corticosteroids. More recently, botox has been used as a treatment option. Anesthetics are generally used in low doses, and steroids given infrequently in the same place, in both cases out of safety concerns. Studies on dry injections with no medication have been reported to show a comparable success rate, although further research may be needed.
Medical imaging can be part of the diagnostic process:Recent studies have suggested that MRE, or magnetic resonance elastography, imaging can locate tension in muscle tissue. Other tests, including CT and MRI scans, may be administered as part of ruling out other potential causes for pain along with getting a more complete picture of what may be causing your problem.
Injections should be followed up with stretching and pressure: As mentioned, trigger point injections are sometimes used in conjunction with types of manual or physical therapy. Although you should avoid strenuous activity for the first few days after your injection, regular stretching of the muscle in the treatment area can help to resolve the pain. A doctor will be able to give you advice on how best to do this.
Treating one trigger point may treat another connected one, but not always: A key trigger point is one connected to a nerve pathway that activates another satellite. In this case, treating the key will likely also treat the satellite. A primary trigger point, on the other hand, is connected to a secondary one biomechanically rather than neurologically. Treating the primary site will not treat the secondary.
Trigger point injections carry some minor risks:As with other types of injections, there is some chance of infection or other tissue damage. Injections in certain spots in the upper back may cause some risk of collapsed lungs, and there are common points in the lower back near the kidneys that carry the risk of organ damage if poorly done.
Your pain management provider can give you further advice if you think trigger points in your muscle tissue may be causing you pain. Although commonly used for mysofacial, head, and neck pain, this type of treatment can be useful for conditions in other areas of the body.