Myofascial trigger points are “knots” located in taut bands of skeletal muscle and the connective tissue that surrounds them. They can develop due to acute trauma or repeated micro-trauma placing stress on the muscle fibers. These trigger points cause pain, stiffness, decreased range of motion, and referred pain upon palpation.
Trigger point injections, a form of pain therapy injection, can inactivate trigger points, improving range of motion and overall function without over-the-counter pain medication, effectively breaking the pain-tension cycle with minimal side effects.
How do Trigger Point Injections work?
Trigger point injections can temporarily relax the taut muscle cord, allowing better blood flow to the area. Extra blood flow allows nutrients to reach the area more easily and waste materials to be removed more efficiently.
The injections may contain corticosteroids, local anesthetics, or botulinum toxin. They may also be performed without any liquid injected into the area in a technique called “dry needling.”
What do Trigger Point Injections treat?
Trigger point injections commonly target painful myofascial pain in certain muscle groups including:
- The hip
- The jaw
- The groin
- The lower back
- The side of the neck
- The neck and shoulders
Targeting trigger points in the trapezius, a muscle running along the neck and shoulders, may relieve tension headaches. And a trigger point injection into the piriformis muscle can relieve pressure on the sciatic nerve, relieving pain and numbness in the buttocks and back of the leg.
How often are Trigger Point Injections given?
Trigger point injections typically relieve pain for about a month; more injections may be needed for long-term relief.
What are the potential complications of Trigger Point Injections?
Potential complications from trigger point injections include:
- Pain
- Bleeding
- Infection
- Hematoma
- Injury to blood vessels
- Allergic or toxic reaction to the anesthetic
The dry needling technique can cause syncope, hemorrhaging, or hematoma at the injection site. In rare cases, pneumothorax can occur if the needling is administered near the lungs.
Are there any contraindications for Trigger Point Injections?
Trigger point injections should not be performed under certain conditions, such as:
- Open skull in the area
- Infection over the injection site
- The area is not safely accessible by a needle
Cautions should be taken before administering trigger point injections in certain situations:
- Poorly controlled psychiatric disorders
- Patient is taking anticoagulants
- Allergies to the local anesthetics
- History of keloid scar formation
- Severe fibromyalgia
- Pregnancy
Conclusion
Trigger point injections can effectively treat myofascial pain, providing significant pain relief and improving mobility. While generally considered safe, potential complications and contraindications should be carefully considered before injection administration.
How do trigger point injections compare with other injection therapies for pain control? Check out our Summary and Comparison Chart.
Sources:
- Trigger Point Injection – StatPearls – NCBI Bookshelf (nih.gov)
- Trigger Point Injections (TPI): What They Are & Procedure (clevelandclinic.org)
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