The Science Behind Trigger Point Injections

Commonly called knots, trigger points are actually bundles of contracted muscle that may feel like a knot. Trigger points involve a group of muscle fibers in an area, and they differ from cramps, such as a charley horse, which typically involve a single whole large muscle. 

Trigger points can arise from everyday activities like weightlifting or other strenuous exercise, from being under too much stress, or from sleeping in a wrong position. Often all they need is some rest, ice, and a good massage. 

But when trigger points hang on and won’t go away on their own or with conservative treatments, you may need a little extra help from a trigger point injection. 

Shachi Patel, MD, our board-certified interventional pain management physician here at Delmarva Pain and Spine Center, uses trigger point injections to bring much-needed pain relief to our patients in and beyond Newark, Delaware. Here’s how it works.

Conditions that cause trigger points

We mentioned a few of the common causes of trigger points, but there are also a few more serious physical conditions that can cause, exacerbate, or occur simultaneously with trigger points, such as:

Trigger points don’t always stay in one place. When they spread from location to location throughout your body, it’s called myofascial (“myo” meaning muscle, and “fascial” meaning connective tissue) pain syndrome. 

Understanding the science behind trigger point injections

When rest, ice, and massage therapy haven’t improved your trigger point pain, trigger point injections may be the answer. 

The goal of the injection is to relax the muscle fibers and stop the pain. But trying to understand exactly how and why trigger point injections work is challenging, because even doctors and researchers are still debating the science behind it.

Trigger point injections work for some people and not others. Typically, if it works for you, you know right away, and your symptoms subside for a few days or a few years. If it doesn't work for you, you know that immediately, too.

Trigger point injections: To medicate or not

Trigger point injections may be effective even without any mediation. This is called dry needling (similar to acupuncture), and studies have shown that some people get significant pain relief from it because the needle itself interrupts nerve signals and muscle activity.

But Dr. Patel prefers to use medication known to alleviate the symptoms causing the trigger point and the pain. The main ingredient is corticosteroid, which reduces inflammation, the main pain-causing culprit. This calms the muscle fibers, connective tissues, and surrounding nerves.

Another ingredient is a local anesthetic called lidocaine. Once this floods the area, it instantly blocks pain receptors from sending messages to your brain.

Botox® can also help in some cases, particularly chronic migraines, because it temporarily paralyzes targeted muscles and prevents contractions that can lead to these debilitating headaches. 

Why worry about muscle pain?

If your trigger points are occasional and minor, they’ll probably only be an annoyance and resolve on their own. But if they don't go away, they may multiply (myofascial pain syndrome), complicate other conditions, and confuse your diagnosis.

Trigger point pain can feel like other types of pain, so you may be misdiagnosed.

That’s why it’s important to come in and see Dr. Patel. She specializes in getting to the bottom of your pain, and if it’s a trigger point problem, relief may be just an injection away. Call us today to book an appointment, or request a consultation by clicking here.

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