The injection consists of the use of a local anesthetic (lidocaine or marcaine) alone or in combination with a strong anti-inflammatory agent such as a corticosteroid like depomedrol. The use of dry needling (no medication use) has also become a popular technique to treat trigger points.
The purpose of this article is to provide you a thorough review of trigger point injections to treat back pain and neck pain.
What Are Trigger Points?
Wikipedia has an excellent review of trigger points and trigger point therapy.
Trigger points, also known as trigger sites or muscle knots, are described as hyperirritable spots in skeletal muscle that are associated with palpable nodules in taut bands of muscle fibers. Trigger point practitioners believe that palpable nodules are small contraction knots[ambiguous] and a common cause of pain. Compression of a trigger point may elicit local tenderness, referred pain, or local twitch response. The local twitch response is not the same as a muscle spasm. This is because a muscle spasm refers to the entire muscle contracting whereas the local twitch response also refers to the entire muscle but only involves a small twitch, no contraction.
The trigger point model states that unexplained pain frequently radiates from these points of local tenderness to broader areas, sometimes distant from the trigger point itself. Practitioners claim to have identified reliable referred pain patterns, allowing practitioners to associate pain in one location with trigger points elsewhere. Many practitioners of chiropractic and massage therapy find the model useful, but the medical community at large has not embraced trigger point therapy. There is no consistent methodology for diagnosis of trigger points and a dearth of theory to explain how they arise and why they produce specific patterns of referred pain.
(Read full article)
Trigger Point Injections Video
Here’s a video presented by Spine Health that describes the process of trigger point injections.
A trigger point injection is an outpatient procedure designed to reduce or relieve the back pain caused by trigger points. These small knots can form in muscles or in the fascia tissue leading to myofascial pain. (Watch video here)
Do Trigger Point Injections Really Help?
The psychological benefits of trigger points to treat back and neck pain are often just as effective as the physical benefits.
Trigger points were first introduced to the medical community over 50 years ago and continue to be a controversial explanation for back pain.
Likewise, the use of trigger point injections as an effective treatment for back pain has not been conclusively established.
In a 2008 study published in Pain Medicine, the safety and efficacy of trigger point injections to treat chronic pain syndromes was investigated. The conclusions from this study indicated:
- Trigger point injections are safe when applied by adequately trained health care providers.
- The net benefit of trigger point injections in the treatment of back pain is questionable.
According to lead author, N Ann Scott, PhD, “The efficacy of trigger point injections is no more certain than it was a decade ago, as there is no clear evidence of either benefit or ineffectiveness.”
The results of this study are consistent with my observations of patients who have undergone trigger point injections to treat back pain. When asked whether the injection therapy was working, the answer I usually get is, “I think so.”
(Read full article)
Do you have additional questions about pain management techniques to resolve your back pain, neck pain, or sciatica? We have a comprehensive list of Patient Guides that discuss specific pain management techniques in detail, including the use of trigger point injections for the treatment of back pain. If you would like access to these informative and easy to understand Patient Guides, just click this link and we’ll make sure you get your copy today. Patients’ Guide To Injections For Pain
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