Trigger points are specific places on the body where muscle fibers become tight due to stress or injury. This condition of the muscle fibers is sometimes referred to as a muscle knot, and can usually be felt under the skin as a raised bump or nodule.
Typically these trigger points will be sensitive or tender to the touch or when pressure is placed upon them, and the tenderness or pain can even extend outward a certain distance from the trigger point. Sometimes pressure on the trigger point will elicit a muscle twitch in the related muscle fibers.
Myofascial pain syndrome is characterized by chronic pain in which compression of a person’s trigger points leads to pain in seemingly unrelated areas of the body, called referred pain. Among the forms of treatment for this disorder are massage therapy, or manual therapy, topical sprays and trigger point injections.
Trigger point injections have been shown to be one of the most effective treatments for inactivating trigger points and providing patients with pain relief.
For a trigger point injection, the doctor will clean the area where the needle is to be inserted. Usually the patient will be asked to stop taking any medications that have blood-thinning effects; this is to prevent excessive bleeding at the injection site.
The patient will be asked to sit or lie in a comfortable position to relax the muscles, and then the physician will insert the needle into the trigger point and release an anesthetic to alleviate pain.
At the moment of injection, the patient may experience a sensation of pressure, a temporary sharp pain as the needle penetrates the tight muscle fibers, or muscle twitching.
Often it will be necessary to administer a few injections in the same area during the same treatment to ensure all the tender areas have been relieved. Overall, the treatment lasts only a few minutes and recovery time is typically very short.
Following the injection, patients are instructed to protect the injection site, and to keep it clean to prevent infection and bleeding. Doctors will also encourage patients to remain active (not strenuous activities) following the injection to stretch the affected muscle, to prevent it from becoming knotted again, and to maintain a healthy range of motion.
Because the bands of muscle at the trigger point are often very taut or tense, often the insertion of the needle alone will ease the tension in the patient’s muscles and the injection of a substance will not be necessary. This is called “dry needling.”
While dry needling and trigger point injections have been found to be nearly identical in effectiveness when it comes to relieving patients with symptomatic active trigger points and patterns of referred pain, the post-injection recovery may be different. Some patients have found that the soreness following dry needling was longer lasting than that associated with the injection of an anesthetic.
Acupuncture, a practice that includes the insertion of very thin needles into certain points in the body, seems similar in practice, but is a different method of treatment and does not include any injections. Acupuncture, whose origins are in traditional Chinese medicine, has been used in western medicine to treat pain, disease, disorders and other conditions, including to improve the symptoms of patients suffering from myofascial pain syndrome.
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