What is a trigger point?
Trigger points are painful areas of muscle that are tender. They may feel like tight bands or knots when pressed. Pressing on the trigger point will “trigger” pain at the area of pressure and often in other areas. For example, pressing on a trigger point at the top of the shoulder may send pain down the arm or up to the neck.
Trigger points are overactive muscle areas that can come from stress, over using the muscle, problems with the spine or posture. They can often be treated by improving posture, reducing stress, and with exercise. If these treatments do not correct a painful trigger point, your doctor may want to treat the problem with a trigger point injection.
How are trigger points injected?
During the treatment, your doctor will mark the skin over the point, clean the skin, and insert a fine needle through the skin into the trigger point area. This may cause a small “twitch.” It tells us that the trigger point has been reached.
Most doctors will inject a small amount of medicine to numb the trigger area. You may feel some burning at this time. This step is not required but will make you feel better during the rest of the treatment. The action of the needle itself is what causes the trigger point to relax.
Most treatments take about ten minutes because we use an ultrasound to make sure we avoid important vessels and structures. When the treatment is over, a small amount of pressure will be applied to stop any bleeding, along with a bandage.
What are the risks of trigger point injection?
The risks of this treatment depend a lot on what part of the body will be treated. The risk is very small – about the same as it would be for any injection. Some patients have had bleeding or infection. Some patients are allergic to the medicines used. Let your doctor know of any known allergies before any treatment takes place. For some injections, puncture of the lung or other organs with the needle can occur. This is rare, especially with the use of the ultrasound.
How will I feel afterward?
You should feel relief right away after the treatment. The medicine will also numb any pain from the shot. Relief will last 4-12 hours or until the medicine wears off. You may then feel some soreness, as you might after a flu shot. You can stretch the muscle, use ice or cold packs, or take pain medicine to treat this soreness. Ask your provider what you can safely use.
Within 1-2 days, the soreness should fade, but the trigger point relief should last. There should be less pain than before the treatment. While these treatments do not always work, most patients get relief for days, weeks, and sometimes months.
These treatments may be done every few weeks to months, if needed. If treatment is done too often, scars may form.
What else should I do after the injection?
When you are pain free, stretch the treated muscle, perform your exercise program, and take steps to keep the trigger point from coming back.
What about injecting other medicines?
Some doctors use other medicines, such as steroids, during trigger point treatment. Botulinum toxin has been tried for use in trigger point treatment to make the relief last longer. While this seems to be safe, it is not clear how well this drug works on trigger points. Please ask your doctor or other provider for more advice about trigger point injection.
If you are a patient receiving care at UnityPoint – Meriter, Swedish American or a health system outside of UW Health, please use the phone numbers provided in your discharge instructions for any questions or concerns.