Introduction

A trigger point is a small area in a muscle that is very sensitive to touch or pressure. It can be extremely painful. Injury, overexertion, muscle tension, and muscle spasms are common causes of trigger points. They most frequently occur in the neck, back, and shoulders. Trigger point injections relax the muscle and relieve pain by placing medications in the trigger point.

Anatomy

Your muscles contract and relax whenever you move. If a muscle does not relax completely, a very tight band of muscle fibers can spasm and form a trigger point.

Causes

Traumatic injury, overexertion, muscle tension, muscle spasms, pinched nerves, and hormonal deficiencies are common causes of trigger points.

Symptoms

A trigger point can cause extreme pain. It may feel tender, hard, or twitch when you touch it. In some cases, a trigger point can irritate surrounding nerves causing pain to spread to nearby areas (referred pain). Your pain may limit your ability to move comfortably.

Diagnosis

You should tell your doctor about your symptoms and any activities, injury, or conditions that you suspect may have contributed to your problem. Your doctor will examine you by carefully feeling the muscle area. The muscle may be gently pressed to identify areas of referred pain.

Treatment

Therapeutic modalities, such as ultrasound and manipulative therapy, can be beneficial for some people. However, trigger point injections are considered the most effective way to inactivate a trigger point for prompt symptom relief. The injected medication usually consists of an anesthetic to relax the area and relieve pain. A steroid medication is sometimes included in the injection.

Trigger point injections can be administered at a doctor’s office. The treatment time is short, usually lasting several minutes. You may receive a nerve block or local anesthetic prior to your trigger point injection to prevent pain. To deliver the trigger point injection, your doctor will insert a small needle into the trigger point and inject the medication.

You will be provided with instructions to reduce initial pain and swelling at the treatment site. Trigger point injections are usually followed by physical therapy aimed at pain relief and muscle stretching. In some cases, trigger point injections may be repeated.