A trigger point is a sensitive or irritable spot in the body that can be a main or associated source of pain when muscle fails to relax. It is a small area in a muscle, which when pressed or touched causes pain in other parts of the body. These tender points usually feel like knots or ropy bands, and can be felt under the skin and may twitch involuntarily when touched (called a jump sign).
The trigger point can trap or irritate surrounding nerves and cause referred pain (pain felt in another part of the body). Trigger points can cause bands of pain radiating quite a distance from the actual trigger spot. Because of this, trigger points can imitate pinched nerves. They can arise because of strain or repetitive use injuries, stress and muscle tension conditions, or specific disorders such as fibromyalgia, herniated discs, pinched nerves, fractures, and surgical incision healing sites. Many of the aches and pains attributed to fibromyalgia or “old age” may actually be due to trigger points and may be reversible.
SYMPTOMS OF TRIGGER POINTS
TRIGGER POINT INJECTIONS
Trigger point injections are a specific type of local injection used to alleviate chronic pain involving tissue around muscle that does not respond to other treatments. Many muscle groups, especially those in the arms, legs, lower back, and neck, are treated by this method. Trigger point injection can also be used to treat fibromyalgia and tension headaches. The injections are given in the soft tissue of the body, not into blood vessels, nerves, joints, or the spinal canal.
Injections may be given in sessions one to two weeks apart. In some cases, you may not feel much change in your symptoms until after the third injection.
Common medications used in trigger point injections can include local anesthetic, normal saline, and small doses of steroid medications. Research has demonstrated that just the local placement of the needle can help with muscle spasms, similar to acupuncture. The volume of the solution can affect the muscle spasm as well, and often times the injections of normal saline can be helpful for pain.
Utilizing a local anesthetic to numb the region of pain can help break the cycle of pain. A small dose of steroid medication at the site can help decrease inflammation of muscles as well.
Your physician may choose a combination of the above medications, depending on your symptoms and response. In addition, he or she may give more than one injection at various sites, depending on examination findings of trigger points.
Source: Prairie Spine and Pain Institute, Dr. Richard A. Kube II, MD.