What is a Trigger Point Injection?

October 17, 2022

A Trigger Point Injection is a low risk pain management treatment used to reduce pain and promote healing of muscle tension and joint conditions. These injections are a mixture of Lidocaine and a corticosteroid that is injected directly into the site of pain to provide immediate pain relief and reduce inflammation, allowing the body to return to normal function. Unlike other anti-inflammatory treatments, like NSAIDs including Advil and Aleve, these injections treat the targeted source of pain and inflammation to stop it in its tracks and allow the body a chance to repair the damaged tissues.

What is a Trigger Point?

Trigger points are focal points in muscles that are prone to irritability and chronic tension when a muscle contracts. These focal points, also called “knots”, become activated in response to:

  • Stress and tension
  • Poor posture
  • Disturbances in sleep or sleeping in a certain position for too long
  • Injury to the muscle or surrounding structures (joints, tendons, ligaments, etc.)
  • Overuse of the muscle
trigger point

Trigger points can occur in different muscles throughout the body, and are accompanied by their own characteristic symptoms, including:

  • Persistent pain that can spread to the surrounding area - often caused by the inflammation of pain receptors in surrounding tissues
  • Decreased range of motion/mobility - often caused by the pain associated with movement or the constant muscle contraction of the knot
  • Disruption of nutrient-rich blood flow through body - they can act like a “road block” for blood vessels
  • Uncontrollable muscle twitching - this is the body’s reaction to the contracted “knot” to try to stimulate the muscle tissue to release the tension
  • Localized autonomic phenomena
    • Vasoconstriction - the constriction of blood vessels, preventing the flow of blood through them
    • Pilomotor Response - the involuntary contraction of arrectores pilorum muscles (the tiny muscles located at the base of each hair follicle) which results in the hair rising, A.K.A “goosebumps”
    • Hypersecretion - excessive secretion of hormones or chemical substances including inflammation-causing chemicals

What is an autonomic phenomena?

The part of the nervous system that is responsible for involuntary bodily functions or responses is known as the Autonomic system. This system controls basic survival functions like breathing, digesting food, changing heart rate and blood pressure, and reactive responses. The “Flight or Fight” response is an autonomic reflex. For example, when a person unknowingly touches something extremely hot or cold, before the brain gets a chance to process the touch sensation as pain, an autonomic reflex response occurs and the person pulls their hand away.

When a trigger point in a muscle becomes activated, it can trigger autonomic responses that aren’t necessary, which is why they are called phenomena. Blood vessels in the area can constrict, blocking the flow of nutrient-rich blood through the area, muscle fibers at the base of hair follicles can contract, causing goosebumps of the skin to appear, and glands in the area can be overactivated and release excess amounts of inflammation-causing chemicals known as pro-inflammatory cytokines. 

One of the more common spots where trigger points are prone to becoming activated and causing pain is in the neck and shoulders. Those pesky “knots” that a lot of people experience in these areas can be quite painful and irritating and when left untreated for extended periods of time, can have some serious side effects. The tension and inflammation of the knot cause pain and the autonomic phenomena of vasoconstriction can impact blood supply to and from the brain. This can cause:

  • Chronic migraines or tension headaches
  • Blurred vision
  • Dizziness or vertigo
  • Shoulder and neck pain
  • Limited mobility
  • Hearing impairment

Over time, the lack of oxygen and nutrient-rich blood supply to brain cells can result in cell death, which negatively affects the brain’s ability to perform normal functions. Symptoms relating to these cell deaths can include:

  • Mood changes and irritability
  • Difficulty focusing and brain fog
  • Memory loss
  • Depressive mood

So how do the injections treat the muscle "knot"?

When the Trigger Point Injection is administered directly into the muscle knot, the lidocaine immediately numbs the area to provide instant pain relief. The action of the needle penetrating the cramped stimulates the muscle fibers to relax, relieving the tension, the lidocaine numbs the area for instant pain relief, and the Kenalong works over the next few weeks to reduce the release of inflammatory cytokines in the area. This reduction in inflammation allows the body to bring growth factors and proteins to the area to repair the damaged cells in the tissues to begin the natural healing process.

Activated muscle trigger points are something that people tend to ignore or use manual release therapies, such as massages to treat them, but often that may not be enough to achieve complete relief. If you find yourself relating to this, you should look into receiving Trigger Point Injections to experience the complete relief you seek. 

How do Trigger Point Injections work for joint pain?

These injections aren’t solely used to treat muscle pain and knots! Trigger Point Injections are corticosteroid injections, which have been used to treat joint pain for decades. The function of corticosteroids is to reduce inflammation by blocking the production of pro-inflammatory cytokines, molecules that produce inflammation of tissues. 

When injected into an inflamed joint, these injections provide immediate pain relief and work to reduce the inflammation in the area. When inflammation is reduced, the body’s natural healing function is able to begin repairing and replacing damaged cells, ultimately working towards healing the tissue, in this case the joint, to return to normal and healthy function. There are many different reasons for a joint to become inflamed and painful, but regardless of the cause, these injections aid in reducing pain and inflammation and give the body a chance to heal itself naturally.

Some common joint problems that can be treated with Trigger Point Injections include:

  • Arthritis
  • Gout
  • Buritis
  • Injuries

On average, these injections provide relief for 1-3 months at a time. That’s 1-3 months of living without the debilitating pain caused by muscle “knots” or joint inflammation, all while your body works to repair the damage caused by these conditions. Trigger Point Injections are helping patients return to their normal daily activities and supporting their body’s natural healing abilities.

Created by: Bailey

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