Trigger points are focal points in a muscle that are prone to irritability and tension, commonly known as “knots” in a muscle. They form when the muscle cannot relax and becomes painful to the touch. Trigger points in different muscles are accompanied by their own characteristic symptoms. An active trigger point can cause persistent pain, a decrease in range of mobility, and localized autonomic phenomena. The autonomic system is the part of the nervous system responsible for involuntary bodily functions and responses to stimulus. For example, when a person unknowingly touches something extremely hot or cold, before the brain gets a chance to process what is happening, an autonomic reflex response occurs and the person pulls their hand away.

The autonomic system also controls functions like breathing, digesting food, and regulating heart beat and blood flow. Trigger points in the neck and shoulders can cause an autonomic phenomena that causes constriction of the blood vessels leading to and from the brain. This constriction can lead to chronic migraines or tension headaches, blurred vision, dizziness, hearing loss, and brain cell death caused by a lack of oxygen, resulting in irritability, difficulty focusing, memory loss, and depression and anxiety.

Trigger points can become active and painful due to stress, poor posture, sleep disturbances or sleeping in a certain position for too long, and as a result of an injury or overuse of the muscle. Trigger point injections are extremely effective in releasing the tension and relieving the associated pain. The injection is a combination of a corticosteroid, Kenalog-40, and an anesthetic, Lidocaine 1%. The Lidocaine provides immediate pain relief and relaxation of the muscle tension while the corticosteroid works long-term to prevent the release of inflammation-causing chemicals from the cells that make up the muscle tissue of the trigger point.

These injections can provide pain relief and prevent flare ups for an average of two to six months, depending on how quickly the patient’s body metabolizes the solution. Common injection sites include neck and back muscles to treat tension headaches/migraines or back pain, SI joints for the management of Sciatica pain, arthritic joints, areas affected by Fibromyalgia pain, and sore muscles caused by an injury or overuse.