Sometimes, you feel a small knot in your neck, shoulders, or back muscles, and when you squeeze it, it causes unbearable pain, right? It's like a small lump inside your body. This is what we call a 'trigger point'. You may be unable to do your daily tasks properly because of this pain. So today we are talking about a treatment that many people don't know about that can help you get rid of this pain.
What exactly are these 'Trigger Points'?
Simply put, a trigger point is a painful 'knot' in our muscles. If you touch the area, it may feel like a small knot. There are a number of reasons why these can occur. It can be caused by a sudden injury (acute trauma), or it can be caused by repetitive micro-trauma (stress) caused by repeated movements.
For these reasons, the muscle fibers become stuck together, tight, and stuck in one place, like a ball of string. These 'stuck knots' are called trigger points.
Trigger point injections are a procedure where a thin needle is used to inject medication into a painful area. This is usually done with a local anesthetic. Sometimes, a steroid or botulinum toxin may be added. Sometimes, this treatment is done without any medication, just with a needle (called dry needling ).
What kind of pain is this injection used for?
This injection is mainly used to treat a condition called 'Myofascial Pain' . Here 'Myo' means muscle, and 'fascial' means fascia. Think of a piece of meat like a sausage, and the thin white sheath around it is called fascia. So, myofascial pain is pain that occurs in this muscle, and the membrane that surrounds it.
The main cause of this pain is the presence of one or more of the trigger points we talked about. Although these knots can form in any muscle, there are a few places where they are most common.
| Muscles that commonly develop trigger points | The area where the pain is usually felt |
|---|---|
| Trapezius | Back of neck and sides of shoulders |
| Masseter | The muscle of the jaw (near the ear) |
| Levator scapulae | On both sides of the neck |
| Quadratus lumborum | Deep down in the back |
| Gluteus medius | Buttocks/hips area |
Surprisingly, sometimes the pain from these trigger points is not felt directly at the site of the knot, but a little further away. For example, a knot in the trapezius muscle in the shoulder can cause you to experience pain in the form of a tension headache .
Who needs this treatment?
Your doctor will not usually recommend this injection right away. If your pain hasn't subsided despite things like painkillers, heat, massage, and physical therapy, you may want to consider this treatment as a next step.
Just think, some people are in so much pain that they can't even do physical therapy exercises properly. In such cases, you can first give this injection to reduce the pain, and then start physical therapy. Then the results are very successful.
Also, before giving this injection, the doctor will check if there are other causes of your pain. For example:
- Muscle strain
- Degenerative arthritis or herniated disc
- Radiculopathy (pain caused by a pinched nerve)
What happens when the injection is given?
The process is very simple. It usually involves a few steps:
1. First, you will be made to sit or lie down comfortably on the examination bed, facing the area where the lump is.
2. Then the doctor will touch the painful knot, or trigger point, and find the exact location.
3. After identifying the location, the skin is cleaned with alcohol and a thin needle is inserted into the nodule.
4. Here, the doctor will move the needle back and forth inside the lump several times, without removing it completely. This is called 'needling'. You may feel your muscle twitch at this point. This is normal and a good sign that the needle is in the right place.
5. Once the muscle has stopped twitching or the doctor feels that the muscle has relaxed enough, a local anesthetic will be injected into the area.
6. That's it. The entire process only takes a few minutes. After that, you can go home.
Does this hurt?
To be honest, it can hurt a little. Because trigger points are sensitive to touch. You may feel pain even when the doctor feels the area with his hand. When the injection is given, you will feel a slight burning or stinging sensation. But when the tip of the needle hits the area, the pain may increase slightly. But don't be afraid, the pain means that the needle has gone exactly in the right place.
What happens after treatment?
After the injection, you can go home and use the affected muscle as usual. However, it is best to avoid strenuous activities for the first two to three days.
If there is a little bruising or pain at the injection site, you can apply an ice pack. It is best to consult your doctor before taking something like paracetamol for pain.
How long is this relief?
For most people, the pain will start to subside within 24 to 72 hours. This relief can usually last for a month or more . If the pain is still there after that, your doctor may recommend that you get a few more injections for long-term relief.
Most importantly: If the injection site becomes red, painful, or has a fever after the injection, it could be a sign of infection. If this happens , see your doctor immediately.
Take-Home Message
- Trigger Point Injection is a safe and effective treatment for painful muscle knots (trigger points).
- This is usually done when the pain does not subside with things like painkillers, massage, or physical therapy.
- Although some pain may be felt during treatment, the relief may last for a month or more.
- Only your doctor can determine if this treatment is right for you. Therefore, if you have severe pain, such as a tight knot in your body, be sure to seek medical advice.
- If you develop symptoms such as fever or warmth at the injection site after the injection, notify your doctor immediately.
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