Trigger Point Injections

Trigger points, also known as muscle knots and trigger sites, are small areas of tightness in the muscle that are sensitive to the touch and though to be the cause of pain throughout the muscle group. These areas of knots in the muscle are small enough that you might not be aware of them unless you were to touch them directly. For this reason, many people are unaware that these trigger points are the cause of their back pain or muscle pain. Pain in these trigger points may be referred to other muscles or other areas of the body, accounting for significant physical discomfort and immobility for the patient. The development of taught bands of muscle tightness in these points may account for a lot of pain and disability in the body. Conversely, the ability to identify and treat these small points of sensitivity in the muscles gives knowledgeable therapist in this area of medicine the ability to successfully treat many pain conditions involving the muscles and muscle covering fascia.

When these trigger points are touched and compressed by the medical specialist, the pressure may elicit pain or a twitch response. This twitch response is not the same as a muscle spasm, as it does not occur through the entire muscle. During a muscle spasm, the entire muscle goes into a continued state of contraction, not a temporary twitch.

The physicians (medical doctors and osteopaths) who are trained to detect and treat trigger points encompass a diverse group of specialists from several areas of medicine. This diversity is the type of specialists who treat these types of muscle problems is accounted for by the fact that it mental and physical factors are thought to be involved in treating the condition. Muscle tension is thought to be brought on as a result of several factors, including stress, anxiety, and poor body mechanics, overuse injuries, and the irritation of the nerves that supply the affected muscles. For this reason, the physician specialists who are involved in the care of trigger point and fibromyalgia type conditions may include psychiatrists, orthopedists, physical therapists, and physiatrists. Non-medical specialists that may be involved in a trigger point treatment program include massage therapists, acupuncturists, and physiotherapists.



Acupuncturists and the field of acupuncture therapy are interesting for being involved in trigger point therapy. Acupuncture and the field of Chinese medicine, states that there are immeasurable energy channels in the body, with certain points within these energy channels that may affect the function of the energy flow, and ultimately our health. These energy channels are known as Meridians, and the key points in these energy channels that may affect the body's health are known as Acupuncture points.

In Chinese Medicine, it is believed that things like accidents, mental illness, injury, and other factors may block the flow of energy in these Meridians. And when the energy flow is blocked, we suffer from the symptoms of disease. Acupuncturists identify the causes of disease in the human body by identifying which Meridians are not working optimally. And they re-establish the flow of energy in these fields by treating acupuncture points in these Meridians. Acupuncturists may treat the Meridians three needle puncture and acupressure (acupuncture massage).

Using modern medicine and western science, it is impossible to prove whether or not this "invisible" energy exists. But we can detect trigger points, based on the feedback of the patients and the feeling of tightness that is felt when the doctor puts his hands these sensitive spots in the muscle.

Studies have been performed showing a strong correlation between the locations of trigger points and acupuncture points on the body.

Trigger Point Injections: Once the trigger points have been identified as the cause of the patient's pain, trigger point injections are administered for pain relief and the reduction of muscle spasms. The agents administered through these injections include local anesthetic agents (bupivacaine or lidocaine or BOTOX (botulinum toxin). A variety of other treatments may be used to numb pain in this area and to stretch and loosen the muscle.