Back Pain Treatments: Trigger Point Injections
Most back pain treatments that involve delivering medicine or chemicals directly into structures of the back involve their delivery into the discs, joints, and other soft tissues. Trigger point injections, on the other hand, involve the delivery of a substance or chemical directly into one of the muscles of the back responsible for healthy back function. Trigger points are specific sites on individual muscles that cause pain (both locally and throughout your back) when pressure is applied to them. You may have trigger points and not even be aware of them until a back expert applied pressure to them manually. Trigger points are believed to develop in certain muscles due to trauma, fatigue, or excessive physical exertion. Treatments for trigger points involve manual therapies (i.e. massage) to loosen and heal the muscles involved, stretching, yoga, electrostimulation, acupuncture, and trigger point injections.
Trigger point injections: Trigger point injections, involve the direct injection of a local anesthetic, sometimes along with a steroid medication, directly into the painful trigger points of the muscle(s). This medication is delivered via a needle by a medical doctor who is trained to perform this procedure. Patients who are determined to have a likelihood of benefiting from this procedure will be sensitive to certain areas of their muscles when doctors manually check for the presence of trigger points upon examination. This procedure may be performed in a surgical setting in a hospital or in an office of a medical clinic on an outpatient basis. The procedure usually involves having between 1-5 injections in one visit for treatment. The entire procedure usually lasts between 5 and 15 minutes. Though side effects from this treatment are very rare, the doctor will usually prefer that you remain in the clinic for up to one hour following the procedure for evaluation. If the patient has no observed or reported ill affects of the procedure, they will be cleared to leave the office and go home. Once at home, the patient will be free to resume most normal everyday activities. However, the patient should avoid any excess lifting or physical exertion for the next few days, especially if the cause of the patient's trigger points is thought to be muscle fatigue from overexertion.
Prognosis: Doctors at many back and pain clinics have reported positive results from this procedure for reducing back pain symptoms. Most doctors recommend using this type of treatment in cases of severe back pain and on a short term basis. Trigger point injections is more likely to promote or accelerate back pain relief when it is used simultaneously with other back pain therapies, such as physical therapy, exercise, icing tender muscle areas, and oral medication therapies.
Risks and Benefits: All medications have some level of toxicity and thus carry some risks. The risks of side effects of medications for back pain vary by specific procedure, but may vary by the types of medications or chemical substances involved, and the placement of the needle by the doctor. Improper placement of the needle, or individual patient reactions for certain medications, may result in infection, bleeding or even nerve damage. However, the risks are rare for this procedure. Risks that are directly related to medical mistakes involving misplacement of the needle include an accidental puncture of the dura, which may cause some spinal fluid to leak. Punctures of the dura (resulting in a temporary condition known as a spinal headache) are rare, and will not lead to permanent damage if it occurs.