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Trigger point therapy is used to alleviate the pain and symptoms associated with trigger points. These injections are given in the physician’s office, and no anesthesia is required during the visit. Trigger point therapy is often used to treat myofascial pain. Also called neuromuscular therapy or myofascial trigger point therapy, these injections often involve use of an anesthetic, botulinum toxin type A, or a corticosteroid.

What are trigger points?

Located deep in the skeletal muscle, trigger points are areas that produce pain when compressed (palpated). These trigger points are usually the size of a dime or quarter, and they may result from trauma to muscle fibers.

What conditions are treated using trigger point therapy?

Trigger point therapy is used for many chronic pain conditions. These include:

  • Persistent cervicogenic headache
  • Temporomandibular joint syndrome
  • Fibromyalgia
  • Myofascial pain syndrome
  • Chronic back pain
  • Sciatica
  • Carpal tunnel syndrome
  • Plantar heel pain

Is trigger point therapy the same as dry needling?

Acupuncture is a form of dry needling that involves placement of needles to stimulate points along a meridian, which carries vital energy through the body. Dry needling to trigger points is slightly different. This involves the insertion of a tiny needle into a painful trigger point, which releases it. No medication is injected into the muscle tissue or subcutaneous tissue with dry needling.

What medications are used in trigger point injections?

The most common solution used in a trigger point injection is a local anesthetic, such as lidocaine or bupivacaine. The doctor may choose to add, or use alone, a corticosteroid, which can be triamcinolone or dexamethasone. Botox is now being used by some pain management specialists. This drug works by temporarily paralyzing the muscle, so the trigger point does not reform. In a study of 6 patients with chronic myofascial pain syndrome, Botox had an 80% efficacy rate, relieving pain by at least 30% in most patients.

What can I expect during the office visit?

Once you agree to have trigger point injections, the doctor will palpate your neck, back, and upper buttock region to locate the trigger points. Once identified, the areas are marked with a surgical marker. The skin is cleaned with an antiseptic. Using a syringe and fine needle, the doctor inserts the needle into the trigger point and instills the medicine. After removing the needle, a band-aid is applied. You should not use heat for several hours after these injections.

Does trigger point therapy work?

In a study involving patients with plantar heel pain, 60 patients were divided into two groups. The first group received stretching exercises, and the second group underwent trigger point injections. According to researchers, at one month, the trigger point therapy group showed greater improvement in mobility and less pain than the other group.

A study was conducted in 2006 involving 36 people with Parkinson’s disease. The patients received trigger point injections twice a week for four weeks. At the end of the study, patients had significant improvement in motor function, as well as modest improvement of quality of life.

In a 2008 controlled trial, 94 patients were injected with meloxicam into various trigger points due to vertebrogenic lumbago-ischialgia syndrome. In the study, three groups were formed. The first group received 3 injections of meloxicam into trigger points followed by taking tablets of the drug.

The second group received intramuscular injections (not in trigger points) followed by taking tablets. In the third group, patients only received saline injections and tablets. Researcher found that the trigger point group had a 76% success rate compared to 64% and 33% in the other groups.

The expert Phoenix pain doctors at Pain and Spine Clinics offer trigger point therapy along with over twenty additional interventional treatments. Most insurance is accepted, call us today for the best treatment!

Resources

Alonso-Blanco C, de-la-Llave-Rincón A, & Fernández-de-las-Peñas C (2012). Muscle trigger point therapy in tension-type headache. Expert Rev Neurother, 12(3):315-22.

Alvarez, DJ & Rockwell PG (2002). Trigger Points: Diagnosis and Management. Am Fam Physician, 65(4):653-661.

Cheshire WP, Abashia SW, & Mann JD (1994). Botulinum toxin in the treatment of myofascial pain syndrome. Pain, 59(1).

Craig LH, Svircev A, Haber M, Juncos JL. Controlled pilot study of the effects of neuromuscular therapy in patients with Parkinson’s disease.” Mov Disord. 2006 Dec;21(12):2127-33.

Renan-Ordine R, Alburquerque-Sendín F, de Souza DP, Cleland JA, Fernández-de-Las-Peñas C. “Effectiveness of myofascial trigger point manual therapy combined with a self-stretching protocol for the management of plantar heel pain: a randomized controlled trial.” J Orthop Sports Phys Ther. 2011 Feb;41(2):43-50.

Shirokov VA, Potaturko AV, & Zakharov I (2008). Safety and efficacy of movalis injected into trigger points in lumbago-ischialgia syndrome. Zh Nevrol Psikhiatr, 108(9), 41-44.