Have you tried endless massages and chiropractic adjustments and have never seen relief from your muscle knots?
These bumps—known as trigger points—usually go away with manual adjustment. But sometimes, they can become impossible to remove no matter how many self-massage tricks or stretches you try.
Your trigger points may not go away on their own, but that doesn’t mean you have to put up with them forever. Trigger point injections (TPI) can provide immediate relief from muscle knots.
What are myofascial trigger point injections, and are you a good candidate? Keep reading to learn more.
What Are Trigger Point Injections?
Trigger point injections (TPI) are injections of anesthetic and steroid directly into the “knots” in your muscle. The knots are known as “trigger points.” They occur when your muscle involuntarily contracts or spasms, which causes the area to become tender and to radiate pain elsewhere in your body.
The small amount of medication in the injection can cause your muscle to relax immediately, which reduces pain and improves circulation in the area so you can heal.
Why Do Trigger Points Form?
Trigger points often form in patterns across your body, usually in places where circulation is already low. However, scientists aren’t sure why they form in all cases, nor do they understand the mechanisms underlying them.
Current thinking suggests these hyperirritable spots may be the result of either acute trauma or repetitive minor traumas, which place too much stress on your muscle. The line of inquiry exists because trigger points also often occur in people who have chronic musculoskeletal disorders, such as:
- Carpal tunnel syndrome
- Tension neck syndrome
- Rotator cuff tendonitis
- Muscle or tendon sprain
However, trigger points can also develop in people who:
- Lack a regular exercise routine
- Experience vitamin deficiencies
- Engage in prolonged poor posture
- Suffer from sleep disturbances
You are also more likely to suffer from trigger points if you have a desk job, sit in an uncomfortable chair, or you perform manual labor with poor posture.
How do you know what is a trigger point and what isn’t? If you can find and reach it, you notice that it is both hypersensitive and it’s much harder than the rest of your muscle.
You will find that trigger points:
- Produce both local tenderness and a local twitch response when touched
- Occur as one point or multiple points
- Appear in any skeletal muscle
- Result in a specific pain pattern
What Do Trigger Point Injections Treat?
TPI treats muscle pain all over your body. It can handle both general muscle knots as well as their consequences like myofascial pain and migraine or tension headaches.
You can use it wherever your trigger points exist. It’s safe to use in all areas of your body.
How Trigger Point Injections Work: Your Appointment
The TPI procedure is a short, in-office appointment.
The description is simple. First, your provider palpates the trigger point to identify the exact areas in the muscle where your knots or trigger points exist.
Your provider uses a small needle to deliver the injection contents directly into the specific area where your trigger point occurs. You may be sitting up or lying down depending on where the trigger point(s) occur.
You may receive more than one injection, depending on the number of trigger points you have.
How Many Appointments Do I Need?
Everybody is different.
Your provider creates a customized plan based on the number of trigger points you have as well as your pain level. If your trigger points reoccur in the same spot again and again, then you may require more rounds of trigger point therapy.
Should I Try TPI or Trigger Point Dry Needling?
One of the other treatments also recommended for trigger point relief is known as trigger point dry needling.
During a dry needling appointment, a provider pushes a thin needle through your skin and into your trigger points. Unlike TPI, they don’t include any medication. Instead, they stimulate the tissue to encourage your tight muscle and brain to communicate and cause a release that allows regular movement.
The needles may only barely penetrate the muscle or be used deeply. The technique chosen usually depends on the pain in question and how long you struggled with it. A short session might place the needle in for a few seconds, but you could also leave it in for up to 10 minutes.
What’s the Difference in Experience?
Studies show that both TPI and dry needling are as effective as each other in myofascial trigger points. Most patients will experience either a complete or partial reduction in pain with both therapies.
The difference in the experience, however, tends to lie in post-injection soreness. The pain resulting from the injection is entirely different from the pain associated with trigger points.
Generally, dry needling tends to be the most painful in the hours and days after the treatment. The pain increases when you need more extensive therapy (deeper and more prolonged needle penetration).
Dry needling may better suit you if you are allergic to anesthetic or if you want to avoid steroidal medications like those used in TPI.
Why Should You Try Trigger Point Injections Over Other Treatments?
There are several ways to treat trigger points and provide pain relief that doesn’t include needles.
Self-massage is one way to relieve some of the minor pain. Doctors or physiotherapists may also recommend treatments like:
- Spray and stretch cooling spray
- Manipulative therapy
- Mechanical vibration
- Low-level laser therapy
During the earliest stages of development, your provider is more likely to try manual manipulation, including massage and stretching, to prevent the knot from becoming embedded and chronic.
However, trigger point injections remain one of the most effective treatments for deactivating the points and provide almost immediate relief.
When is TPI the best choice? You typically receive the injections when they don’t respond to manual or other mechanical/laser therapies and when your trigger points result in further pain or injury.
Who Shouldn’t Try TPI
TPI is a safe, effective, and non-invasive treatment for trigger points and myofascial pain. However, it’s not for everyone. You aren’t a good candidate for TPI if you:
- Have bleeding or an anticoagulation disorder
- Have a local infection
- Have a systemic infection
- Have an allergy to anesthetics
- Have a needle phobia
- Have experienced acute muscle trauma
You also can’t use TPI if you took aspirin (a blood thinner) within three days before the treatment or if you recently had surgery. You also typically need to avoid TPI (and dry needling) if you are pregnant.
Are There Any Complications?
After your appointment, you should feel immediate relief. If you have any short-term, mild complications, they are the result of using the needle and occur around the injection site.
For example, you might experience temporary numbness or pain at the site (but not in the muscle). Your provider should minimize the risk of infection or bleeding by adequately cleaning the site and then applying pressure after the injection to stem any blood.
Although severe complications are rare, especially when the treatment is provided correctly, they can occur. The most common complications are:
- Skin infections
- Needle breakage
- Hematoma formation
If you experience one of these complications, seek medical attention immediately.
Post-TPI: How to Prevent Your Trigger Points from Returning
You may or may not need to follow up sessions after your first round of TPI. Regardless, there are things you can do to prevent muscle knots from forming at all.
The four essential factors in preventing trigger point pain include:
- Stretch/posture breaks
Let’s dive into each.
What does your diet have to do with your knots? More than you think.
Dehydration, in particular, can contribute to muscle knots, particularly when combined with other problematic lifestyle issues like poor posture, sitting at a desk, and failing to exercise.
Your muscle fibers need to keep space between them. The area is known as critical interfiber distance and becoming dehydrated limits that space. When the critical interfiber distance disappears, your muscles stick together like poorly cooked spaghetti.
If you are prone to muscle knots, ensure you drink at least two liters of water each day. You should also drink more on days when you exercise vigorously or when you drink coffee or alcohol.
And as always, a healthy diet contributes to healthy muscles as well as reducing your stress and anxiety.
Your muscles aren’t designed to move from your bed to your car to your office chair. They need to be challenged because our bodies were built to move and to perform.
Find a form of exercise that you find challenging to give your muscles a reason to work. It doesn’t need to be Crossfit or Olympic lifting. Yoga, pilates, or another focused exercise style will serve you just as well and be just as challenging for your muscles (with a lower risk of injury).
Massage is not a treat–it’s essential. It is particularly important if you struggle with muscle tension or muscle knots.
Yes, massage feels good and reduces pain. However, the mechanisms underlying those feels are what is most important.
Professional therapeutic massage offers two mechanical responses in your body. First, it increases your circulation because the pressure releases chemicals that encourage your muscles to relax. When your circulation improves, your blood moves more freely and better delivers the oxygen your muscle cells need.
Excellent circulation also makes it easier to remove waste, which stops swelling in your muscles.
Second, massage reduces your nerve compression. This is incredibly important for pain because when your muscles are always contracted, they can compress the surrounding nerves. When your nerves are free to operate the way they should, they go back to transmitting messages to the brain, which improves your general functioning.
If you can’t get in for a regular massage, it’s helpful to learn self-massage techniques, particularly those that cater specifically to muscle knots.
Self-Massage for Muscle Knots
At a minimum, you should massage the painful knots on your own—as long as you can reach them!
The technique is simple. Use your fingers to press on the area (firmly) and move in a way that creates small circles.
Today, most of us spend hours a day sitting. Commuting, desk jobs, and other sedentary activities keep us down.
Although we can’t avoid sitting all the time, we can lessen the load by getting up and stretching. You can keep muscle knots and other muscle pain at bay by getting up once an hour and walking around.
Desk yoga or stretching can also keep you feeling nimble and improve your posture, which helps mitigate the damage done by sitting.
You Don’t Have to Live in Pain
Muscle knots happen, and while many respond to massage and stretching, some spots won’t budge no matter how hard to try.
Trigger point injections use anesthetic and steroids to provide instant relief to those trouble spots and relieve the pain they inflict elsewhere in your body. TPI, along with stretching, a healthy diet, and regular massage, can help manage your pain and reduce recurrences.
Are you ready to finally relax and live without pain? Schedule an appointment at our pain treatment center today.