What is Trigger Point?
Sore muscles can be a pain! Muscles that are tight are not expanding and contracting correctly, which reduces blood flow, oxygen and overall function. Essentially, the muscle has gone from healthy tissue, to an area of spasm, fibrosis and inflammation. Many of us have had sore muscles or a “knot”, especially after an injury or a strenuous workout, and these tend to resolve in a matter of days or weeks. If the issue persists, then this process can lead to a trigger point, an irritated area in the muscle that is stiff, painful to touch, and can transmit pain in areas other than the tight muscle itself.
Because modern life involves a lot of driving and working at the computer, trigger points are most common in the neck, shoulders and scapula. Many feel like they “wear” their stress in these areas and are accustomed to ongoing pain in these regions that can flare up and be severe. Often the muscle tension in the high parts of the neck can lead to headache as well (see cervicogenic headache). Other areas where trigger points occur commonly are the low back and buttocks.
Possible Treatments for Trigger Point
Treatments for trigger points include efforts to make the muscle expand and contract in a healthier manner, including physical therapy, yoga, stretching, and pilates. Direct physical handling to the tight muscle can also help reduce the spasm and pain, such as massage and chiropractic manipulation. Ice, heat, acupuncture, medicated ointments, and oral medications can help. For many, these treatments are sufficient to resolve the trigger point. However, if the trigger point continues despite these treatments, or if the pain is moderate to severe, injection of the muscle may be most effective in reducing both the pain and the spasm.
Trigger Point Injections For Muscle Relaxation
A direct injection to the tight and painful muscle is called a trigger point injection. The injected agent can vary, but most frequently involves a local anesthetic. The local anesthetic will cause the muscle band to totally relax in a way that cannot be achieved by a massage, stretching, or manipulation. The anesthetic numbs the nerves and reduces the muscle’s abnormal activity and irritability. This reset of the muscle allows for increased blood flow and oxygen and stops the cycle of muscle spasm. Often, an anti-inflammatory medication is added to reduce the inflammation in the area. Sometimes during the procedure, the provider will manipulate the needle to various aspects of the muscle and intentionally induce the muscle to fire, a process called dry needling, which can further act to reset and calm the muscle. Trigger point injections are often performed in a series of three injections separated by 1-2 weeks, depending on the severity of the spasm. In some situations, just one injection is all that is needed to resolve the problem. Importantly, trigger point injections are often performed in conjunction with massage and physical therapy to optimize results.