Chronic pain and pain management are increasingly in the medical limelight in the United States. Recent research indicates that just over 20% of American adults, or roughly 50 million people, live with chronic pain. That is a staggering number. There are many treatment plans available for pain management, and trigger point injections are proving to be an effective choice for many patients.
Typically, medical practitioners consider someone to be in chronic pain if they report six months or more of daily or almost daily pain. Sometimes these situations arise from injuries, and the symptoms eventually subside with time.
But for many Americans, persistent pain is a way of life due to conditions such as autoimmune disorders, injuries that don’t heal properly, or joint problems related to aging. Patients who have undergone treatment for cancer may also have lingering chronic pain as a side effect from various drugs and procedures.
One study reports that pain costs the United States over $560 billion each year. Between medical visits, prescription costs, alternative therapies, mental health treatment, and lost productivity, pain takes an enormous financial toll on our society. And with an aging population and an increase in chronic conditions, that dollar amount is likely to rise.
What is a Trigger Point?
Patients who are in pain often experience trigger points. Commonly called “knots,” trigger points are hypersensitive spots where a muscle has shortened and tightened up, forming a lump. These lumps can be as small as a pea or as big as a walnut, and patients often can feel them under the skin. Pushing on these points can be very painful but can also result in some relief if the muscle releases back to its normal position.
Trigger points can be active or latent. Active trigger points not only create pain at the site, but they also cause referred pain and fatigue in other areas of the body if they push on surrounding nerves. Tension headaches, for example, are a common result of knots in the neck and shoulders pressing on nearby nerves. Tinnitus and TMJ pain also can arise from referred pain.
Latent trigger points, however, usually are asymptomatic and do not cause referred pain. Latent trigger points typically do not require treatment until they become active and cause pain.
Although they can happen in any muscle, trigger points tend to develop most frequently in the neck and shoulder area, as well as in the legs and lower back. These painful knots and lumps can come from an acute injury, overuse, or a chronic condition such as fibromyalgia. Another disorder, myofascial pain syndrome, can lead to multiple trigger points resulting from repetitive use and stress.
How Does a Trigger Point Injection Work?
When dealing with acute or chronic pain, many doctors and patients turn to over-the-counter and prescription medications. Some may try massage, acupuncture, relaxation techniques, or physical therapy as well.
When other pain management options do not bring relief, trigger point injections (TPI) can be a great choice. And for patients and who prefer to avoid medications, this course of treatment is a good alternative.
During the procedure, a doctor will palpate the area to find the precise location of the trigger point. The doctor then inserts a needle directly into the knot to try to release the muscle tension.
The needle may contain a saline solution, a steroid, a local anesthetic, or a combination of these. Sometimes the practitioner uses a dry needle technique in which there is nothing in the injection. This dry needling is often the first course of action in TPI and is also useful for patients who have allergies to medications or who prefer to avoid their use.
Depending on where the trigger point is, you may be sitting or lying down during the treatment. If you have multiple trigger points, your doctor may be able to provide injections in all of them during one session.
For otherwise healthy patients, TPI is a quick procedure with minimal side effects. Some patients have temporary redness and tenderness at the injection site, but more severe reactions are rare. After the trigger point injection, you can resume most normal activities, although it is best to wait a day to engage in any strenuous exercise.
If you are feeling ill or fighting an infection, it is best to wait until you feel well before receiving trigger point injections. Patients with bleeding issues or who are on anticoagulants should discuss treatment with their doctors to determine if TPI is safe for them.
How Effective Are Trigger Point Injections?
For trigger points that develop from an acute injury, one or two TPI treatments often bring long-term relief. When dealing with chronic pain conditions or damage resulting from repetitive motion or stress, however, more procedures may be necessary.
TPI can be a highly effective way to address ongoing pain from conditions that do not have a cure yet. Although patients are likely to need repeat injections in these situations, most prefer to do that rather than relying on opioids or other prescription painkillers.
At Camas Swale, we strive to help your body heal with a course of treatment that is minimally invasive and that avoids risky side effects whenever possible. Although prescription pain medications have a place and purpose, we recognize that opioid abuse is on the rise, and we take our responsibility for our patients’ safety very seriously. TPI is a valid treatment option for pain for many patients, and we are proud to offer it in our office.
Our doctor, Damon Armitage, MD, works to treat the whole person. Through family medicine, wellness checks, preventive care, immunizations, and specialized treatment options, we provide high-quality care to our Creswell community.
We support our patients in all stages of their lives and all areas of their health. In addition to routine healthcare, we provide support and management for endocrine and cardiovascular issues, depression and anxiety, and chronic asthma and allergies.
Give us a call today to schedule an appointment. We look forward to meeting you and being of service to you on your health and wellness journey.