Trigger Point Injection Therapy for Chronic Pain

Understanding Trigger Points in Your Body

Trigger points are specific, hyperirritable spots within a muscle or its surrounding fascia (the connective tissue that surrounds muscles). These areas of tightness or knots can feel tender to the touch and often refer pain to other parts of the body, a phenomenon known as “referred pain.” This means the discomfort isn’t always felt right where the trigger point is located; instead, you might feel it in a completely different area. For example, a trigger point in your shoulder muscle might cause pain that radiates down your arm or up into your neck and head.

These points can significantly affect how your muscles function, leading to stiffness, decreased range of motion, and sometimes chronic pain if not addressed. Many people describe the sensation as a dull ache, pressure, or deep soreness that doesn’t quite go away.

Trigger points can develop for several reasons, including:

• Injuries: Trauma from accidents, falls, or strains can damage muscle fibres. As the body heals, scar tissue or tight muscle bands may form, leading to the development of trigger points.
• Prolonged Muscle Tension or Over-exertion: Repetitive movements or holding a muscle in a contracted position for too long can fatigue the muscle. Over time, this overuse can create areas of sustained tension that evolve into trigger points.
• Poor Posture: Sitting or standing in an improper position, especially for extended periods (like hunching over a computer or phone), places continuous stress on certain muscle groups. This constant strain can cause muscles to tighten up, contributing to trigger point formation.
• Irritated Nerve Fibres: Nerve irritation, whether from spinal issues, pinched nerves, or inflammation, can lead to abnormal muscle tension. Muscles react protectively, tightening up around the nerve, which can create trigger points.

Understanding how and why trigger points form is the first step in learning how to release them and restore your body to a healthier, more relaxed state.

Understanding the Injection Process

During the consultation, the pain consultant will identify your trigger points, which will be marked with a medical marker pen. The skin area is then cleaned and sterilised. Following this, an ultrasound probe is placed over the tender area to identify the different myofascial planes to identify the optimum position for the injection. Ultrasound is used to guide the needle to this position. On the monitor, the injection can be visualised.

The injection contains a local anaesthetic, which leads to instant pain relief. The consultant may add corticosteroids to the injections if required, which can lead to a longer period of anti-inflammatory effect from the injection.

Things to Expect After Trigger Point Injections

Usually, patients will experience some instant relief from the local anaesthetic injections into their trigger points although for others it may take a few days to be fully effective. Sometimes, there can be some local swelling and inflammation at the injection. Anti-inflammatory medications, ice packs and heat packs can help to settle down post-injection inflammation.

Some patients may need to undertake stretching exercises after their injection to help relax tense muscles once pain relief has been achieved with a trigger point injection.