Trigger points are painful “knots'' in your muscle fibers that are highly sensitive to touch/pressure. They may form after an acute trauma or become chronic by stress on the fibers, such as with repetitive motion. The muscle fibers become stuck in a contracted state, and you can feel the knot when you touch the muscle.
At Memphis Neurology, our board-certified neurologists understand how uncomfortable trigger points can be, which is why we offer trigger point injections (TPIs) to our patients in Southaven, Mississippi and Germantown, Tennessee, to alleviate the pain. Some conditions respond better than others to TPIs.
Myofascial pain and TPIs
Myofascial pain describes the pain associated with trigger points. “Myo” refers to muscle, and “fascial” refers to the thin, white connective tissue that covers the muscle. The pain from the trigger point actually stems from the fascia. The myofascial pain/trigger point combination is very common — about 85% of people develop it at some point in their life.
Trigger point injections are used to relax the muscle knots and quell the pain. The doctor injects a local anesthetic (often lidocaine) into the knot, either with or without a corticosteroid (to reduce inflammation) or botulinum toxin (to prevent muscle contractions). They can also insert the needle without any injection substance, a procedure called dry needling. It’s believed that the insertion of the needle disperses the fibers engaged in the knot.
Researchers also believe the injections interrupt the nerve signaling pathways that cause pain referred from the trigger point to other parts of the body.
5 conditions that respond well to trigger point injections
Conditions that result from muscle tightening or spasming respond particularly well to TPIs. These include:
1. Myofascial pain syndrome
As we’ve seen, TPIs relax the knots in the fascia, providing relief.
This chronic pain condition used to be classified under the arthritis “umbrella,” but though it shares some symptoms of arthritis, it affects the soft tissue instead of the joints.
Historically, doctors diagnosed fibromyalgia in people who reported pain or tenderness in 18 specific trigger points on the body, with nine on each side. However, that’s since been revised to include widespread pain throughout the body that lasts three months or longer.
Since fibromyalgia pain is widespread, unlike myofascial pain syndrome, doctors believe it may originate from neurological problems that affect how the brain processes sensory information.
With that said, myofascial trigger points and fibromyalgia cause similar pain profiles, and some researchers believe that myofascial trigger points contribute to fibromyalgia pain.
3. Tension-type headaches
This type of headache originates from muscle tension in the neck that refers to the head. TPIs administered to the muscle knots in the neck can reduce headache pain.
A 2016 study examined the relationship between trigger points and pressure pain sensitivity in people with either episodic or chronic tension-type headaches. The participants who had more trigger points were more sensitive to pressure pain than those who had fewer points.
4. Chronic migraine
Migraine is a neurological disorder that produces discrete attacks characterized by extreme, throbbing pain on one side of the head; visual disturbances; nausea and vomiting; and sensitivities to light, odors, and sounds.
According to the American Migraine Foundation, trigger points in the shoulders, neck, and head can contribute to migraine attacks.
One 2014 study compared the presence of myofascial trigger points in 20 physiotherapy students with episodic migraine and 20 individuals without migraine. The authors found a significantly higher number of myofascial trigger points in the group with migraine.
5. Piriformis syndrome
A trigger point located in the piriformis muscle of your buttocks can lead to piriformis syndrome — when the muscle presses on the sciatic nerve, which exits the spinal canal in the lower back. It causes pain and/or numbness in your buttock and down your leg.
Your provider may use TPIs alongside physical therapy and stretching exercises to relieve your pain.
This strategy is particularly helpful for people who can’t do physical therapy or stretching due to intense pain. The TPI can relieve the pain enough to allow physical therapy to be more effective.
Are you struggling with tight muscle knots that are tender to the touch or refer pain elsewhere in your body? Trigger point injections may be the answer. Give Memphis Neurology a call at either location to schedule a consultation with one of our neurologists, or book online with us today.