A trigger point injection is a potential treatment option for myofascial (muscular) back pain. Trigger points are small patches of tightly contracted muscle tissue that may cause tenderness, weakness, loss of coordination and inflammation. They can also limit range of motion. Additionally, trigger points can sometimes worsen the symptoms of neck and back problems.
Trigger points are usually caused by overuse (performing repetitive movements over a prolonged period of time) or overexertion (lifting an object that is too heavy for a muscle to adequately support). Poor posture and traumatic injuries can also contribute to their development. While trigger points can form in any muscle, they are particularly common in the neck and upper back.
Trigger point treatment
Trigger points can often be successfully treated through manual manipulation. A chiropractor, physical therapist, massage therapist or other medical professional can sometimes manually release a trigger point, leading to significant and immediate pain relief. Additionally, the application of heat to a tender area may help relax tight muscles, and the application of an ice pack can reduce inflammation. Meanwhile, over-the-counter medications, such as aspirin and acetaminophen, can also help relieve pain caused by the trigger point.
Injections for stubborn trigger points
If these remedies do not successfully alleviate a trigger point, an injection may be recommended as the next step. With this treatment, a physician injects a medication or combination of medications directly into affected muscle tissue. Usually, an injection contains an anesthetic (numbing medication), such as lidocaine. In some instances, the anesthetic is combined with a long-acting anti-inflammatory steroid, such as cortisone.
A single trigger point injection is often sufficient. If the trigger point redevelops or does not fully release after one injection, additional injections may be recommended. While injections that only contain anesthetic medication can be repeated fairly frequently — even on a monthly basis — those that contain steroids should be used more sparingly to prevent nerve damage.