Trigger Point Injection Therapy

Finding a treatment for the pain of fibromyalgia can often be as challenging as the illness itself. Most fibromyalgia sufferers have tried every therapy they can think of to reduce their discomfort. Because many fibromyalgia sufferers also have myofascial pain syndrome, trigger point injection therapy has proven useful in minimizing and relieving joint and muscle pain. If you are looking for a treatment that can effectively reduce your pain symptoms, read on, and find out more about trigger point injection therapy.

Trigger Points vs Tender Points
If you have fibromyalgia, you will have noticed that certain areas of your body are more painful than others. These areas are called tender points and they are actually sore spots that develop inside your muscles. There are 18 specific areas on the body where these tender points can develop. These tender points are what cause the widespread pain of fibromyalgia.

Trigger points affect people with myofascial pain syndrome. Myofascial trigger points can develop in any muscle in the body, and cause extreme discomfort and pain. Trigger points are different from tender points in that they can actually cause pain in areas of your body that are nowhere near your trigger points. Many fibromyalgia sufferers have both fibromyalgia tender points and fibromyalgia trigger points.

What Are Trigger Point Injections?
Trigger point injection therapy is a treatment used to relieve the pain and stiffness caused by trigger points in your muscles. Trigger points are like knots in your muscles, and they prevent your body parts from relaxing properly. In order to relieve trigger point tenderness, special injections containing anesthetics or corticosteroids are put directly into each trigger point. These injections "shut down" the trigger points, providing quick or immediate relief from pain.

Types of Trigger Point Injection Therapy
There are two main types of trigger point injections:

Injection by Manual Palpation: This type of trigger point therapy involves the physician manually locating the trigger point by massaging the skin. A trained physician can usually tell where a trigger point is located, how big it is, and how deep it is lying within the muscle. However, sometimes it is difficult to estimate the exact location of a trigger point.

Needle EMG-Guided Injection: This type of injection uses both manual palpation and guided imagery to locate the trigger point. First, the physician will feel around for the trigger point. Then, a needle is inserted into the area. This needle relays information back to a monitor, which the doctor can then look at to guide the needle directly into the trigger point. This method is much more accurate.

Effects of Trigger Point Injections on Fibromyalgia
Trigger point injections, though designed to relieve myofascial pain syndrome, can provide great benefits to those with fibromyalgia. Because so many fibromyalgia sufferers also have myofascial pain syndrome, trigger point injections are becoming more and more effective at treating fibromyalgia pain. Trigger point injections provide a variety of benefits to the patient:

  • Trigger point injections provide quick, long-lasting relief from trigger point pain
  • Injections reduce the amount of referred pain
  • Injections help to minimize the effects of other symptoms, including fatigue, stiffness, and disability
  • Injections can be done quickly and conveniently in your physician’s office or at a pain clinic
  • There is minimal recovery time involved in trigger point injection therapy

The Procedure
Trigger point injection therapy is actually a very simple and short procedure. The majority of trigger point injections are performed in your doctor’s office, a physiotherapists office or at a clinic specializing in pain reduction therapy. Trigger point injections can also be performed in hospital if the patient requires IV sedation.

The procedure takes about 30 minutes. You will be asked to sit or lie down in a comfortable position. The physician will palpate your skin, looking for the trigger points that are causing you pain (about four trigger points can be injected at every trigger point session). Once the trigger point has been detected, your doctor may use a special needle connected to a monitor or locate the exact position of your trigger point. When the trigger point has been found, a needle containing 3 to 5 mL of local anesthetic (usually procaine) will be injected directly into the site. If your trigger points are particularly painful or inflamed, a corticosteroid may also be injected into the site.

How do Trigger Point Injections Feel?
Trigger point injections aren’t painful, but they do cause some discomfort. As your doctor palpates your skin to find the trigger point, you may feel some aching or burning pain. You may also notice that you have a twitch reaction when the trigger point is located. The injection itself will not be that painful. If you have a particular fear of needles or if your trigger point is located in a sensitive area, your doctor can give you a spinal block, which will numb any feeling in the area. When the needle enters the trigger point you may feel some pain, but it should only last for a few seconds.

After the Procedure
Recovery from trigger point injection therapy is relatively quick and painless. If you haven’t received a sedative, you should be able to go back to work after your injections. If you have been sedated, you will need someone to drive you home after the procedure. Your pain symptoms should disappear within a few minutes of your injections.

Physical therapy is recommended in the hours after your injections. Stretching of the muscles seems to enhance the effects of trigger point injections, so if you can, try to book an appointment with your physiotherapist or have massage therapy after your injections.

Side Effects of Trigger Point Injections
The side effects of trigger point injections are minimal. In the days immediately following your injections you may notice:

  • Lightheadedness
  • Tingling or burning as the anesthetic begins to take effect
  • Bruising around the injection site
  • Pain around the injection site

If you notice persistent redness or swelling around the injection site you should contact your health care provider. This may be a sign of infection, which, if left untreated, can cause a number of complications.

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I have noticed that my results can vary with the injections as does the length of time they help. Sometimes it doesnt help at all and it puts me in more pain as the tissues that were injected get inflammed and swollen.I guess like most things with this condition it is a hit or miss. Good luck to all that is effected by Finbro!
I had 4 shots last Thur. By Thur evening, I could barely walk. The trigger points which were in a flare, became very swollen and pinched nerves running down the front of legs. They tried to give out on me several times when I stood up. I had to take it easy for three days. I had to ice pack them that night and next two days because the area was so painful and swollen. I now have had 24 but need about 40 more.