Trigger Point Injections

What are Trigger Points?

Occasionally, a specific muscle may generate pain due to sustained contraction and subsequent localized ischemia & oxygen deprivation. While this type of pain is usually secondary to another problem, it can occur primarily. These areas of muscle pain (as seen above) are called trigger points and are described as irritable spots in skeletal muscle that are associated with palpable taut and tender bands of muscle fibers.

Researchers believe that these tense are small contraction knots and a common cause of pain. Compression of a trigger point may elicit local tenderness, referred pain, or local twitch response. It also creates an increased local energy demand. This local energy crisis releases neuroreactive biochemicals which sensitize nearby nerves. The sensitized nerves initiate the motor, sensory, and autonomic effects of myofascial trigger points by acting on the central nervous system. Muscles with trigger points are muscles in a constant state of energy crisis.

The trigger point model states that unexplained pain frequently radiates from these points of local tenderness to broader areas, sometimes distant from the trigger point itself. Practitioners claim to have identified reliable referred pain patterns, allowing practitioners to associate pain in one location with trigger points elsewhere.

How do Trigger Point Injections work?

Trigger point injections employ small needles and local anesthetic (lidocaine) to mechanically break up the muscle “knots”. The procedure takes less than 5 minutes. Side effects may include mild soreness during the first 24 hours, followed by a sense of openness and looseness in the muscle group. Possible side effects of any injection include a risk for bleeding or infection. Lidocaine is an anesthetic which can stop cardiac arrhythmias, but can also cause them if injected intravenously. Because the injection site is the muscle and the syringe is pulled back to make sure we are not in a blood vessel the risk is extremely low. Lidocaine is metabolized in the liver. Lidocaine leaves the body within 4-6 hours. Aside from lidocaine, traumeel, a blend of several herbal medications, can be injected into the trigger points.

Dr. Donaldson prepares his injections by mixing a solution of a local anesthetic & a natural homeopathic which is then administered directly into the trigger point of the associated muscle. This injected solution facilitates relaxation of the muscle at the exact site of the trigger point. After a series of injections (along with some myofascial release), the muscle “learns” to calm down and the patient regains optimal function free of pain and limitation.