Trigger Point Injections
A common source of muscle pain is from the development of painful trigger points in the muscle in a condition called myofascial pain. These are little areas of localised muscle spasm within the substance of the muscle and can sometime be felt as "bands" or "knots" in the muscle. They are commonly present as a source of pain in themselves, or they can develop in response to other pains in the same part of the body or elsewhere and can themselves contribute to the pain. Often, pain from trigger points radiates in characteristic patterns.
Sometimes, to try to break the vicious cycle of pain and further spasm that is involved in maintaining these points, they may be injected with a small quantity of local anaesthetic. Some doctors also use some locally acting steroid mixed in with this or, very occasionally, botulinum toxin.
If the treatment helps to reduce the pain and provide a "window" of pain relief it is critical that this period is used to increase exercise and fitness, which in the longer term is very important in myofascial pain.
There is some evidence that a very important part of this procedure is the actual process of putting a needle into the trigger point, not just the injected drug. Indeed, this discovery was one of the factors that led to the development of Western medical approaches to acupuncture – so called “dry needling” of trigger points.
(Please see general comments on the Procedures page)
The Trust's information sheet on trigger point injections can be downloaded here
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Pain Service Website, Gloucestershire Hospitals NHS Foundation Trust
Webmaster Dr J G de Courcy, Consultant in Pain Medicine and Anaesthesia
Page updated 22/6/2016