Trigger Point Injections

Trigger points are irritable “knots” in the bands of skeletal muscle tissue. These knots can cause pain, radiated pain, and are present in many chronic musculoskeletal diseases. Repetitive micro-trauma and acute trauma can lead to stress on the muscles and muscle fibers creating trigger points that can limit mobility, cause pain, and radiate pain to wide areas that include large muscle groups. Trigger points can affect the muscles that lead to poor posture, for example, neck, shoulders, and back. Trigger points can also contribute to tension, headaches, migraines, TMJ, back pain, and leg pain.  Lack of exercise, chronic poor posture, vitamin deficiencies, joint problems, and sleep disturbances can contribute to increased trigger points. Acute sports injuries and repetitive movements such as tennis elbow, golfer’s elbow, pitchers or golfers shoulder, surgical scars, and tissue under tension following surgery can increase the risk for trigger points.

Over 10% of the population (~23 million persons) are affected by chronic disorders of the musculoskeletal system. These disorders affect more of the working population and the elderly population and are among the leading causes of disability in these populations.

Trigger points can be classified as active or latent. Active trigger points can cause pain at rest. It is tender to palpate and often times when palpated radiates pain to a referred pattern in which patients will complain of pain, for example, the shoulder. A latent trigger point does not always cause pain but can limit mobility and range of motion. With limiting mobility and range of motion, the muscles can often times become weak and cause weakness within the joint.

Our Nurse Practitioner can assist with identifying trigger points in acute or chronic injuries that result in pain, limited range of motion, and cause radiation pain to affected areas. Trigger points consist of multiple injections of a local anesthetic (for example lidocaine) into the affected areas to release tension and break up the “knot” in the muscle. This elevates pain and allows for the muscles to move as it is intended.

In conjunction with trigger point injections, it is recommended to have evaluation and treatment by Janelle Brown LMT, CNMT with Biomechanical Integrity LLC. After trigger point injections, the muscles are relaxed and scar tissue buildup is broken down. Janelle can then provide tissue manipulation to improve range of motion and tension within the affected muscles. She also works to identify imbalances within the body to decrease chances of further trigger point manifestation. By incorporating stability, mobility, movement training, and soft tissue manipulation with trigger point injection therapy, prevention of painful muscle tissue and scar tissue of the muscle can be accomplished.


Kevin Wolf