Trigger Point Injections

What are trigger points?

Also known as trigger sites or muscle knots, trigger points are hyperirritable spots in muscles that are associated with palpable nodules—lump-like knots in tight tender bands of muscle fibers.

Unexplained pain frequently radiates from these points of local tenderness to broader areas, which are sometimes distant from the trigger point itself. There are reliable referred pain patterns which associate pain in one location with trigger points elsewhere. For example a trigger point in the shoulder can radiate pain into the arm.

Compression of a trigger point elicits local tenderness, referredpain, or local twitch response. The local twitch response is not the same as a muscle spasm. This is because a muscle spasm refers to the entire muscle contracting whereas the local twitch response refers a small twitch, no contraction.

Diagnosis of trigger points

Trigger points are diagnosed by examining signs, symptoms, pain patterns and manual palpation. Usually, there is a taut band in muscles containing trigger points, and a hard nodule can be felt. Often a twitch response can be felt in the muscle that activates the “all or nothing” response in a muscle that causes it to contract. Pressing on an affected muscle can often refer pain. Clusters of trigger points are not uncommon in some of the larger muscles, such as the gluteus group (gluteus maximus, medius or minimus in the buttocks). Often there is a heat differential in the local area of a trigger point.


Our Approach:

A successful treatment protocol relies on identifying trigger points, resolving them and if all trigger points have been deactivated, elongating the structures affected along their natural range of motion and length. In the case of muscles, which is where most treatment occurs, this involves stretching the muscle using combinations of passive, active, active isolated AIS, muscle energy techniques MET, and stretching the local area affected. Fascia (soft tissue coverings) surrounding muscles are also treated, with myofascial release to elongate and resolve strain patterns, otherwise muscles will simply be returned to positions where trigger points are likely to re-develop.

Specialized Physical Therapy: Our myofascial trigger point therapists may usemyotherapy(deep pressure), massage, mechanical vibration, pulsed ultrasound andelectro stimulation to de-activate the trigger point and relieve pain.

Trigger Point Injections:

Trigger point injections (TPI’s) are a valuable option in treating pain experienced by many patients including,

Myofascial Pain Syndrome and Fibromyalgia

The Injections, which include: saline, local anesthetics andcortisonecan provide more immediate relief and prove effective when other methods fail. The injections are performed using continuous ultrasound guidance to ensure pin-point accuracy.

These procedures are effective in treating pain inyour muscles, joints, neck, mid back and lower back.

Most health insurance will cover trigger point injections.



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