Myofascial Pain and
Trigger Point Injection (TPI)

Myofascial pain syndrome (MPS) is a chronic pain disorder that affects the muscles and the connective tissue that surrounds them, known as fascia. Trigger points are a common characteristic of MPS, which are areas of muscle that are hypersensitive and can cause pain in a local or referred pattern. Trigger point injection (TPI) is an effective treatment option for patients with MPS and can provide relief from pain, stiffness, and mobility restrictions.

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Trigger points are a common cause of myofascial pain and can be found in up to 93% of patients with chronic musculoskeletal pain. The condition is more common in women than men, and the incidence increases with age.

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Symptoms of MPS and trigger points may include:

 

• Localized or widespread muscle pain

• Tenderness or tightness in affected muscles

• Stiffness or limited range of motion

• Pain that worsens with activity or stress

 

What is Trigger Point Injection (TPI) Treatment?

 

Trigger point injection is a minimally invasive procedure that involves the injection of a local anesthetic or a corticosteroid into the trigger point. This can help to relieve pain, reduce inflammation, and improve mobility. The injection is typically given using a small needle, and the procedure takes only a few minutes to complete.

 

TPI Efficacy and Treatment Course

 

The treatment course for trigger point injections varies depending on the severity of the myofascial pain and the number of trigger points being treated. Most patients require a series of injections over several weeks to achieve optimal results. After the injection, patients may experience some soreness at the injection site, but this should subside within a few days. Patients should avoid strenuous activity for at least 24 hours after the injection.

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Randomized controlled trial published in Pain Medicine in 2013 found that patients with chronic neck pain who received TPI with lidocaine and corticosteroids had significant reductions in pain intensity and improved function compared to those who received placebo injections. The study concluded that TPI can be an effective treatment for chronic neck pain.

 

A systematic review and meta-analysis of TPI for MPS, published in the Journal of Back and Musculoskeletal Rehabilitation in 2019, concluded that TPI is effective for reducing pain and improving function in patients with MPS, and that it has a favorable safety profile.

 

A randomized controlled trial published in the Clinical Journal of Pain in 2020 found that patients with chronic low back pain who received TPI with lidocaine and dexamethasone had significantly greater reductions in pain intensity and disability compared to those who received sham injections. The study concluded that TPI can be an effective treatment for chronic low back pain.

 

Aftercare

 

Following TPI, patients may experience some mild discomfort, swelling, or bruising at the injection site. These symptoms should subside within a few days. Patients should avoid strenuous activity for the first 24 hours after the injection and may need to modify their activities for a short period following the procedure.

 

TPI is generally considered safe and effective for treating trigger points in muscles throughout the body, including the neck, shoulders, back, and legs. However, as with any medical procedure, there are potential risks and complications, including bleeding, infection, and nerve damage. It is important to discuss the risks and benefits of TPI with a healthcare provider before undergoing the procedure.

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If you are suffering from MPS, talk to Dr. Afshari about whether trigger point injections may be a suitable treatment option for you