Trigger points
What are trigger points?
Trigger points are painful areas, nodules or taut bands in muscles or fascia.
Why are they formed?
Trigger points are usually formed following a muscle strain or injury.
Why do they cause pain?
Persistent small areas of muscle fibre contraction do not allow the muscle to act in its normal physiological fashion of contraction followed by relaxation. These tense areas cause local pain in one area of the body, or the pain can be felt away from the trigger point itself. By identifying and injecting these trouble spots, the tiny areas of over-contracted muscle or tight fascia suddenly release, allowing the muscle to return to its normal resting length. There is often immediate relief of pain, and greater range of movement. Sometimes there is a return of pain to a lesser degree either due to other deeper trigger points surfacing, or due to re-injury of the muscle, or on-going irritation from poor posture or ergonomics. Once these are corrected, the pain goes away.
Are there different types of injections?
Dextrose, saline, sterile water or local anaesthetic can be used.
How are trigger point injections different to other forms of treatment?
Acupuncture uses very fine needles inserted into a defined series of points identified by the Ancient Chinese. These needles stimulate the body to produce its own substances to facilitate healing. There are no medications injected hence the needles are very fine. Intramuscular stimulation also uses acupuncture needles and these are inserted directly into painful areas. Trigger point injections use hypodermic needles to allow for the use of medications and to cause a more effective break up of the trigger point itself, but these needles are also very thin.
Do I need a referral?
Yes. We need a referral from a physician who knows you, preferably your family doctor. This promotes better health care for you, as health information is shared – we receive a medical history, and in turn we give a consultation report to your doctor, which is helpful for the integration and communication of your health care.
Will it hurt?
The needles are quite thin and most people tolerate them well. We will do everything we can to make the injections as comfortable as possible.
Are there any risks associated with trigger point injections?
There are very few side effects to trigger point injections. However, you may notice some of these:
· Light-headedness (not serious) or nausea (very rare)
· Bruising (not serious) and sometimes bleeding/oozing (stops with pressure)
· Brief “treatment stiffness” from the process of having an injection
· Infection (very rare). Let us know if any of the sites become increasingly red or painful.
· Pneumothorax (extremely rare but serious). If you develop sudden shortness of breath or significant chest pain or major trouble breathing you should immediately go to the nearest emergency room.
What is the cost?
Medical Services Plan (standard BC healthcare) covers the cost of the procedure. You do need a valid health care card and you do need to be registered with MSP before your appointment. If you do not have MSP coverage, you will be billed the BCMA private fee rate. Worksafe also covers the cost of the procedure.
There is no cost for the procedure if you have MSP coverage. We do however charge a fee for therapeutic drugs (injectables) used at your visit. We will give you a receipt for this when you pay. We cannot guarantee that your extended health plans will reimburse you for the cost.
What to expect at my appointment
Your first appointment will be a consultation during which time we will discuss your pain history, and examine you. Then if you have trigger points they may be injected which feels like….well, like an injection! Sometimes you feel a muscle twitch which can be the release of the trigger point.
How will I feel after the appointment?
You may experience a little "treatment stiffness". This doesn't last long, usually no more than a day. After this you should have less pain and better range of movement. It is safe to continue all your usual activities after treatment.
Practical advice
· Bring a hair tie if you have long hair
· Wear stretchy, easy to remove or loose-fitting clothes/sports clothes. A tank top and loose shorts are preferred.
· Wear dark clothes – they might get a little blood-stained.
Other treatment you may wish to consider
We also offer perineural injections (excellent for “nerve” pain), prolotherapy and medical acupuncture. All of these involve the use of needles but there is a manipulation technique we can use for releasing trigger points should you not wish to be injected. We offer advice for stretching, exercising and can recommend good reading material for dealing with pain.
More information on Trigger Point Injections can be found on the blog.
Trigger points are painful areas, nodules or taut bands in muscles or fascia.
Why are they formed?
Trigger points are usually formed following a muscle strain or injury.
Why do they cause pain?
Persistent small areas of muscle fibre contraction do not allow the muscle to act in its normal physiological fashion of contraction followed by relaxation. These tense areas cause local pain in one area of the body, or the pain can be felt away from the trigger point itself. By identifying and injecting these trouble spots, the tiny areas of over-contracted muscle or tight fascia suddenly release, allowing the muscle to return to its normal resting length. There is often immediate relief of pain, and greater range of movement. Sometimes there is a return of pain to a lesser degree either due to other deeper trigger points surfacing, or due to re-injury of the muscle, or on-going irritation from poor posture or ergonomics. Once these are corrected, the pain goes away.
Are there different types of injections?
Dextrose, saline, sterile water or local anaesthetic can be used.
How are trigger point injections different to other forms of treatment?
Acupuncture uses very fine needles inserted into a defined series of points identified by the Ancient Chinese. These needles stimulate the body to produce its own substances to facilitate healing. There are no medications injected hence the needles are very fine. Intramuscular stimulation also uses acupuncture needles and these are inserted directly into painful areas. Trigger point injections use hypodermic needles to allow for the use of medications and to cause a more effective break up of the trigger point itself, but these needles are also very thin.
Do I need a referral?
Yes. We need a referral from a physician who knows you, preferably your family doctor. This promotes better health care for you, as health information is shared – we receive a medical history, and in turn we give a consultation report to your doctor, which is helpful for the integration and communication of your health care.
Will it hurt?
The needles are quite thin and most people tolerate them well. We will do everything we can to make the injections as comfortable as possible.
Are there any risks associated with trigger point injections?
There are very few side effects to trigger point injections. However, you may notice some of these:
· Light-headedness (not serious) or nausea (very rare)
· Bruising (not serious) and sometimes bleeding/oozing (stops with pressure)
· Brief “treatment stiffness” from the process of having an injection
· Infection (very rare). Let us know if any of the sites become increasingly red or painful.
· Pneumothorax (extremely rare but serious). If you develop sudden shortness of breath or significant chest pain or major trouble breathing you should immediately go to the nearest emergency room.
What is the cost?
Medical Services Plan (standard BC healthcare) covers the cost of the procedure. You do need a valid health care card and you do need to be registered with MSP before your appointment. If you do not have MSP coverage, you will be billed the BCMA private fee rate. Worksafe also covers the cost of the procedure.
There is no cost for the procedure if you have MSP coverage. We do however charge a fee for therapeutic drugs (injectables) used at your visit. We will give you a receipt for this when you pay. We cannot guarantee that your extended health plans will reimburse you for the cost.
What to expect at my appointment
Your first appointment will be a consultation during which time we will discuss your pain history, and examine you. Then if you have trigger points they may be injected which feels like….well, like an injection! Sometimes you feel a muscle twitch which can be the release of the trigger point.
How will I feel after the appointment?
You may experience a little "treatment stiffness". This doesn't last long, usually no more than a day. After this you should have less pain and better range of movement. It is safe to continue all your usual activities after treatment.
Practical advice
· Bring a hair tie if you have long hair
· Wear stretchy, easy to remove or loose-fitting clothes/sports clothes. A tank top and loose shorts are preferred.
· Wear dark clothes – they might get a little blood-stained.
Other treatment you may wish to consider
We also offer perineural injections (excellent for “nerve” pain), prolotherapy and medical acupuncture. All of these involve the use of needles but there is a manipulation technique we can use for releasing trigger points should you not wish to be injected. We offer advice for stretching, exercising and can recommend good reading material for dealing with pain.
More information on Trigger Point Injections can be found on the blog.