TRIGGER POINT INJECTIONS
Myofascial pain is among the most common complaints for which patients seek care from their Physicians. There are over 600 muscles in the human body and many chronic and complex medical conditions can have an element of Myofascial injury.
Myofascial pain is associated with pain within the fascia. Fascia is a band or sheet of connective tissue beneath the skin. This tissue attaches, stabilizes, encloses, and separates muscles as well as other internal organs. Fascia can be found throughout the entire body within superficial and deep layers. This tissue has a lot of nerve supply which is one contributing factor to the pain that fascia can manifest.
Myofascial pain can also be associated with muscle tenderness arising from Trigger Points within a specific muscle. Trigger Points are described as focal points of tenderness caused by contracted muscle fibers which are only a few millimeters in diameter. Upon examination these Trigger Points are identified as painful bands/nodules found at singular and/or multiple sites within the effected muscle as well as the fascia of the muscle tissue. They form as a local contraction in a small number of muscle fibers within a muscle bundle or even the larger muscle itself. These Trigger Points can pull on tendons and ligaments associated with the muscle they are found in and can cause pain deep within a joint where there are no actual muscles.
TRIGGER POINT INJECTION THERAPY
Trigger-Point Injection Therapy is used to treat muscular and fascial pain. Treatment can help improve muscular range of motion and function. It is performed by injecting the trigger point with a small amount of injectable such as saline, vitamin B or an anesthetic.
Our Doctor uses less then 1 drop (about 0.1 cc) of 1% Lidocaine (a local anesthetic) for each area of trigger points released.
During the treatment, when the needle is inserted a "twitch" response may occur. The injection of the local anesthetic as well as the insertion itself facilitates the relaxation of the effected muscle fibers, ie the Trigger Point. It is this disruption of the trigger point by the needle that "releases" the contracted muscle fibers which in turn relaxes the whole muscle.
After treatment the Doctor will usually suggest home care. When the area is pain free and mild stretches are performed the patient is commonly and quite quickly able to move more freely without pain. The increase in movement may also help treat other possible satellite trigger points found within the effected muscle. The final result is the entire muscle being able to relax. The anesthetic wears off in less than an hour but, the pain free range of motion has been known to last.
Using an injection of saline, or any other substance, does not further relax the muscle. There is no difference in long term relief. Using Lidocaine, the local anesthetic, at 0.5-1% concentration, merely decreases the amount of discomfort and length of time of post needle soreness.
The average patient can have positive results within 3-8 treatments. This depends on where the Trigger Points are located and how chronic the issue is.
A rest period of 3-5 days is recommended after each treatment to allow the treated muscles to recover. This means DO NOT over use the muscles that have been treated with moderate to extreme exercise. It is suggested to maintain mobility with basic movement such as walking and gentle stretching.
All treatments at our clinic are provided by a fully licensed Medical Doctor who has many years of experience with Trigger Point Injection Therapy. Often people confuse Trigger Point Injection Therapy with Acupuncture, IMS or other types of injections. It is not the same at all. It is important for the patient to understand that Trigger Point Injection Therapy is a procedure and, in this case, is performed by a Medical Doctor. The injectable is a short acting local anesthetic (without steroids or adrenalin). No other medication is injected.
Patients who cannot be treated include:
Trigger Point Injection Therapy may not be considered as a beneficial treatment for some patients. These patients have a higher risk for complications. Please consult with your Family Doctor before treatment if you are one of the following:
Patients who have been prescribed blood thinners
Patients who have a Compromised Immunity
Patients who are pregnant
Patients with blood disorders like hemophilia
Patients who have an infection around the area the needles need to be inserted
Patients who are severely scared on needles
Conditions that could benefit from Trigger Point Injection Therapy include:
Pain in the muscles without injury or cause
Whiplash of the shoulder & neck (e.g from a Motor Vehicle Accident)
Tension Headaches and/or Migraines
Strain or Sprain injuries of any part of the body
Mechanical back pain
TMJ (jaw) pain
As with any procedure, side effects may occur during and/or after treatment. Patients may have some varying degrees of the following symptoms.
Side Effects of treatment can include (but are not limited to):
Parasympathetic reactions such as feeling warm, full body sweats, dizziness
Tenderness where the needle was inserted
Bleeding where the needle was inserted
Tiredness or Exhaustion
Rare side effects can include:
Flare-up of initial complaint
Dizziness resulting in the patient fainting
Infection where the needle was inserted
Nerves and/or blood vessel injury
Skin irritation caused by an adverse reaction to the anaesthetic
Depending on the area treated, Pneumothorax may occur. This is a serious condition and needs emergency treatment.
The MD will go over all possible risks of treatment during the consultation.
If you are a resident of BC with valid MSP coverage then treatment is provided at No Charge.
To be seen at VIP Therapy for Assessment and/or Treatment, a referral is required from your Family Doctor and/or Specialist. It is absolutely necessary that you and your Doctor/Specialist have a clear discussion about receiving Trigger Point Injection Therapy. There may be other medical conditions that need to be treated prior to receiving this treatment.
Please be sure to have your Physician Referral Form emailed or faxed to the office PRIOR to your first appointment. Without this form the MD cannot perform treatment. The referral form can be found on the "Referrals and Forms" page of this website where you can download and print it. The form needs to be completed by your Doctor and the appropriate investigations and/or history are to be provided along with the referral.
Please note that VIP Therapy does not accept open WorksafeBC cases without prior WorksafeBC approval.
If you have further questions regarding the Trigger-Point Injection procedure or general inquiries please call VIP Therapy @ 604-948-0260. Be aware that we cannot discuss your case or provide specific medical advice over the phone.