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TRIGGER POINT INJECTIONS
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Background

Trigger point injections are a safe and quick procedure that can be performed at a sports medicine physician's office to relieve pain and discomfort from trigger points. Trigger points are localized painful areas within a muscle, often described as "knots" or spasms. They are common for athletes and non-athletes alike.

Typically, these points are in the upper and lower back and the core muscles involved with posture and balance, such as the large muscles of the legs. Trigger points can result from various reasons, including increased stress, underlying medical conditions or more commonly, acute injuries or overuse.

Symptoms/Risks

The typical symptoms of a trigger point involve focal muscle pain, which can expand or “refer” to other areas as a part of a recognized pattern when pressed. For example, a trigger point involving your neck or upper back may cause discomfort down your arm.

A single trigger point may be associated with surrounding trigger points that cause similar symptoms. Trigger point injections are safe but have small risks of infection, damage to underlying structures and brief soreness or numbness during or after the procedure.

Sports Medicine Evaluation & Treatment

Suppose you are experiencing pain from what may be a trigger point. In that case, you can visit a sports medicine physician for evaluation. At this visit, your doctor will discuss your symptoms, including your medical history, and perform a musculoskeletal examination to identify possible trigger points or alternative causes for your discomfort. Depending on your situation, your doctor may order additional tests such as blood work or imaging to help confirm that your pain is related to the trigger points instead of another medical problem.

Trigger points are typically initially treated with physical therapy, massage or over-the-counter medications. If these treatments don’t work, your physician may offer a trigger point injection. This procedure includes using a small syringe to inject numbing medication and inserting a needle into the painful area to help to break the muscle spasm and encourage blood flow to promote healing. These are often performed in outpatient doctor's offices and do not require preparation before the procedure, such as changing medications.

The response to these injections varies from person to person, depending on the severity of symptoms and the overall treatment plan. Sometimes, relief is instantaneous, while other times, it may take additional treatment to achieve desired pain control.

Injury Prevention

Trigger point injections can be a great primary or additional therapy to help restore pain-free motion and overall function as an athlete recovers from acute or chronic injuries as a part of a structured rehabilitation program.

Return to Play

Depending on the response to the trigger point injection procedure, athletes can return to normal activities without restriction immediately or gradually. The best treatment of painful trigger points requires a comprehensive, interdisciplinary and team-based approach that can include injections to get athletes back on the field safely and able to perform their best. 

AMSSM Member Authors
Jordan Phelps, DO, Marvin Sineath Jr., MD, and Mims Ochsner, III, MD

References
1. Shipton B, Sagar S, Mall JK. Trigger Point Management. American Family Physician. 2023;107(2):159-164A. Accessed April 25, 2023. https://www.aafp.org/pubs/afp/issues/2023/0200/trigger-point-management.html

2. Christopher C Madden, Margot Putukian, Eric C McCarty, Craig C Young. Netter’s Sports Medicine - 3rd ed. 3. Elsevier;. 2023.

3. Hammi C, Schroeder JD, Yeung B. Trigger Point Injection. PubMed. Published 2022. https://www.ncbi.nlm.nih.gov/books/NBK542196/

4. North. North Cobb Spine and Nerve Institute (Infinity Healthcare). Northcobbspine.com. Published 2023. Accessed May 9, 2023. https://northcobbspine.com/trigger-point-injections.html

Category: Back and Neck, Chest and Abdomen, Leg and Thigh, Overuse Injuries,

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