Trigger Point Therapy
The term myofascial pain refers to discomfort that originates in the muscle tissue. Trigger points are the mediators of muscular pain. They are nerve centers within the muscle that control the state of contraction. Injury, overuse, stress, illness, and cold drafts are factors that can activate a trigger point. Active trigger points cause spasm and pain in the muscle. The pain may travel to another site, usually down an arm or leg, or around the trunk. Muscular spasm also restricts range of motion, i.e. movement.
Treatment consists of physical therapy, manipulation, and stretching, as well as injection of the trigger point. Physical therapy consists of using heat, cold, massage, ultrasound, various electrical treatments, and therapeutic exercise for stretching and strengthening. Manipulation uses controlled passive and active motions of the affected joints.
Injection of the trigger point is an option if more conservative treatments fail. Injection techniques use very fine needles to hit the trigger point and elicit a trigger or twitch response. Then Lidocaine is injected to numb the area (Lidocaine is a local anesthetic; cortisone preparations are rarely used). Next, the affected area is stretched. Then a hot pack is applied to the area. The Injection site may be sore from the needle for up to three days (usually local application of heat will alleviate any discomfort caused by the needle). Stretching exercises should be done for the next three days on a regular basis; however physical therapy, especially massage, should be avoided for the next three days. Injections are repeated only if necessary.
The initial brief discomfort of the injection is balanced by the long lasting relief, especially when other forms of treatment have failed.