Local anaesthetic and anti-inflammatory steroid drugs can be injected into the trigger point. Painful conditions affecting one or more areas can be treated in this way. Only a small amount of steroid is needed and it will not cause any of the side effects sometimes associated with taking steroid tablets. They are not the same kind of steroids that athletes may take.
What has gone wrong?
It is not always clear why trigger zones develop. They can be associated with various illnesses, such as fibromyalgia, myofascial pain and chronic fatigue states. Trigger zones may be related to underlying inflammation. Often they occur because of lack of use of a muscle, when pain of whatever cause has been present for a long time.
The aim of the procedure is to reduce the spasm and ‘unknot’ the muscle. This lowers the sensitivity of the trigger zone, which reduces the pain messages. It is hoped that this will produce long lasting relief from your pain.
Your pain should be reduced and you should be able to move around more easily. This will make it easier to perform your daily activities. You will be able to reduce the number of painkilling tablets that you take.
Are there any alternatives?
By the time that you consider having the trigger zone injection you should have already tried other more simple treatments. These include rest, both pain-killing and anti-inflammatory tablets, and physiotherapy.
You may also have tried a transcutaneous electrical nerve stimulation (TENS) machine for your pain. This works by sending soothing pulses across the surface of your skin and along the nerve fibres. The pulses prevent pain signals from reaching the brain. They also stimulate your body to produce higher levels of its own natural painkillers, called endorphins.
What if you do nothing?
If you do nothing there are several things that may happen:
Who should have it done?
The following patients should have the procedure done:
Who should not have it done?
Each patient must make the final decision on whether to proceed or not. If you are unhappy about the procedure for any reason you should not continue.
There are specific medical situations when trigger zone injections should not be done and they are as follows:
When a patient is on medication that prevents blood from clotting, such as warfarin. This would lead to more bleeding than normal. It may be possible to stop the medication a few days before the procedure. This will need to be discussed with your doctor
When a patient is suffering from an illness that prevents blood from clotting, such as haemophilia. This would also lead to more bleeding than normal
When there is infection of the skin over the site where the needle needs to be put in. This could lead to deeper infection
Author: Dr Sean White FRCA. Consultant in pain and anaesthesia
© Dumas Ltd 2006