Trigger point injections can alleviate muscle-related back pain by reducing inflammation in overly tight or knotted muscles. Also known as myofascial pain syndrome, a trigger point can develop when stress or an injury causes the tissue that covers a muscle (myofascia) to tightly contract and adhere to itself, cutting off its blood supply and preventing the underlying muscle from working properly. Back pain can result from a trigger point that develops in a muscle near the spine, or it can be “triggered” by a taut muscle located in another area of the body.

Types of trigger point injections

Contrary to popular belief, not all trigger point injections contain steroids. Furthermore, in those that do, the steroids are anti-inflammatory medications (corticosteroids) rather than muscle-building agents (anabolic steroids). Two main types of injections are used to treat trigger points:

• Cortisone (steroid). A mixture of a local anesthetic, saline solution and anti-inflammatory medication (corticosteroids) is administered directly to a tense or tender muscle. The anesthetic will temporarily desensitize the injection site, and the saline and anti-inflammatory medications will help relax the muscle, which can enhance circulation and promote healing.
• Dry needling. Similar to acupuncture, the local placement of a small needle alone can sometimes calm muscle spasms. This option may be suitable for a patient who has a history of allergy to local anesthetics or cortisone or prefers to avoid the use of medications.

When to consider injections

Many individuals who are living with chronic back pain benefit from nonsurgical treatment. Prior to recommending trigger point injections, however, most physicians advise their patients to begin with more conservative options such as physical therapy, stretching, hot/cold therapy and pain-relieving oral medications. If the pain persists despite several weeks or months of first-line treatment, a patient might consider a more aggressive approach, such as an injection.

While not a miracle cure for back pain, trigger point injections can potentially provide fast and effective relief without surgery. With that said, it’s important to understand that this treatment does not work for everyone, and even when it does, its effects are only temporary. However, it can be a good option for helping a patient get through a particularly painful episode. If you would like to learn more, you are encouraged to talk with a physician.