Trigger Point Shot/ Trigger Point Injection

[sc4bbedwing]

I have a client coming in who said she had this done. A quick google search brought this up

Trigger Point Block
A trigger point block is an injection into an area of muscle spasm. The medication can include anesthetics like Novocain. It sometimes includes steroids for inflammation. Its goal is to reduce spasm and break what is called a vicious cycle. Untreated, spasm causes muscle injury, which causes more muscle spasm, more injury and so on. If one can get rid of the spasm, it may not come back.

Where will the medicine be injected?
Trigger point injections can be done anywhere there is a muscle. The commonest places that have spasm and large knots (the trigger points) are the trapezii muscles of the shoulders, the rhomboids between the shoulder blades, and the low back.

Are there risks?
Problems are uncommon. Rarely, there can be bleeding or infection from any shot. A nerve can be injured by shots in some areas. Trigger points over the chest have a small chance of causing a pneumothorax, a condition where air gets outside of the lung and needs to be removed by placing a c chest tube (a tube inside the chest but outside of the lung) for a day or two. As with any procedure, the chance of injury (risk) needs to be less than the chance of improvement. If the risk of injury is more than the likelihood of improvement, there would be no reason to do the procedure.

How long will it take?
You can expect to be in the doctor's office for about twenty minutes. You are asked to stay that long to make sure that you do not have a reaction to the medication. Normally you do not need a ride home. If the block is in an arm or leg, we ask you to bring a driver.

You may have some extremity numbness for a short while after the procedure. This is normal.

Are there any restrictions afterward?
After this type of block, we ask you to relax for a day or two and then resume your normal exercises. The area of the injection should, however, be stretched out a few times in the first twenty-four hours. If you do not know the stretches, ask the doctor.

Client has said that she believes that these shots may have developed some scar tissue where they were injected.
Does anyone have any insight on them, have you worked with them?
Thanks


edit:
Also found this

What are the different types of injections?

Cortisone falls into a group of chemicals called steroids. It is very different from anabolic steroids commonly abused by weight lifters or competitive athletes. The cortisone/steroid injections, used in medical practice, fall into three broad categories, articular injections, "trigger point" injections, and epidural steroid injections.
......

The "trigger point" injection is done to a tendon area or into the bursa surrounding such joints as the shoulder, knee, or the hip. These follow the same guidelines as articular injections as far as frequency.

 

[Pompal 09.]

i had ONE session with a client who had injections. she had TrP injection 3 or 4 months prior to the session. she told me she did not experience ANY relief from the injections. she also told me she was not participating in any self care, which from my reading seems to be very important following the injections (stretching in particular, along with correcting perpetuating factors). also this woman was an RN, she could not tell me much about the injection, such as muscle injected (indicated area of upper trapezius or levator scapula) or what solution was used. hopefully your client can give you more information than mine did.

TrP injections can include dry needling, procaine injection, lidocaine injection, isotonic saline injection, corticosteroid injection and botulinum toxin a injection.

i could find nothing in my reading in Travell & Simons' Myofascial Pain and Dysfunction about scar tissue forming at site of injection. just the following caveat:

A needle with a burr at the tip must not be used. When the tip of a disposable needle contacts bone, the impact frequently curls the tip to produce a "fishhook" burr that feels "scratchy" and drags as the needle is drawn through tissues; it causes unnecessary bleeding and should be replaced immediately.

good luck, and i am quite interested to know what you find out from the client, if you don't mind sharing.

 

[Pompal 09.]

I have treated clients that had previously had trigger point injections. I have also trained people that received corticosteroid injections. In both cases, the success of the injections varied wildly, from no relief to many months of symptom relief.

In general, a person receiving either type of injection needs to engage in self-care stretching and/or exercises unless specifically prohibited by their medical pro. This will promote the most rapid recovery of the tissues.

It's unlikely that a single injection would create enough scar tissue to significantly impair the health/function of the area. It's possible that the client started with a small amount of scar tissue from the injection. The sensation of tightness or limitation in that area may have dissuaded the client from moving/stretching it sufficiently to break down the scar tissue. Fascial adhesions could begin developing from this.

What the client perceives as "scar tissue" may simply be fascial adhesions resulting from their own lack of participatory activity. A quick visit to my web site to see "The Fuzz Speech" by Gil Hedley, Ph.D. would help explain this. I put it on my site so my massage and training clients, plus my yoga students, could better understand the importance of movement as part of their self-care. (My thanks to Gil for making this possible! )

 

[VisualEcho]

I had one session with her so far, and she said that they injected her with cortizone 7 or 8 years ago.
I didn't physically feel anything in the muscle besides "normal" knots.
I do have another session scheduled for later this month.

Will keep you posted!


On a side note, I'm kind of surpised that this subject never came up during school, I had never even heard of it before!