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Back Pain Relief with Trigger Point Injections & Intramuscular Stimulation

Andrew in Sheffield, UK asks:

"A pain specialist suggests Trigger Point Injections or Intramuscular stimulation for my longstanding back pain. Could you explain more about this before I have it done?"

T J Salih, Senior Chartered Physiotherapist at the back2normal back and neck clinic, London replies:

"Muscle shortening can produce pain. It can often be felt in the muscle as tight ropey bands or as small points within a muscle. Small areas of muscle tightening associated with tenderness when palpated are often known as trigger points. A shortened muscle can be released by either injection of a chemical into the shortened area or by 'desensitising' the tight area by using sterile acupuncture needles. When a shortened muscle is released, pain which is caused by the shortened muscle is also eased.

"Trigger point injection is when a pain specialist or rheumatologist injects these trigger points with some sort of anti-inflammatory medication or muscle relaxant. The idea is to release the tension within the tight muscle and to relieve the pain associated with it. There are obviously side effects with any injection therapy.

"Intramuscular stimulation works by releasing the tight muscle areas by needling the trigger point with thin acupuncture needles. As the acupuncture needle is solid it tends to be a lot smaller in diameter than a hollow needle used for injections, so there tends to be less discomfort. When a needle is inserted into a normal muscle, there is minimal resistance felt. When a needle is inserted into a trigger point, there is more resistance felt and often the needle is grasped or held by the tight muscle fibres. Sometimes the tight trigger points actually twitch as the needle is inserted, if this occurs, there tends to be immediate muscle relaxation of the trigger point, and so relaxation of the muscle. Multiple trigger points can be needled in one session allowing a large muscle to be treated. Alternatively many different muscles can be treated in one session.

More about T J Salih >


Article published: 25th March 2004

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