Trigger Point Injections
Information about Trigger Points and their Treatment
- Use a tool if possible (such as a firm rubber ball) and save your hands.
- Use deep stroking massage, (a repeated milking action) not static pressure.
- Massage with short repeated strokes, moving the skin with your fingers, and releasing at the end of each stroke to go back to the starting point.
- Do the massage stroke in one direction only, whether with the grain of the fibres or across them.
- Do the massage stroke slowly, no more than one stroke per second.
- Aim at a pain level of 7 on a scale of 1 to 10.
- Limit massage to one minute per trigger point.
- Work a trigger point 6 to 12 times per day, until pressure on it elicits a pain level of only 2 or 3.
- If you get no relief, you may be working the wrong spot.
Is there anything more I need to do after massage has relieved the symptoms? Yes. After massage it is very important to: 7 Apply a hot pack covered with a dampened flannel or towel to the treated area for a few minutes. 7 Then gradually and gently stretch the treated muscle through its full range of movement 3 times, with a pause to deep breathe and consciously relax between each cycle.
- Learn respect for your muscles. They were not designed to be held for long periods in a sustained contraction or in a fixed position. Vary your tasks each day. Lift very carefully.
- Slow your working pace, and take short rests frequently, especially if feeling muscle fatigue.
- Do a daily program of passive stretches that puts the affected muscles through a full range of movement, and repeat the stretches throughout the day. Be like the cat– it rarely tries to walk after a sleep without first stretching smoothly and slowly.
- Massage any TPs up to a dozen times a day, for a minute at a time, as described above.
- Learn relaxation techniques, (eg yoga, meditation).
- Always watch your posture when sitting, reading, using the computer car or phone. Don’t stay too long in any one position.
- Work out what particular postures, movements and activities stir up your TPs. If you don’t have to do that activity, then don’t. If you do, then modify how its done.(eg use the other hand).
- Avoid getting the muscles cold, by wearing an extra warm layer of clothing, and adjusting heating etc.
- Correct any imbalances in your diet, and take vitamin and mineral supplements as recommended by your doctor.
- When the TPs are very active and you have pain at rest, then gentle stretches and hot packs are your limit.
- Once the TPs are inactivated and constant rest pain fades, then a carefully graded exercise program is needed to increase muscle endurance and strength. This involves muscle lengthening exercises (adding a new exercise on alternate days), before working up to shortening exercises. Post-exercise soreness and stiffness should not last longer than 3 days or the program needs altering.
- Then a regular conditioning program is recommended, at least twice a week, for example swimming or cycling.