Trigger Point Injection
A trigger point injection is a procedure designed to reduce or relieve the back pain caused by trigger points, which are small knots that form in muscles or in the fascia tissue leading to pain caused by muscle irritation. Myofascial trigger point pain is defined as pain arising from one or more myofascial trigger points, which are hyper-irritable spots in the skeletal muscle that are associated with hypersensitive palpable nodules in taut bands.29 A systematic review is a type of literature review that collect and critically analyze multiple research studies or papers. A systematic review by Cummings and White assessed the effectiveness of trigger point injection therapy for myofascial pain.29 The systematic review included a total of 23 randomized controlled trials in which all tested needle therapy to relieve myofascial pain.29 While the needling was effective, the positive effect of the therapy was more likely attributed to the needle of the placebo, not the drug injected. There was no pain improvement between direct needling or placebo.29
A systematic review is a type of literature review that collect and critically analyze multiple research studies or papers. Scott et al. studied the effectiveness of trigger point injections for chronic non-malignant musculoskeletal pain in their systematic review.31 Participants’ pain must have lasted more than 3 months to be included in the study.31 15 randomized controlled trials were included for the purpose of the study.31 Researchers found no evidence supporting the effectiveness or ineffectiveness of trigger point injections.31
In regards to pain relief, the three systematic reviews display no evidence for the effectiveness of trigger point injection therapy. A trigger point injection may not provide pain improvement, but a recent study has shown that ASTR treatment can result in significant pain improvement. ASTR stands for Advanced Soft Tissue Release, a manual therapy specialty developed by Dr. Joesph Jacobs, DPT. ASTR takes a holistic approach to treating the source of soft tissue restriction in a way that is virtually pain-free and highly effective.
28. Cotchett MP, Landorf KB, Munteanu SE. Effectiveness of dry needling and injections of myofascial trigger points associated with plantar heel pain: a systematic review. J Foot Ankle Res. 2010;3:18.
29. Cummings TM, White AR. Needling therapies in the management of myofascial trigger point pain: a systematic review.Arch Phys Med Rehabil 2001;82:986-92.
30. Xue CC, Helme RD, Gibson S, et al. Effect of electroacupuncture on opioid consumption in patients with chronic musculoskeletal pain: protocol of a randomised controlled trial. Trials. 2012;13:169. doi:10.1186/1745-6215-13-169.
31. Scott N. A., Guo B., Barton P. M., Gerwin R. D. Trigger point injections for chronic non-malignant musculoskeletal pain: a systematic review. Pain Medicine. 2009;10(1):54–69. doi: 10.1111/j.1526-4637.2008.00526.x.
32. Ernst E, Canter PH. A systematic review of systematic reviews of spinal manipulation. Journal of the Royal Society of Medicine. 2006;99(4):192-196.