Most people have experienced muscle tension pain at some point in their lives, whether it’s a charley horse in the leg or a tight neck and shoulders from long hours at a desk. Sometimes, though, pain can spring up unexpectedly in your neck or back and have no clear source.

At Arctic Medical Center in Anchorage, Alaska, Dr. Chester Bradstreet can help identify back pain arising from a “trigger point.” If a specific knot of muscle causes pain to spike, he can provide an injection at the trigger to unknot your muscle and release your pain.

Understanding trigger points

Overuse of a muscle or an old injury can cause clusters of muscle fibers to become oversensitized. When these fibers tighten due to stress or other stimuli, they form a “knot” under the skin which you’ll often be able to feel or even see — they look and feel “ropy.”

This knot, or trigger point, can impact a nerve or cluster of nerves. You may feel not only direct pain in the muscle where the trigger point is located, but also referred pain in muscles elsewhere in the body that are connected by the nerves. This referred pain can affect multiple areas at once.

If the trigger points persist, are paired with fatigue and/or depression, and your doctor has ruled out other likely causes, he might diagnose you with either fibromyalgia, a condition where your body amplifies the sensation of pain by affecting the way your brain processes pain signals; or myofascial pain syndrome, a “catch-all” term that means you have widespread pain and inflammation in the fascia (connective tissue) that surrounds the muscle.

Treating trigger point pain

Trigger point pain, regardless of the diagnosis, can often be successfully treated with trigger point injections, or TPI. Dr. Bradstreet will work with you to identify where your trigger points are located — if he presses on a muscle, and you feel the pain radiate to other body parts, that indicates a trigger point. Once the source of your pain is identified, he can create a plan for treatment.

In most cases, TPI is the recommended treatment. The doctor uses a fine needle to inject a saline, a saline/anaesthetic, and/or a corticosteroid solution directly into the trigger point. While corticosteroids reduce inflammation around the nerve cluster, and an anaesthetic temporarily numbs the area, researchers can’t yet agree on how or why saline works to reduce trigger point pain.

To take it a step further, sometimes doctors use a dry needle (no solution at all) as the “injection,” and it does work in some people, though, again, the mechanism is unknown. In fact, TPI’s effectiveness as a treatment method for trigger point pain is still being studied.

Trigger point injections can be repeated at intervals, if needed, to relieve pressure and release pain. Dr. Bradstreet often uses TPI in conjunction with other treatments for back pain, such as physical therapy or massage.

Dr. Bradstreet may also give you some tips for adjusting your lifestyle. Changing your chair position, desk height, mattress type, or sleeping position are all potential ways to help you avoid stressing the muscles in your back and triggering myofascial pain.

If you have unexplained neck or back pain and think it could be a trigger point problem, Call our office at (907) 290-8111 or request an appointment online.