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Trigger Point Injections For Migraines

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What Is A Trigger Point Injection

Trigger point injections with Botox in the treatment of neck pain London Pain Clinic

To begin, lets go over the basics. What is a trigger point injection treatment?

TPI is a procedure used to treat painful areas of muscle that contain trigger points, or knots of muscle that form when muscles do not relax. Many times, such knots can be felt under the skin. Trigger points may irritate the nerves around them and cause referred pain, or pain that is felt in another part of the body.

What Are Trigger Point Injections Used For

Healthcare providers use trigger point injections to help treat myofascial pain. Myo means muscle and fascial means fascia. Your fascia is the thin, white connective tissue thats wrapped around every muscle.

The pain and tenderness in myofascial pain are typically due to one or more trigger points. To the touch, trigger points feel like small bumps, nodules or knots in your muscle.

Trigger points can develop in any muscle, but the most common muscle groups that are treated with trigger point injections include:

  • Levator scapulae .
  • Gluteus medius .
  • Quadratus lumborum .
  • Sternocleidomastoid .

Trigger points can cause certain types of pain or issues. For example, trigger points affecting your trapezius muscle may cause tension headaches. A trigger point affecting your piriformis muscle can cause piriformis syndrome when the piriformis muscle presses on your sciatic nerve. It causes pain or numbness in your buttock and down the back of your leg.

Is Migraine Surgery An Effective Way To Treat Migraine Triggers

Migraine surgery often helps patients reduce the severity, duration and frequency of migraine attacks. It may provide a viable alternative to migraine patients who failed to relieve their migraine pain with medications or Botox injections, too.

For chronic migraine patients who are considering surgery, meeting with Dr. Cabin offers a great starting point. Dr. Cabin learns about a migraine patient and performs a full evaluation. He then crafts a custom treatment plan based on a patients migraine triggers. If Dr. Cabin believes surgery provides a safe, effective way to address migraine pain, he will recommend surgery. Or, if a patient does not qualify for migraine surgery, Dr. Cabin is happy to provide alternative treatment options.

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How Are Anatomical Migraine Trigger Sites Diagnosed

Dr. Cabin will perform comprehensive testing to determine whether a patient is a candidate for migraine decompression surgery, and which anatomical trigger sites to treat. However, he will complete a patient assessment only after an individual has received a chronic migraine diagnosis from a neurologist and finds that current medications are not working and/or cause intolerable side effects.

It may take several weeks or months to determine a patients anatomical migraine trigger sites. During this time, Dr. Cabin mayA may perform or prescribe one or more of the following tests to verify an anatomical migraine trigger site:

  • Nerve block injection
  • Examination by other specialists

Trigger Point Injections For Headaches Migraines & Muscle Pain


Headaches and migraines are complex conditions with many potential causes. In order to be able to treat them properly, we have to be prepared to offer many different treatments that can target these causes and provide relief.

One treatment we offer for these and other painful conditions is trigger point injections. This safe, noninvasive treatment can provide relief for many people with chronic headaches, migraines and muscle pain.

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How Trigger Point Injections Can Relieve Tension Headaches

Tension headaches can stop you in your tracks. One of the most common headaches, tension headaches can feel as if you have a tight band around your head. They can strike when you least expect it, and they can vary from mild to debilitating.

If you receive a tension headache diagnosis, trigger point injections may help you get relief. At Valerius Medical Group & Research Center in Los Alamitos, California, Nathaniel Neal, MD, and Rebekah Neal-Kraal, MD, offer trigger point injections as part of their comprehensive treatment for headaches. Trigger point injections are effective in reducing the frequency and severity of tension headaches.

What Are The Risks

The risk of complications from a trigger point injection is low. Infection and bleeding at the site of the injection are uncommon.

Before you get the shot, be sure your doctor knows about your medical history, allergies, and all medications you take. Let them know if you have any concerns about the injections or their side effects.

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What To Expect After Receiving Trigger Point Injection

After your injection, you should be able to return home without restrictions. In some cases, trigger point injections and manipulation can cause referred pain, which is pain in another area of the body other than the one that was treated.

In terms of migraine pain, some people have relief within hours, while others have none at all. If the treatment works to relieve migraine pain, it can last for several weeks before another injection is needed.

Is It Possible To Treat Migraine Triggers

Trigger Point Release Headache Therapy – Occipital Muscle Treatment and Self Help

There is no one-size-fits-all treatment to address the anatomical triggers of migraines. Following an initial migraine diagnosis from a doctor, individuals often receive preventative and pain-relieving medications to treat migraine pain. Preventative medications are designed to help individuals alleviate migraine pain over an extended period of time, while pain-relieving medications act quickly to treat migraine pain as it occurs.

Although migraine medications may be prescribed, these treatments sometimes fail to help patients achieve long-term migraine pain relief. In some instances, migraine medications are ineffective and do not help patients minimize migraine pain. Or, in other cases, migraine medications cause intolerable side effects like nausea, vomiting, dizziness and fatigue.

Dr. Cabin of The Migraine Institute treats the four anatomical triggers of migraines. He is happy to help individuals who have received a chronic migraine diagnosis and find that their current migraine medications are ineffective or cause unwanted side effects.

Dr. Cabin uses a comprehensive migraine consultation process to help a patient determine if Botox® or minimally invasive surgery is a viable option. He allocates significant time and resources to perform a patient assessment. That way, Dr. Cabin can help a patient find the best way to alleviate migraine pain both now and in the future.

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Benefits Of Trigger Point Injection For Headaches

There are lots of different treatment options out there geared toward those struggling with headaches. What makes trigger point injections different?

One of the primary benefits of trigger point injections for headaches is the fact that it can help to address the problem at the root.

If your headaches are triggered by tension in your neck and shoulders, taking pain medication will help for a little while. Eventually, though, the effects of the medication will wear off, and youll be left with the same pain as before.

Trigger point injections do involve the administration of medication to help relieve pain. They also aim to promote relaxation of the muscles in the neck and/or shoulders, though.

This combination provides immediate and more long-term relief. This is especially true when the injections are combined with other treatment modalities.

You could pair it with physical therapy to correct your posture. This would also help to reduce the amount of strain and tension placed on certain muscles.

How Are Injections Given And What Can I Expect

Doctors can give trigger point injections in their office during one of your appointments. You can be awake the entire time. First, they will do an exam to find the area or areas in your muscles that cause pain when they touch them firmly.

You may have more than one trigger point. If so, your doctor can give you multiple injections during a single visit. Depending on where your trigger points are, your doctor may ask you to sit or lie down. Then, theyâll use a small needle to inject the medication.

You may have some pain during the injection. Itâs also common to be sore or feel numb in the area of the shot for a little while afterward.

Although youâll be able to use your injected muscle right away, you shouldnât do hard activity or lift heavy objects. Ask your doctor when itâs OK to go back to your normal exercise routine.

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Can Trigger Point Injections Help My Headaches

As you probably know, headaches are extremely common. In developed countries, tension-type headaches affect more than a third of men and half of women. And of those people, up to 1 adult in 20 has a headache every day. Migraine, a neurological headache disorder, affects at least 1 adult in 7 worldwide.

At Pinnacle Pain and Spine, Matthew Crooks, MD, and our staff understand how disabling headaches can be, making it difficult to concentrate or even to function.

For those whose headaches are brought on or exacerbated by trigger points, trigger point injections may provide the relief you so desperately need.

Who Can Benefit From Trigger Point Injections

Trigger Point Injections Headache

Many people can benefit from trigger point injections, especially those who have both muscle pain and migraines.

Your doctor will review your medical history and other migraine treatments youâve tried, and they may do a physical exam to see if muscle tightness and trigger points are making your pain worse.

You may twitch or notice a spasm when your doctor pushes a tight muscle in your neck or shoulders. If that happens, it may be a sign that these injections can help ease your muscle tension and migraine pain.

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What Happens During Trigger Point Injections

First, your provider identifies the trigger point. Then your provider injects the saline solution and medication into the trigger point. If you have several trigger points, you may receive injections for each trigger point during your visit.

Treatments usually take just a few minutes. Along with the injection, your provider may also massage the knot to help loosen the trigger point and enhance the effectiveness of the injection. The injection site may feel sore, and you may notice some bruising after your injection, but this should resolve within a few days.

To see if trigger point injections can relieve your tension headaches, book an appointment online or over the phone with Valerius Medical Group & Research Center today.

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How Frequently Will Patients Need Trigger Point Injections

Optimally, a trigger point resolves after one injection. This may happen when a patient has one isolated trigger point, especially if the cause of the trigger point has been removed . Trigger points caused by chronic conditions such as fibromyalgia and myofascial pain syndrome tend to recur due the underlying problem. In these cases, trigger point injections may be administered on a regular or as needed basis. The frequency of trigger point injections depends on the medication being injected. If only lidocaine or a mixture of anesthetics is injected, then the injections can be administered as ongoing therapy as frequently as monthly. If a steroid medication is injected, TPIs should be administered much less frequently, at the discretion of the treating health care professional, because of the risk of tissue damage or shrinkage from the steroid medication.

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Can Certain Foods Trigger Migraines

Certain foods have been shown to trigger migraines in some patients. These foods include:

  • Aged Cheese: Cheddar, feta and other aged cheeses contain tyramine, a substance that has been linked to headaches.
  • Alcohol: Beer, red wine and other alcoholic beverages increase blood flow to the brain. Some alcoholic beverages also contain sulfites that cause headaches.
  • Food Additives: Hot dogs, ham and other foods may contain preservatives that dilate the blood vessels.
  • Cold Foods: Consuming ice cream or drinking cold beverages too quickly may lead to headaches. In fact, recent research indicates approximately 90% of migraine sufferers are more sensitive than others to ice cream.
  • Caffeine: Drinking excessive amounts of coffee, tea and other caffeinated beverages may cause headaches. Also, caffeine withdrawal has been linked to headaches.

What Are Trigger Point Injections And Can They Help Me

Trigger Point Therapy | Tension Headache | Suboccipital Muscles

A trigger point injection is a mixture of saline and a local anesthetic like lidocaine into the muscle knots.

You should feel relief at the spot of the injection and in the areas of referred pain since the muscle contractions have been silenced. That means if the pain is being referred into your neck and head, causing headaches, you should experience headache relief following the injection.

The anesthetic works by blocking pain receptors within the nerves surrounding the muscle, thereby reducing the pain signals sent to the brain.

If Dr. Crooks includes a steroid, it works to reduce the inflammation and swelling of tissue around the nerves, also helping to reduce pain. Even using a needle without any medication can be helpful since it separates, relaxes, and lengthens the muscle fibers. We often use it for patients who are allergic to the anesthetic.

The best candidates for trigger point injections are patients who have specific trigger points that generate pain when touched. They can provide immediate relief if you suffer severe pain from a tension-type headache or a migraine attack. They can also treat a worsening of symptoms if you have a chronic headache disorder.

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How Does A Trigger Point Injection Work

A trigger point injection is formulated to target the knots or trigger points in the body, helping soothe pain in muscles, especially in the lower back, arms, legs and neck.

At Advanced Surgical Technology, each person is assessed individually. During consultation and assessment, an examination is done of the painful points in the body to locate and feel the severity of the trigger points you suffer from.

Based on this assessment, an injection of a small amount of steroids or anesthetic, or in some cases, both, is prepared. This is then injected, while you sit or lie down. The injection goes directly into the trigger point, helping to break up the knot and ease the pain, offering relief and allowing injuries to heal. The process of injection takes only a few minutes.

Botulinum Toxin Injections Nerve Blocks And Trigger Point Injections Are Safe Andeffective In

Regina Krel, MD and Paul G. Mathew, MD, DNBPAS, FAAN, FAHS

In persons with headache disorders for whom oral therapeutics are inadequate, poorly tolerated, or contraindicated, procedural options should be considered. Procedures can be abortive and/or preventative, as well as diagnostic in some cases. These treatments also vary in invasiveness ranging from peripheral nerve blocks to surgical decompressions. Procedures can be used independently or with oral pharmacologic and nonpharmacologic treatment options.

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Indications: Physical Exam Posture

The key to injection treatment of most primary headache disorders is the identification of areas on the head and neck that reproduce the patient’s headache pain., Most patients having migraine without aura, some having migraine with aura, and most who have tension-type headache have myofascial TP tenderness of muscles, ligaments, and tendons of the head and neck which, when pressed, reproduce their typical headache pain both during and between headache episodes., – Local anesthetic injection to these tender areas can stop pain arising from them for hours to months.

Forward head posture, as measured by a variety of techniques, occurs in many patients who have TTH and also migraine without aura it may be associated with continuous myofascial strain of the neck extensors, which could be a chronic source of local and referred pain., Correction of forward head posture may be an important but relatively unexplored aspect in the treatment of primary and secondary headache disorders.

Trigger Point Injections: The Effective Headache Remedy You Havent Tried

Trigger Point Injections Chicago

Most everyone experiences a headache at some point, but some people are prone to chronic and debilitating head pain that interferes with their lives in significant ways. If you fall into this unfortunate group, youve likely exhausted the over-the-counter medications that dont seem to even come close to remedying your pain.

Here at Bryn Medical, we pride ourselves on tackling chronic headaches from every angle to garner effective and long-lasting solutions that dont simply mask the pain. As part of our treatment plan, weve had great success with our patients in Chattanooga, Tennessee, using trigger point injections.

If youd like to explore how trigger point injections may work to remedy your chronic headaches, read on.

Loosening the knotYour body is an incredibly complex system where everything is somehow connected, which is especially true of your soft tissue, including your muscles. If youve ever had a small muscle spasm, you understand how that small knot of muscle can cause both localized and radiating pain that affects your surrounding muscle. This is because your complex network of muscle is being pulled by the knot of tension. Imagine pulling at the center of a spider web and the effect it has on every thread in that web as theyre drawn taut.

After we thoroughly examine you and review your symptoms to identify the trigger point that may be responsible for the radiating pain, we inject that area, which provides you with immediate, much-needed relief.


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What Are Migraine Trigger Point Injections

A migraine trigger point injection involves the use of an injectable treatment to alleviate migraine pain. The injection may contain a local anesthetic or steroid medication and is intended to provide immediate migraine pain relief.

Typically, a migraine trigger point injection is performed at a doctors office. It does not usually require sedation and may be performed while a patient is sitting or lying down.

During a migraine trigger point injection procedure, a small needle is inserted into a patients skin. A doctor may use one or more injections during a single treatment session. He or she may also perform peripheral nerve blocks in conjunction with trigger point injections.

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