What is a "Trigger Point Injection" or TPI?
TPIs are numbing medicine shots into the trigger points. Typically, while a trigger point is being injected, symptoms like numbness and tingling or pressure are felt at distant sites, confirming that the trigger point is why you felt symptoms in those distant sites in the first place. The symptoms in the far-away place are typically aggravated for a few seconds (maybe even a minute or two), but the area should quickly feel better than before the shot. Note: “dry-needling” can also be done by PTs or by Dr. Hancock if you can’t have numbing medicine for some reason, because the act of sticking a needle into a trigger point, even without medicine, can be helpful.
The medicine is “xylocaine” or “lidocaine”, which is the same medicine that most dentists use to numb your mouth, except there is no epinephrine in it, so it won’t make your heart race. This medicine is NOT a steroid. You don’t need a steroid because trigger points are NOT “inflamed.”
When injected into the knot, the medicine forces the trigger point to relax. The medicine washes away soon…faster than at the dentist’s office because there’s no epinephrine in the shot. However, the act of shutting down that knot even for a half hour is all it takes to “reset” the muscle’s tension regulator, the “muscle spindle,” at a lower level of tension. Think of it as being like when your computer starts acting weird and you power it down, wait ten seconds, and then power it back up. The computer supposedly “dumps” it’s short-term memory and wakes up refreshed and acting more normal. Similarly, after the trigger point injection, the muscle wakes up way more relaxed, with less of a knot or with the knot gone or at least less painful.
The duration of relief is typically MUCH, MUCH longer than the amount of time your face is numb at the dentist’s office. The relief can be permanent after one round of injections, and this is especially true if the muscle “twitches” on insertion of the needle. However, more commonly, the shots must be repeated on a few visits. It’s also possible that the shots will work for only a few hours. It’s impossible for Dr. Hancock to know until she tries them on you because everyone is different.
A twitch on injection is a sign that the knot was a bad one and really needed to be injected. When you get a twitch, the relief is usually impressive and immediate.