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How to Treat Chronic Myofascial Pain

If you are constantly experiencing pain, if it prevents you from sleeping at night, this is most likely myofascial nders your sleep at night, it is likely myofascial pain. You may also think you have a headache, although it could also be myofascial pain in nature.

Muscle pain or myofascial pain

Most people experience muscle pain from time to time. However, with myofascial pain syndrome, the pain is much more prolonged.

Myofascial pain syndrome is not the same as muscle spasm, although it involves muscle spasms. Without treatment, myofascial pain often manifests as a recurring cycle of spasm, pain, and spasm again. The exact cause of muscle spasm is unknown. It may be associated with the leakage of the neurotransmitter acetylcholine, which causes sustained muscle contraction.

What are trigger points?

In myofascial pain, there are areas called trigger points. Trigger points are usually found in the connective tissue (fascia) or tense muscles. If the muscles are irritated, inflamed, or tense, they can form trigger points. These are clusters of muscle fibers that are tense due to injury or repetitive movements (microtrauma).

These trigger points can then irritate the nerves around them, which can cause pain anywhere along the nerve pathways, even in areas far from the trigger points (referred pain).

These points are not visible, but they can be felt. It may feel like knots or nodules under the skin that are painful when pressure is applied. This results in muscle fibers getting stuck in a shortened state. Sometimes you may feel these knots by massaging the painful muscles.

One unique characteristic of trigger points is that the pain is not always felt at the location of the trigger point itself but may instead be felt in another area of the body, known as referred pain. In some cases, you may not feel pain at all. Instead, the muscle may feel tense, stiff, or have a limited range of motion.

Trigger points can be either active or passive. Active trigger points cause pain at rest or when pressure is applied. Passive or latent trigger points only cause pain in response to physical pressure.

Why do trigger points occur?

Trigger points often form after injuries, such as a car accident. But you can also strain your muscles by lifting a heavy box. If you’re hurt because of someone else’s actions, like in a car crash, it’s important to get help. Consider reaching out to a personal injury lawyer for guidance on getting compensation for your injuries and related costs. If you’re looking for Bakersfield, CA personal injury lawyers, contact the Johnson Attorneys Group! If this happens with extreme damage, contact a truck accident lawyer to assist you.

Many individuals with chronic myofascial pain have some form of vitamin and mineral deficiency. Changing the diet, treating gastrointestinal issues, and replenishing vitamin and mineral deficiencies through oral supplements can also help. However, to achieve quick and lasting results, it is necessary to address local nutrient deficiencies in the muscle tissues.

How common are these problems?

Myofascial pain and trigger points are widespread—about 85% of people experience them at some point. If your injuries were caused by someone else’s negligence, a personal injury attorney can help you seek compensation.

What are trigger point injections?

An injection into a trigger point can help reduce myofascial pain, especially in the neck, head, shoulders, arms, legs, and lower back. The goal of trigger point injection therapy is to alleviate pain by targeting and weakening these areas.

Trigger point injections typically involve the use of local anesthetics with or without corticosteroids, sometimes combined with botulinum toxin injections or multiple dry needle punctures without any injection substance. Each of these methods has its pros and cons, but I want to talk about another method that I consider to be the most effective: injections of a mixture of vitamins and minerals. These injections not only help relieve muscle spasms but also replenish the local deficiency of nutrients. This can resolve the issue more quickly and for a longer duration. Additionally, this method has minimal contraindications and side effects.

The treatment usually takes only a few minutes, and multiple trigger points can be targeted in one visit. No other form of trigger point therapy achieves this goal, which is why the effects are often temporary or require a much longer wait for sustainable results. When blood flow to an area is disrupted, the delivery of nutrients is also impaired. Injecting these substances is practically the only quick solution to address this problem.

What substances are included in the injections?

A local anesthetic is used, typically a 1% or 2% lidocaine or procaine solution, to provide pain relief through the injection into the trigger point. However, this can also have a therapeutic effect. Procaine is preferred over lidocaine because it serves as a nutrient for damaged muscles.

Local anesthetics also block sodium channels, thereby preventing depolarization. The overall effect is a reduction in muscle hyperexcitability in the injected area.

A deficiency of vitamin B12 and folates reduces the production of blood cells. Blood cells carry oxygen to the muscles. Magnesium aids in muscle tissue relaxation, while the rest of the B-complex vitamins act as co-factors for the Krebs cycle, the primary intracellular energy production cycle. Pain is primarily a sign of oxygen deficiency in tissues, and the supply of oxygen to tissues requires energy for blood transport.

Trigger point injections are very safe and, due to the presence of local analgesics, are virtually painless. After the local anesthetic wears off, patients may experience some discomfort at the injection site, which quickly dissipates.

Ozone injections into muscle tissue

Ozone injections can be performed after the administration of a local anesthetic into the tissue. Ozone also helps oxygenate the tissue and assists in combating any local infection that may be present in the inflamed tissue due to inadequate oxygen supply. The function of mitochondria in the tissues receiving ozone will also be improved.

By combining injections of local anesthetics with a complex of vitamins and minerals with ozone injections, the maximum effect in treating trigger points can be achieved.

Conditions where trigger point injections may help

  • Fibromyalgia;
  • Tendinitis/tendonosis;
  • Various muscle pains;
  • Ligament sprains;
  • Headaches caused by muscle problems;
  • Neck/back/lumbar pain, acute or chronic.

How does massage work in treating trigger points?

Massage helps release trigger points by increasing blood flow and flushing out toxins that have accumulated during blood stagnation in that area. This procedure can be quite painful compared to injections, but it helps alleviate pain by supplying the affected area with oxygen and stimulating muscle relaxation.

If you rely solely on massage, you will not achieve noticeable effects after the first session. A series of treatments is needed. Additionally, I often hear from patients that the effects of therapy cease once they stop regularly visiting the massage therapist. This makes such therapy highly expensive and time-consuming. By combining massage with trigger point injections, you can achieve much faster and more sustainable treatment results.

What is usually used to treat such issues?

Typically, pain medications or corticosteroid injections are prescribed. Long-term use of painkillers can lead to serious gastrointestinal and liver problems. Corticosteroid injections are also a temporary measure, and there are limitations on the number of injections due to significant side effects. Even if you use these methods to maintain functionality, it is better to combine them with other therapies that can help heal the problem rather than temporarily alleviate the symptoms.

Trigger Point Prevention

Despite trigger points being benign, they can cause severe pain and impact your daily life. Therefore, it is best to prevent their formation in the first place.

Here are some therapies and preventive measures you can try at home:

  • Regular stretching and exercises.
  • Maintaining proper posture.
  • Quality sleep in the correct position.
  • Proper diet and supplements.


Trigger points may be small, but they can cause intense pain and discomfort. Pain can restrict your physical activity, leading to the formation of new trigger points. Over time, this can create a vicious cycle of problems that can only be broken by initiating treatment for your chronic pain and restoring your mobility.