Soft Tissue / Joint Injection for Pain Relief

 Joint / Soft Tissue Injection Therapy 

Trigger Point Injection / Soft Tissue / Joint injection therapy may be used as an option for treating chronic pain in some patients.

These are Injection shots medicated with needles. They can be given in a joint or soft tissue between bone and muscles. The Needle can be used to take out fluid or put in medicine. 

Anti - Inflammatory medicine is the most common drug to use in injections, these include corticosteroids and pain reliever such as lidocaine.

The injection can help diagnose or treat many different conditions like, 

• bursitis.
• tendinitis.
• arthritis.
• osteoarthritis.
• carpal tunnel syndrome.
• rheumatism.
• 
  
• Chronic Musculoskeletal and sports conditions like Fibromyalgia, Frozen shoulder, Chronic ankle sprain, and muscle belly strain are some common indicators for soft tissue dysfunction. 

Trigger Point Injection 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.

 belly strain is some common indicators for soft tissue dysfunction.

Recent advancement and evidence studies revealed that the commonest location for the formation of tender knots is not in the muscle belly but in the muscle-tendon junction. 

Fascia research suggested that the trigger or tender spots are often found in the fascia layer covering the muscle fiber.

 Why Do Trigger /Tender Knots develop?

There are several proposed mechanisms to account for development for trigger point or tender spots in muscle or MT Junction and its subsequent pain pattern, but scientific evidence is lacking.

Both acute and chronic stress syndrome on muscle, tendon or bone.

poor posture, Sleep Disturbance, Vitamin D Deficiency, Alcohol, Drug toxication, Performance enhancement drugs, and anxiety or mental/ emotional stress may lead to the development of knots in the postural muscles.

 Physiology

Nociceptors  (Free Nerve Endings) causes local edema and venous congestion in Muscle and other connective tissue. 

leading to ischemia, Ischemia interfere with normal muscle metabolism stopping production of ATP,

 ATP later disturb the CALCIUM PUMP preventing Actin and Myosin to release from its contracted state

Commonest Muscles to get the knots are...

Neck 

(Upper Trapezius + Levator Scapulae + Rhomboid Minor)

Shoulder 

(Supraspinatus, Infraspinatus, and Deltoid ) 

Back 

 (Paraspinal + Quadratus lumborum)

Pelvis 

 (Hamstring + G Medius + Piriformis )

Common Indication

Rheumatoid Arthritis.

post-traumatic arthritis.

Ankylosing spondylitis.

osteoarthritis.

bursitis.

ligament sprain.

tenosynovitis / vaginitis.

plantar fascitis.

muscle belly strain.

Contraindication

Immune Disorder.

Septic Arthritis.

Diabetes.

Prosthesis.

Bacterial Endocarditis.

Coagulation.

Local Skin Infection.

Allergy.

TB.

Haemarthrosis.

Procedure 

In the TPI procedure, a healthcare professional inserts a small needle into the patient's trigger point. The injection contains a local anesthetic or saline and may include a corticosteroid.

 With the injection, the trigger point is made inactive and the pain is alleviated. Often, a brief course of treatment will result in sustained relief. Injections are given in a doctor's office and usually take just a few minutes. 

Several sites may be injected in one visit. If a patient has an allergy to a certain drug, a dry-needle technique (involving no medication) can be used.

Drugs 

Lidocaine - Most preferred drugs for muscle belly lesion for the fact that its effect starts within 2 min and lasts up to 60 min.

Tenoperiosteal and ligamento -  periosteal junction lesion can be treated by the infiltration of triamcinolone acetonide.

 Condition treated with SOFT Tissue IT.

few procedures done on the patient suffering from chronic pain syndrome are listed below

Location - HPE UK London, Physical therapy center.

1. Tennis Elbow

 

2. KNEE JOINT

Although some training is required, intra-articular injections are no longer considered an orthopedic sub-specialty procedure, and there are a number of benefits to incorporating these injections into your practice. Many patients appreciate their primary care clinician making available services that traditionally required a referral to a specialist. Patients also avoid treatment delays.

The best approach to a knee injection is the path of least obstruction and maximal access to the synovial cavity, which could be superolateral, superomedial, or anteromedial/anterolateral.

video link for intraarticular knee joint injection

3. Trapezius

Commonest muscle to get knotted is the upper trapezius in the shoulder region responsible for either a localized pain or referred pain to the shoulder or elbow joint

Soft tissue injection therapy procedure was performed on the tight trapezius muscle in response to chronic inflammation in sitting and in a prone position. 

4. Shoulder Joint

Chronic Shoulder pain Conditions like Frozen shoulder, Rotator cuff tendinitis, Supraspinatus tendinitis, AC Joint impingement

Procedure: these are injected by a needle into and around the joints to relieve pain and swelling. The surgeon should rule out any tear in the rotator cuff, which can be confirmed by investigation such as an MRI Scan. however, the infection should not be too frequent as this can increase the risk of vascular necrosis. 

post-therapy...

Stretch 

Local ice application.

Avoid weight-bearing activity.
Restrict meat intake.
Increase the hydration level.


HPE UK Physiotherapy studio - cover trigger point injection therapy in advance dry needling courses hosted in London, UK and Mumbai,India.

visit: www.hpeindia.in