Pain is an experience that every person faces in one way or another at certain periods of their life. The definition of pain was made by the International Organization for Pain Research in 1979 as follows:

“Pain is an unpleasant sensation that originates from any part of the body, is connected to an organic cause or not, and covers all the experiences that a person has had in the past.”

A trigger point is a disorder characterized by the deterioration of the microstructure of November muscle tissue and its transformation into a harder tissue, fibrotic tissue. In the occurrence of this condition, even a small November muscle injury plays an important role. This may be a sudden injury, or it may also be due to slow-developing difficulties. The best example of slow-developing traumas is the muscle tension that develops due to stress. Nov. The fact that the muscle is constantly tense and Novated causes the formation of a trigger point.

How is Back Pain Treated With Trigger Point Injections?
We most often administer trigger point injection to patients admitted to Meltem hospital pain clinic. This procedure is performed by detecting active trigger points and applying them with local anesthesia or injection of ozone/oxygen mixture. It is usually administered 2 to 3 times a week unless otherwise indicated by the physician.

In addition, methods such as ultrasound, electrotherapy, magnetic field therapy are also added to be localized to the trigger point. November October, In addition to the methods we mentioned above, anti-inflammatory drugs, muscle relaxants may be recommended. Support for treatment is provided by applying exercise programs to the patient. Finally, RSWT ( Radial schock wawe therapy – radial shock wave therapy ) is also applied in our clinic as a very effective treatment method. With this method, the spasm at these points is relieved by applying a shock wave to the trigger point. Apart from these applications, the patient should give up habits that may lead to discomfort. It should be recommended to avoid chronic injuries by reviewing the activities of the patient’s daily life. The basis of treatment for chronic back pain is to break the vicious cycle of pain by eliminating trigger points. For this purpose, as it is used in other regions, many local treatment methods can be used for back pain.

Which Type of Back Pain Is It Used For?
There is no diagnostic laboratory or imaging technique for the treatment of back pain with trigger point Injection. Therefore, after other diseases are excluded in the differential diagnosis, diagnosis (diagnosis) is made by clinical examination.Five major and at least one minor criteria are required for the diagnosis of back pain.

Major Criteria :

A complaint of pain that is regional.
Pain and sensory change reflected from the trigger point to a certain area.
A tense band condition that Novates in the accessible muscles.
Extreme sensitivity that occurs at some point along the stretched band.
A decrease in the measurable range of motion.
Minor Criteria:

Pain caused by pressurized suppression of the trigger point.
Regional twitching response by suppressing the sensitive point in the taut band and needling.
Reduction of pain by injection of the sensitive point or stretching of the November muscle.
Is the Treatment Permanent?
The basis of the treatment applied with trigger point injection is to break the vicious cycle of pain by eliminating trigger points. For this purpose, many local treatment methods can be used.

Meltem hospital applies trigger point injection most often in our pain clinic. This procedure is in the form of local anesthesia or injection of an ozone/oxygen mixture into the active trigger points. Usually 2 a week?it is applied 3 times. The results of the applied treatment method vary from person to person and their reactions to the treatment, on average, pain gradually decreases and disappears within 3 weeks. Generally, 80 to 90% and some cases provide a 100% success rate.

How Many Sessions Do I Need to Practice?
With trigger point injection, the patient with back discomfort is placed on the massage table in the appropriate position for his discomfort, after which the locations of the muscles thought to be associated with pain are accurately determined by specific extension, flexion or November movements, and the trigger points are accurately determined by palpation. After that, the trigger points are deactivated with deep impact massage. In order to relax the muscles, opening and stretching exercises are also performed, depending on the discomfort, at least three and Nov 8 to 10 sessions are usually sufficient, unless otherwise indicated by the doctor.

When Does It Show Its Effect?
Gradually, the benefits begin to be felt during the first session of the application. According to the size and level of discomfort experienced by some patients, the procedure can be repeated according to the decisions of the physician in patients who do not benefit from the first procedure. However, it is not recommended to repeat it more than 2 times within 6 months. Especially in cases caused by disc overflow, the improvement is usually permanent. In cases that reach more serious dimensions, the chances of success are inversely proportional to the duration of the disease. In cases of severe nerve pressure, on the other hand, the improvement may be completely superficial. In cases where there is a mechanical pressure on the nerve, the doctor may also recommend surgical intervention.

What Needs to Be Done Before Injection
Before the epidural injection, ask your doctor to explain the method to you in detail.
Your doctor will ask you for written consent according to the law before treatment.
Inform your doctor about all your other ailments, if any, the medications you use, the factors that cause allergies, if any, and the medications you use. Herbal medicines such as vitamin E, glucosamine,garlic, ginseng can also lead to bleeding.
Since all blood thinning medications other than aspirin should be discontinued before entering the session, it is useful to inform and consult your doctor about it.
Take all your examinations, MRI,computed tomography, laboratory findings with you before entering the intervention.
Wear comfortable and non-boring clothes, leave your watches, rings and other jewelry at home.
Water and food intake should be stopped 4 hours before the procedure. But medications that need to be taken due to other systemic diseases can be taken with a very small amount of water.
Since a superficial anesthesia procedure called sedation will be performed during the procedure, it is not allowed to return home alone. Must be accompanied by an escort. At the same time, it is forbidden to drive because the local anesthesia applied may cause temporary weakness and numbness in the legs.
Are There Any Side Effects?
Epidural injections applied for trigger point back pain and other types of pain are among the treatments that have been performed safely in the world for about 50 years. Side effects are quite low in injections made with imaging technology. During the entry of the needle into the nerve canal, the spread of the contrast agent in the nerve canal can be seen live on the screen and an extremely result-oriented and safe injection can be made. Nevertheless, despite all the technological developments and precautions, there may be some undesirable side effects due to the procedure itself or the drugs used, at least a little. The most common side effects observed are temporary headache, temporary pain due to injection and blood pressure drop during injection. In some cases, there is also a risk of bleeding and infection, although much more rarely in some cases.