Trigger points are discrete, focal, hyperirritable spots located in taut bands of skeletal muscle. They produce pain locally and in a referred pattern and often accompany chronic musculoskeletal disorders. Acute trauma or repetitive microtrauma may lead to the development of stress on muscle fibers and the formation of trigger points.
Trigger Point Injections are used to reduce muscle pain and attack the cause of the pain at its source.
Patients may have regional, persistent pain resulting in decreased range of motion in the affected muscles. These include muscles used to maintain body posture, such as those in the neck, shoulders, and pelvic girdle. Trigger points may also manifest as a tension headache, tinnitus, temporomandibular joint pain, decreased range of motion in the legs, and low back pain. Palpation of a hypersensitive bundle or nodule of muscle fiber of harder than normal consistency is the physical manifestation typically associated with a trigger point.
Trigger point injection has been shown to be one of the most effective treatment modalities to inactivate trigger points and provide prompt relief of symptoms.
Cortisone is a form of steroid. Cortisone injections decrease inflammation and are used to relieve joint pain, tendonitis and bursitis. At Truong Rehabilitation Center, all Cortisone Injections are performed with ultrasound guidance for precision, resulting in increased effectiveness, fewer adverse effects, less needle pain and require less medication.
Treatments with Cortisone
Cortisone Injections are a common treatment for low back or leg pain. In use since 1952, these injections are still an integral part of the non-surgical management of sciatica, low back pain, and arthritis joint pain. The goal of the injection is pain relief. At times the injection alone is sufficient to provide relief, but commonly a cortisone injection is used in combination with a comprehensive rehabilitation program to provide additional benefit.
While the effects of the injection tend to be temporary (providing relief from pain from one week to one year), an injection can provide sufficient pain relief to allow a patient to progress with a rehabilitative stretching and exercise program. If the initial injection is effective, the patient may have up to three in a one-year period.
Hyaluronic Acid Joint Fluid Injections lubricate knee joints helping to relieve stiffness and pain.
Hyaluronan is a natural substance found in your joint cartilage and in the synovial fluid that fills your joints. In the knee joint, hyaluronan acts as a lubricant and a cushion.
The goal of Hyaluronan is to supplement poor-quality hyaluronan in your painful knee with additional highly purified hyaluronan. Hyaluronan is a non-surgical, non-pharmacologic therapy for knee osteoarthritis. This therapy can help relieve your pain, improve your mobility, and get you back to your normal activities.
Neural Fascial Prolotherapy decreases the inflammation of nerves that supply the joints that are causing pain. This treatment involves the injection of dextrose into the subcutaneous tissues to induce healing. This is contrasted to traditional Dextrose or PRP Prolotherapy whereby Prolotherapy solutions are injected into ligament and tendon attachments onto bone (fibro-osseous junction injections).
Dextrose is a potent TRPV-1 receptor antagonist that causes down regulation of several pro-inflammatory mediators such as Substance P, CGRP and glutamate. These TRPV-1 receptors are found in abundance in our subcutaneous sensory nerves and seem to be at least part of the reason our chronic pain conditions remain so chronic. Until the use of low-dose near-nerve dextrose injections, we did not have an effective way of helping these superficial nerves to heal. Studies show that if these painfully inflamed nerves are treated with several injections of low-dose dextrose, these nerves will heal and the result is healing of the damaged tissue where the nerves end.
During this treatment, small amounts of low dose dextrose are injected just under the skin overlying the painful joint. If affected nerves are working properly, positive growth factors are transported up and down the length of the nerve signaling and controlling the healing mechanism. If these nerves are injured, entrapped, swollen or cut, this will block the flow of these growth factors and potentially impede healing. This may be an important factor in successful healing that has been ignored by modern orthopedics up until now. And paying attention to the superficial sensory nervous system may help explain why there is such a poor rate of healing of soft tissue injuries that leads to the chronic pain that plaguing so many of our patients.
Electromyography (EMG) is a diagnostic procedure to assess the health of muscles and the nerve cells that control them (motor neurons).
Motor neurons transmit electrical signals that cause muscles to contract. An EMG translates these signals into graphs, sounds or numerical values that a specialist interprets.
An EMG uses tiny devices called electrodes to transmit or detect electrical signals.
During a needle EMG, a needle electrode inserted directly into a muscle records the electrical activity in that muscle.
A nerve conduction study, another type of EMG, uses electrodes taped to the skin (surface electrodes) to measure the speed and strength of signals traveling between two or more points.
EMG results can reveal nerve dysfunction, muscle dysfunction or problems with nerve-to-muscle signal transmission.
Nerve Conduction Study and EMG are diagnostic tools commonly used to evaluate the functional level of electrical conduction of the sensory and motor nerves.
Nerve Conduction Studies and EMG are used mainly for the evaluation of paresthesia (numbness, tingling, burning) and/or weakness of the arms and legs. The study is used to evaluate conditions such as: