If you’ve ever felt a deep, heavy, and constant pain in your back or neck, and when you touch it you notice a small knot or a tense area that makes you jump with pain, you know exactly how exhausting it can be. Doctors call this myofascial pain syndrome, and those pesky knots are known as trigger points. This pain affects both the muscles and the fascia (the thin membrane that covers and protects them). In a city like New York, where we’re always on the go, it’s very common for the body to take a toll. When the origin of your back or neck pain is muscular, a trigger point injection or dry needling become wonderful options to help you relieve that discomfort and restore your freedom to move without suffering.
Myofascial pain is one of the main reasons people visit the doctor for relief here in New York City. Unlike other issues such as tendinitis or joint wear and tear, there’s no visible damage on an X-ray. This means that if you don’t see a specialist, it can be difficult to diagnose, and you may feel frustrated because “they can’t find anything wrong,” even though you’re in a lot of pain.
Any muscle in your body can be affected, but it’s much more common to feel this heaviness in the neck, shoulders, hips, and lower back. Although it can occur at any age, it’s a condition we see very often in middle-aged women and, interestingly, in older men.
Sometimes this pain is accompanied by other conditions, such as fibromyalgia. That’s why early detection is key to preventing the pain from becoming a part of your daily life and affecting your quality of life, your sleep, and your ability to keep up with the pace of city life.
Trigger points are small, trapped areas within your muscles that become extremely sensitive. When a specialist examines you and presses on this tense area or knot, two very interesting things happen: the muscle usually contracts involuntarily, and the pain isn’t limited to that point but radiates to another part of your body (for example, if they press on your shoulder, the pain extends to your head).
We know that with the fast-paced lives we lead, when back pain has been with you for a long time, spasms and inflammation become more severe, making it difficult to pinpoint the exact knot.
Generally, the first step to relieve this tension involves stretching, correcting your posture while sitting at the computer, and applying hot and cold compresses alternately. This helps to relax the spasm and reduce inflammation in the area naturally.
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If you’ve tried everything for 4 to 6 weeks and the pain continues to affect your daily life, your doctor may suggest a treatment that works directly on the trigger point: dry needling or injections with anesthetics. Both techniques are designed to completely deactivate the trigger point and relax the muscle band that refuses to let go.
For this procedure, the specialist uses extremely fine needles. By carefully inserting them into the skin, the doctor can reach the deepest muscle tissues, which cannot be accessed or massaged by hand.
This procedure is performed by a specialist in a completely sterile environment, using new needles that are discarded immediately and all the necessary protective equipment to ensure your complete safety. Dry needling, for example, doesn’t require the injection of any medication; the simple physical stimulation of the needle is what breaks up the knot and releases the tension.
Science has shown that by stimulating the trigger point with a needle, communication between your nerves and muscles returns to normal, turning off the warning signal that was causing the pain. This significantly accelerates your recovery process. Additionally, the procedure is typically performed under local anesthesia for your comfort.
During the session, the doctor will palpate your muscles until they find the exact spot. When the needle is inserted, most people don’t feel anything on the skin’s surface, but upon reaching the trigger point, it’s normal to feel a sensation similar to a muscle cramp or a slight pull. Don’t be alarmed! That spasm or contraction means the needle has hit the mark and the trigger point is being deactivated.
To protect your muscles and prevent internal scarring, your doctor won’t give you more than three injections in the same area during a single session.
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Both are excellent and serve the same purpose: to break up the knot. The only difference is that dry needling is done with just the needle, without injecting any medication. With the other option, the doctor injects a small amount of anesthetic to numb the area so you don’t feel any discomfort. Your doctor will tell you which one is best for you.
The needles are so thin that you can barely feel them when they enter the skin. What you will notice is a slight tug or a quick prick when the needle touches the knot. It might startle you a little, but don’t worry! That prick is a good sign: it means the exact spot has been found and the muscle is already starting to release.
You’ll almost always feel the muscle much relaxed and less painful between the second and fourth sessions. This varies from person to person, depending on how long you’ve had the pain or how many knots we need to release so you can comfortably walk down the street or use the subway again.
It’s best to rest for the rest of the day. Since we work on the muscle from the inside out, it’s normal to feel a little tired or sore for a few hours, as if you’d had an intense workout at the gym. We recommend going home to relax and leaving long walks or heavy work for the next day.
You don’t have to live with pain! At New York Pain Medicine Associate, our team of qualified specialists is dedicated to providing you with the relief you need to improve your well-being. Contact us today to schedule a consultation in Manhattan, Brooklyn, the Bronx, Queens, or Hempstead, and together we’ll find the perfect medical solution so you can once again enjoy New York to the fullest.