Injection substances: Nutrients or local anesthetic medications, typically a 1% or 2% solution is used of lidocaine or procaine, while additionally being diluted by sterile water or saline. Used to help create a pain relieving effect with trigger point injection and assist in therapeutic response. Procaine is preferred over lidocaine due to several reasons: Procaine is metabolized locally into diethylaminoethanol (DEAE) and para-amino benzoic acid (PABA); DEAE is thought to increase acetylcholine while PABA is part of the folic acid molecule. So in this sense, procaine serves as a nutritive to damaged muscles. Lidocaine is longer acting and metabolizes in the liver; the possibility for achieving lidocaine toxicity is much greater than that of procaine, especially in the event of multiple injections in a short time period. Having experienced previous adverse reactions to local anesthetics is a contraindication to using either one of these injectants.
Local anesthetics also have the effect of blocking sodium channels, thereby preventing depolarization. This has the overall effect of decreasing muscle hyperirritability in the local area of injection.
Other injectants include vitamins B1, B6 or B12, homeopathics, sterile water or magnesium sulfate. Each one has its considerations; however, the clinical success of trigger point therapy is dependent on operator technique, patient metabolism, and physical response to treatment when combined with other treatment modalities to maximize efficacy.
These medications help to block inflammation. Inflammatory substances in the muscle produce pain by sensitizing nerve endings and receptors. In addition, the physical force of the fluid helps to break muscle spasm and adhesions.