Trigger Point Injections vs Nerve Blocks: Which Is Best For A Lumbar Herniated Disc?

Is Your Back Pain A Herniated Disc?

Lower back pain (LBP) affects 84% of American adults at some point and shows no signs of slowing down. While most people write off the pain as a normal part of aging, in many cases, the issue could be a lumbar herniated disc. The spine consists of bones called vertebrae, separated by tough, fibrous discs. The discs help with weight distribution and movement. Due to injury or wear and tear, the inner disc material can shift out of place, pressing on nearby nerves. This condition is common in the lower back or lumbar region. There are different treatment options for herniated discs, including trigger point injections (TPI) and nerve blocks.

Can a trigger point injection help?

Sometimes a lumbar herniated disc can develop trigger points in the lower back. Trigger points are tender locations within the muscle. These tiny knots form within the muscle’s connective tissue, which can be painful to the touch. As the disc limits movement due to pain, the muscles can tighten and develop trigger points. Some trigger points even cause symptoms like sciatica. A TPI provides relief by injecting anesthesia and corticosteroid into the muscle. The procedure can provide immediate relief, relaxing the muscles while reducing inflammation.

What to expect with a TPI

Trigger point injections are outpatient procedures performed at a doctor or pain management specialist’s office. The doctor will insert a needle several times to help locate the trigger point and gauge the depth of the knot. Once the doctor finds the best point, the medication is released into the connective tissue and muscle. The patient will feel momentary discomfort during the procedure but can leave the same day. After the procedure, some tenderness, swelling, and pain may be present but will subside within 24-48 hours. On average, relief from TPIs last 1-2 months, allowing the patient to temporarily pursue other treatments such as physical therapy (PT) during this time.

You’ve got some nerve

Another effective treatment option used by doctors for decades is a nerve block. Herniated discs impact muscles and nearby nerves that branch out the spinal cord through tiny holes in the vertebrae. These nerves are close to discs, so should the inner disc material leak out, the nerves become compressed. As a result, the nerve pain can radiate down the back and cause sciatic pain. As the name implies, nerve blocks target the root of the nerve by injecting medication to reduce inflammation.

Performing a nerve block

Like TPIs, nerve blocks are outpatient procedures that can provide immediate relief. The patient will visit a doctor, radiologist, or pain management specialist for the injection. Nerve blocks require a guided x-ray called fluoroscopy to locate the exact group of nerves causing pain. Once the patient confirms the location of the pain, the injection can occur. Sometimes, a follow-up injection is necessary. There will be some pain and tenderness for 24-48 hours. The patient will then feel relief which can last for several months.

Some similarities are evident

Nerve blocks and trigger point injections effectively reduce pain as both treatments contain anesthesia and steroids. Both target specific pain symptoms caused by the herniated disc. Trigger points present as tight knots that are painful to the touch. Nerve pain can feel like stinging, intense pain that radiates down the spine, buttock, and leg. Using the correct technique to target the right symptoms is vital.

Which is best for herniated disc pain?

Nerve blocks last much longer than TPIs and have diagnostic properties. In other words, nerve blocks determine if more treatment is required, like nerve ablation or surgery. Trigger points offer quick, immediate relief for a short period. The doctor will help the patient choose the best treatment. Both procedures are great non-surgical options for treating a lumbar herniated disc.


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