Possible Side Effects: Needling Treatments
Treatments involving injections or needling
Most of the risks involved with Trigger Point Injections, IMS, and other needling techniques are minor and time limited. The risk of severe complications is low.
The information below includes mild, moderate and severe complications, but the list may not include every possible side effect.
Muscle Fibre Release Sensation
This is a common and mild side effect.
When myofibrils release you may feel momentary discomfort. The sensation varies with each individual. Patients have variously described the feeling as a pulling, tugging, burning, electrical or “weird” sensation. Others feel a heat release or a muscle twitch.
Muscle twitches, either observed or felt, are clear indications that muscle fibres are releasing. A twitch reaction is a good indicator that the treatment will have good results. The greater the twitch, the more fibres are being released.
Some patients experience a very brief radiation or an electrical signal to a limb or up and down the body. This is a positive reaction indicating release of fascial tissue associated with the treatment site.
The clinician selects needle size appropriate to the muscle and to reduce the incidence of bleeding.
Commonly, patients get tiny blood spots on the skin surface at insertion sites during treatment. These are inconsequential and resolved during treatment.
Sometimes bruising (a localized hematoma or layer of blood in the subcutaneous tissues) may develop. This can happen if the needle enters a vein causing an upwell of venous blood to the skin surface. If evident at the time of treatment, your clinician will apply direct pressure to reduce the risk of bruising.
If visible bruising occurs, your skin colour at the bruise site may change from black to yellow to green over 2 to 10 days. Occasionally the bruised appearance may extend downward from the needle insertion site as gravity results in blood tracking in the subcutaneous layers of tissue.
Patients commonly experience a bruised feeling at the treatment sites. This sensation usually disappears within a day or two after treatment.
Patients who have a significant amount of muscle release may experience fatigue and need for a longer sleep following the first treatment. This is largely a phenomenon following the first treatment and doesn’t seem to occur after subsequent treatments.
Accordingly, new patients may want avoid driving immediately after their first treatment.
Rarely, a patient might experience nausea during or immediately post treatment. In general, this symptom only occurs in those who have had nausea from similar medical procedures previously.
Pre-Syncope – Lightheadedness or Dizziness
This is more likely to result in someone who has had previous history of similar symptoms following immunization or visualizing blood. Fainting or loss of consciousness is rare. It is important to tell your physician immediately if you feel lightheaded, dizzy, nauseous or faint.
Pain Migration and Flare ups
Sometimes as patients get pain relief in the treated areas, they experience a migration of pain to new areas. Pain migration generally reflects one of two positive treatment results.
1. Muscle fibres treated are released and pain is resolved at that specific site. Sometimes, the patient has other longstanding muscle fibres in sustained contraction which were subordinate to or eclipsed by the pain from the treated areas. When the dominant painful area is resolved, other muscles in sustained contraction become dominant and the patient feels pain in new areas.
A follow-up treatment that addresses the new painful sites can resolve the issue of migrating pain.
2. Sometimes new pain results from a realignment of the interrelated muscular framework resulting from the newly relaxed muscles. The mechanism for this is unclear but may reflect disruption of the long established muscular interrelationships of shortened muscles that must readjust to a new relationship with functional muscles. Generally, patients find their bodies readjust and pain disappears within a few days.
On the rare occasion, individuals may experience short-term worsening or flare-up of pain following treatment which generally resolves within 24 hours. Please call the clinic for assessment if a pain flare-up lasts more than 24 hours. Your doctor may recommend an alternative treatment to relieve the pain.
The CHANGEpain Clinic uses appropriate hygienic technique to avoid infection on of the soft tissues (skin, subcutaneous fat and/or tendons). According to standard accepted medical protocol, the clinician preps treatment sites on the skin with a 60% alcohol gel. Other preparations are available for patients with allergies or other sensitivities to our standard gel.
However, a low risk of infection remains, which would be evident by skin redness, soft tissue swelling, increasing pain and/or fever. The risk of infection increases for patients with diabetes, immune-compromised states or if the treatment included many separate insertion sites.
Increased pain that begins several days after the injection may be a sign of infection. This may suggest cellulitis or infection of soft tissues. You should call your pain clinician if this occurs.
Shortness of Breath, Chest Pain or a Sudden Reduction in Exercise Capacity
These rare symptoms may suggest a pneumothorax. Seek treatment immediately if this occurs. Call the clinic to speak with your treating physician, or if after hours, seek treatment at an urgent care facility or emergency room. Note – this complication would only result where treatment was applied in skin over the lung fields, most likely in the upper back or lower neck area.
Additional Possible Complications for iSITES procedures
There are additional possible complications involved with iSITES procedures. There is a very low likelihood that these complications will happen:
- Very rarely: for spine procedures – nerve root damage, spinal injury, nerve irritation, epidural puncture headache, spinal anaesthesia
- Potential reactions to injected medications
- Pain flare up
Symptoms and Signs That Need Urgent Medical Attention
Please call us or otherwise seek medical attention if you experience any of the following symptoms within 72 hours following treatment:
- shortness of breath, chest pain or sudden reduction in exercise capacity
- skin redness with swelling of superficial or deep tissues
If you experience any of these symptoms, you should be immediately assessed. Here are some options for you:
- Call your treating physician at CHANGEpain 604-566-9101 (We answer phones during opening hours only – 8am to 5pm Monday through Saturday)
- See your family doctor if you can get an appointment on the same day
- Go to a walk-in medical clinic
- Go to a hospital emergency room