Trigger Point Injections FAQ’s

Trigger Point Injections have become a popular treatment option for those with pain, numbness, muscle tenderness and decreased range of motion. I have seen great success with the use of Trigger Point Injections to help patients recover more quickly and improve healing outcomes. If you’re interested in learning more about this treatment option, continue reading as I answer some of the most frequently asked questions.

What is a Trigger Point?Trigger Point Injections

Trigger points, also known as “muscle knots” or “myofascial muscle pain” commonly occur in the neck and back. They can also occur in other muscles including those in the shoulders, arms, legs, and buttocks. They are hypersensitive, contracted muscles that cause a person pain and tenderness. Trigger points often form as the result of overuse or an injury. Sometimes trigger points can cause something called referred pain. This occurs when the taut muscle fibers compress or irritate a nerve causing pain in other regions of the body.


What is a Trigger Point Injection? What medications may be used in a Trigger Point Injection?

A Trigger Point Injection (TPI) is a procedure in which a needle is inserted into the painful trigger point to help break up the taut muscle fibers that have caused the trigger point to occur. Medications used in a TPI procedure usually include lidocaine and bupivacaine, which are both local anesthetics. These medications help to provide a numbing sensation to the injected region and provide pain relief for a short time. It is the needling procedure that actually helps to break up and alleviate the myofascial muscle pain over time, though. Corticosteroids are not used in TPI’s at Team Health Care Clinic.


When/why is a Trigger Point Injection used?

Trigger Point Injections are most often used in conjunction with physical therapy (PT) or massage therapy. Trigger Point Injections are usually performed prior to PT or massage therapy because we have found that the combination of these therapies allows us to work as a team to provide our patients with a better outcome from their myofascial muscle pain. After a Trigger Point Injection has been administered, the taut muscle fibers begin to break apart, then muscle work performed in either PT or massage helps to loosen the painful “knots” even more, giving our patients greater relief of pain.


What is the benefit to the patient?

There are a number of benefits that patients can achieve from TPI’s. Trigger Point Injections can help to alleviate pain by relaxing tight muscles, improve flexibility, improve range of motion, alleviate stiffness and weakness from the affected muscle, and alleviate referred pain.


What are complications and side effects of Trigger Point Injections?

The most common side effects of Trigger Point Injections include a “pinching” pain during the injection, numbness at the injection site for a few hours from the local anesthetic, mild bruising, and increased soreness for the first 24 to 48 hours. The soreness should then subside and benefit from the injection should be noticed after that time period. It is important to stay well hydrated prior to and for the first 24 hours after your Trigger Point Injection.


How frequently do Trigger Point Injections need to be administered?

Trigger Point Injections are usually administered one time per week for 3-4 weeks in conjunction with physical therapy or massage therapy appointments. The series of injections is necessary as positive results continue to build with additional injections to provide patients with the most benefit.

Tiffany Watson, CNP

Tiffany Watson, CNP



Understanding Numbness and Nerve Pain

A patient and I were discussing today how nice it would be if we could diagnose our health problems in a similar way to car problems. When we have problems with our car, our mechanic connects it to a machine that generates a diagnostic code. Unfortunately, with people, it’s not always easy to understand the source of pain or the cause of our limited mobility.  In healthcare we do have a variety of different testing or diagnostic tools but it still can be challenging to get to the root of the cause for what is going on when someone is having pain. 

What if you are experiencing numbness, tingling and/or pain in your fingers or hands?  As medical providers, we understand that this could be caused by issues stemming all the way to your neck.  It could also be coming from issues in your shoulder, elbow or wrist.

You may have what we call radiating symptoms, which include pain or a feeling that is not just in one area but moves to another area.  Sometimes it will follow in a line that you can feel numbness from your shoulder blade into your forearm or you might feel tingling only in your fingertips.  When there is degeneration in your neck or cervical spine this can cause damage or irritation to the nerves which travel all the way down to your fingers. 

There are 3 main branches of nerves:

  1. Median Nerve: This nerve runs along the inside of the arm and travels through into the 1st through 3rd fingers or thumb to middle finger.
  2. Ulnar Nerve: Runs along the inside of the arm and elbow and into the outer part of the hand and 5th digit or little finger. 
  3. Radial Nerve:  Runs along the back of the arm and into the 1st through 4th digits or thumb to ring finger. 

There can be many causes but there are also a wide variety of treatments for these very uncomfortable symptoms.  Because our bodies are so complex, we often need to address several areas to stimulate healing and help you feel better. Finding a well rounded team of providers will help you achieve the best outcomes from any necessary treatment. In our Champlin, MN clinic, we have medical, physical therapy and chiropractic providers that work together to understand the cause of pain and recommend the appropriate plan of action. 

Emily Franklin, PTA

Text Neck, Computer Neck, or Forward Head Posture? Here’s Your Solution


Do you find yourself on your tablet, computer, cell phone or other hand held device more and more?  Have you noticed, or even worse, have others noticed that your posture has gotten worse over the years? At Team Health Care Clinic, we have seen an incredible increase in injuries and pain from what is commonly called “Text Neck,” “Computer Neck,” or Forward Head Posture. If not corrected, it leads to stubborn neck pain, upper and lower back pain, headaches, shoulder pain and even poor breathing. It later can lead to bulging and eventually degenerative disc disease.  How can a forward head posture create all of these conditions?neck pain

The problem with Forward Head Posture

We first need to consider that the head is a 10-pound weight sitting on the top of the spine if one has ideal, perfect posture.  However, for every inch one’s head moves forward, we add 10 pounds of adjusted weight to the neck and back.  So a patient with one-inch forward head posture is applying 20 pounds of weight to the neck and back musculature, vertebra and discs. Two inches forward is 30 pounds of weight and so forth.

Hour after hour, day after day, this extra strain creates an accumulative injury. Vertebral misalignment, knotted muscles and damaged discs eventually develop. The body tries to compensate by altering posture and kinetics, resulting in injuries in the low back, shoulders and arms as well.

This has become an epidemic due to our increasingly sedentary lifestyles and poor posture.  Fortunately, at Team Health Care Clinic, our combination of providers developed a unique Forward Head Posture (FHP) rehab program that has proven success.

How does it work?

The FHP program incorporates principles from The Pettibon System, the experience of our chiropractors, and the expertise of our physical therapists. In addition to regular chiropractic adjustments, the patient is engaged in rehab “stations” each time they come in. These stations may include, forward head posture supine traction, standing traction, an innovative rehab chair with a weighted head band, and more. The 20-30 minute treatments are pleasant and not particularly strenuous, just precise for this condition.

Are you a candidate?

The success is high due to our patient selection process.  A patient starts with neck x-rays to determine if they have a forward head posture. This requires the doctor to make a series of measurements that is reviewed with the patient.  If the measurements confirm the condition, a second x-ray is taken while wearing a rehab, weighted head band.

This x-ray determines if the patient’s neck responds well to the procedure.  If the x-ray demonstrates some immediate improvement, it gives the doctor more certainty that the patient will respond permanently with the full FHP program.  Approximately 5-10% of patients will be screened out.  Midpoint and final x-rays are performed to determine the patients progress.

If you suspect you have worsening posture, start with neck x-rays and determine if you are even a candidate for the program.  If you are already a patient, we may be able to use your previous x-rays as a starting point.  Don’t wait until there are signs of damage from years of strain to your neck and back.

Joe Bertsch, DC

Joe Bertsch, DC








Allergy Relief with NAET

Many people are plagued by the symptoms of allergies which include sinus problems, rashes, headaches, joint pain and more. Over the counter and prescription treatments often have undesired side effects. For those looking for an effective way to eliminate the cause of your allergies, I suggest you look into NAET.

What is NAET?

NAET stands for Nambudripad’s Allergy Elimination Technique and is named after the doctor who developed it.

NAET combines healing techniques from various medical disciplines including allopathy, acupuncture, chiropractic, kinesiology and nutrition. It is a completely natural, non-invasive and drug free holistic treatment. The NAET protocol allows practitioners, with incredible accuracy, to test a patient to determine sensitivities. This includes substances that promote an immediate allergic response in a patient as well as substances that cause a delayed immune response (hypersensitivities).

Once a patient’s allergies have been identified, NAET allows the practitioner to assist the patient so that the body will no longer identify that substance as an “allergen,” thereby eliminating the body’s immune response to that item. In other words, patients can now safely consume the food or come into contact with the substance without getting sick from it! Up until NAET, avoidance and drug therapy were the primary choices for treatment for those suffering from allergies.

How does it work?

Allergies are identified by the doctor using kinesiology in the form of muscle response testing (MRT.)  MRT works as follows: any given muscle will display weakness in the presence of an allergen (incompatible energy), thereby indicating the allergen is adversely affecting the body. Conversely, a strong muscle response indicates the substance is compatible with the body and there is no allergy present.

If the muscle response is weak, the patient will then be treated holding the allergen in his or her hand, while the nervous system is stimulated up and down the spine by a series of gentle pressures. The patient will then be tested using MRT after the treatment. A strong muscle test in the presence of the allergen indicates that the substance has now been accepted by the brain as compatible.

The fact that a person’s allergies can be eliminated has already changed the lives of many of those who have taken NAET treatments. We have numerous examples of patients in our Champlin, MN clinic who have gotten rid of their allergies and been able to resume a more normal life.

Jay Bertsch, DC

Reducing Muscle Aches and Pains with Rapid Release Therapy

In the past week, Team Health Care Clinic has been excited to introduce a new adjunctive therapy to our clinic called Rapid Release Therapy.  This new therapy utilizes vibration technology to help alleviate muscle tightness, spasms, and minor aches and pains.  In a blog on Rapid Release Technology’s website, one chiropractor in Florida who uses Rapid Release has found great success with numerous top-level sprinters in the world.  So, how does this vibration therapy work?

How vibration affects muscles

To begin it’s important to understand how vibration works at a micro-level.  When a muscle is tight, muscle spindle fibers are “set” at a rate of contraction or spasm. When a vibration stimulus is applied to a tight muscle or knot, there is activation and subsequent relaxation of these muscle spindle fibers, allowing muscles to relax.

Muscle aches - Rapid Release

Dr. Starr demonstrates Rapid Release Therapy

In addition, vibration helps dampen and quiet pain fibers.  There are two major types of nerves that carry information to the brain.  Small diameter nerves carry information about pain to the brain at a very slow rate.  On the other hand, large diameter nerves carry sensation, joint position sense, proprioception, and of course, vibration information.  These are carried at a very fast rate. When more large diameter nerves are stimulated, it dampens and calms the small diameter pain fibers, causing a decrease in pain.  The perfect example of this is when someone hits their elbow on something.  What’s the first response? Rubbing their elbow.  This activates these large diameter nerves so that the pain lessens and it doesn’t hurt as much.

Why is Rapid Release Therapy better than the device I use at home?

What makes Rapid Release Therapy different from other vibration instruments is the frequency at which it works.  While most vibration tools work at lower frequencies anywhere from 40-80 Hz, Rapid Release works at a frequency of 160 Hz.  This major increase in the speed and frequency of which this tool works provides greater stimulation of these large diameter nerves to lessen pain.

We are excited to provide this therapy and utilize the benefits of vibration in conjunction with other therapies.  Interested in trying it out?  Stop in today to talk about how this new therapy in our clinic can benefit you.

Erik Starr, DC

Erik Starr, DC

What Causes Thyroid Disease?

If you are among those diagnosed with thyroid disease, have you ever asked why the thyroid gland quit working?  What answer did you get? Often, there is no answer at all.  Many patients have come to Team Health Care Clinic using the recommended thyroid medication with their thyroid levels testing normal, but they still feel terrible. That’s why it is so important to evaluate and deal with the cause of the thyroid malfunction.

Hyperthyroid or Hypothyroid?

Thyroid disease affects about 10% of the population with women experiencing it about 7 times more frequently than men. There are two ways that the thyroid can dysfunction.  One can have an overly active thyroid known as hyperthyroid disease. Symptoms from this include increased heart rate and palpations, anxiety, weight loss and fine brittle hair.

Thyroid Problems - Causes and Natural Treatment Options


The opposite is a thyroid that is under active.  This is the most common type of thyroid disease and is called hypothyroid disease.  Those symptoms included fatigue, loss of hair, weight gain, constipation and depression.  Unfortunately, these symptoms are common to a lot of conditions so one needs to do proper testing to fully evaluate for thyroid disease.

Most thyroid disease, about 90%, is related to autoimmunity.  In other words, your own immune system is attacking its own tissue, the thyroid gland in this case.  The causes for this attack can include food sensitivity reaction, improper digestion or ‘leaky gut’, reaction to chemicals, reaction to virus or bacteria, stress, lack of Vitamin D as well as other causes.  Not taking care of these problems is what keeps people feeling awful even when they have a balanced hormone test.

At Team Health Care Clinic we are interested in the root cause of disease.  We are always asking the ‘why’ question.  We have the ability to help you by evaluating the causes I listed above and are not satisfied until those are dealt with.  The goal is to get you working and feeling better.  Remember, no matter what your condition, to always ask the why? questions.

Tim Bertsch, DC, DABCI

Tim Bertsch, DC, DABCI


Hip Flexors and Low Back Pain: A Surprising Connection

Hip flexor tightness can affect many individuals, young, old, active, and sedentary. Many of the patients in our clinic that suffer from low back pain don’t realize that tightness in the hip flexors can be a contributing factor. In this blog, we explore mechanics of the hip flexor, what you can do to prevent hip flexor tightness and treatment techniques for those who are experiencing pain.


The hip flexors are a group muscles that cross the front of the hip.

Some of the muscles are:

Iliacus: this one attaches from the iliac crest to the femur (leg bone)

Psoas Major: attaches from your lumbar vertebra to your femur

Rectus Femoris: this quad muscle crosses the hip and the knee and controls hip and knee movement.


The muscles need to keep a balance to hold the bones of the body together. If there is tightness in a muscle group it causes imbalanced for on the bones, and pulls the bones out of a neutral alignment. Poor alignment places strain and stress on the affected joints and causes pain.  When the hip flexors are tight this causes a pull on the spine resulting in an anterior tilt of the pelvis. This anterior pelvic tilt causes an increase in lordosis or curve in the low back. Because the psoas attaches to the lumbar vertebra, hip flexor tightness is often a contributor to chronic low back pain. If not addressed, eventually the increased lordosis and anterior pelvic tilt can also weaken the abdominal muscles. Our abdominal muscles are needed to support the pelvis and the lumbar spine. Think of them as a natural corset for the trunk providing stability.

Preventing Injury

We all know what stretching is, and most of us have probably done some stretching movements at some point in our lives. We hear about stretching to prevent injury, to warm up, and to gain flexibility but is it really that necessary? Stretching and flexibility is especially important when it comes to hip flexors and back pain.

Sitting can cause an increase in hip flexor tightness as well as running or biking without performing stretches needed to maintain muscle length.

Treating Hip Flexor Tightness

There are many pieces to the puzzle that tight hip flexors can affect with the balancing act our body does with muscles and bones. Tightness in the muscles can be treated with myofascial release, soft tissue mobilization, stretching, and kinesiotaping. Targeted exercises are given for the areas that are weak to help return muscle balance. Therapists in our clinic assess the posture, muscle lengths and weaknesses. We determine what muscles groups need to be addressed as well as what is causing the imbalance. Treating the cause of the imbalance causing the symptom is what will make life long changes.


Andrea Newport, PT

Andrea Newport, PT

rTMS for Depression, Anxiety, ADHD, Insomnia and Dementia

At Team Health Care Clinic, we are pleased to introduce an innovative, drug free, noninvasive treatment best known for depression: Repetitive Transcranial Magnetic Stimulation (rTMS).  rTMS is an FDA cleared device for treatment of depression but has also been shown to be beneficial for ADHD, anxiety, insomnia, some forms of dementia, and other brain related disorders.

rTMS treatments are not painful and patients can read or watch TV during their treatments.  Patients can resume their normal activities following their treatment as the worst side effect may be a mild headache.  These are even rare.


This is in sharp contrast to electroconvulsive therapy and medication management where symptoms are potentially significant such as weight gain, sexual dysfunction, cognitive impairment and many others.

How does it work?

rTMS is a medical grade magnet that is used to balance the speed of abnormal operating nerves in the brain.  The magnet sends a signal that can be varied to stimulate or slow down the nerves in specific regions.  For example:


Scientists expect brains to fire at is 15-20 pulses per second (pps) in the left frontal lobe.  Patients with mild depression will fire at 10-12pps and below 10pps in more severe cases.  In these cases, we will stimulate the brain with rTMS to fire at a normal frequency.


Normally, the left side of the brain fires at a higher frequency than the right side.  When this pattern reverses and the right brain works at a higher frequency, the individual often exhibits symptoms of anxiety.  In this case, the brain would be balanced by stimulating the speed of the left side of the brain or slowing the speed of the right side.


rTMS can be used to improve abnormal frequencies in the brain, either stimulating or quieting it, to treat a wide variety of conditions.

In order to get the most precisely directed and successful treatment, you should consider the following:

  1. Request only EEG guided rTMS

Patients should request their provider measure the frequency of firing of the entire brain with a 19-lead electroencephalogram, or EEG.  An EEG measures the function of the brain like and EKG measures the function of the heart.  Without this information, a provider is making recommendations based on a patient’s history alone.  With the information discovered from the EEG, a provider can give precise rTMS treatment to the specific unbalanced region of the brain. No guesswork!

  1. Not all rTMS units are equal

Some rTMS units can only treat at 10pps frequency and are consequently limited in the conditions it can successfully treat.  Find providers that are using a state of the art unit that can vary its frequency of stimulation from 1 to 20pps.  This allows the provider to treat a wide variety of conditions beside depression.

  1. Evaluate Brain Chemistry

Find providers that evaluate brain chemistry including blood glucose, neurotransmitter deficiency, brain-gut connections, gluten sensitivity and many other factors.


If you suffer with depression, anxiety, insomnia, ADHD and other brain related disorders, I would encourage you to explore rTMS as a highly successful, low risk solution for qualified candidates.  In our clinic, we determine your candidacy by starting with an examination, including an EEG.

Tiffany Watson, CNP

Tiffany Watson, CNP


Brain Inflammation and Sugar: A Surprising Connection

Inflammation has been a buzzword in recent years as researchers have continued to find links between inflammation and symptoms like headaches, fatigue, memory loss, brain fog and many more. In previous blogs, we have talked about the three needs of a neuron, or brain cell. These include glucose, oxygen, and stimulation. Your brain cannot branch out and make new connections unless it receives proper stimulation to specific areas, and to do this, you must provide the proper chemical environment for those cells to do so. This means having an adequate oxygen supply, and just as importantly, a proper glucose (blood sugar) response.  So, what happens when blood sugar levels are too low or too high? How can this lead to inflammation? And what can I do to prevent this from happening?

Blood Sugar Imbalances

One of the most important things you can do for your brain is to maintain stable blood sugars. When blood sugar is chronically low, it’s called hypoglycemia. On the flip side, if blood sugar is too high, it’s called hyperglycemia or insulin resistance.

Common Symptoms of Hypoglycemia

  • Feeling agitated or nervous
  • Eating to relieve fatigue
  • Becoming light headed if meals are missed
  • Increased energy after meals
  • Cravings for sweets between meals

Common Symptoms of Hyperglycemia/Insulin Resistance

  • Difficulty losing weight
  • Constant hunger
  • General fatigue
  • Fatigue after eating meals
  • Cravings for sweets that are not relieved after eating them


How This Leads to Inflammation

When blood sugars are too high, or if one is constantly fluctuating between low blood sugar and high blood sugar, this leads to activation of microglia, the brains immune cells. This directly leads to an inflammatory cascade in the brain, or neuroinflammation. When brain inflammation arises, there are immediate and long-term effects. It immediately slows down transmission speed of signals in the brain, leading to the feeling of brain fog and a drop in brain endurance. In the long-term, chronic brain inflammation will lead to sustained microglial activation and eventually neuronal death. This is why researchers are now referring to Alzheimer’s Disease as Type III Diabetes. Neuroinflammation has many more far reaching effects that we will discuss down the road.

What Can I Do?

Since chronic microglial cell activation has no automatic “off switch” to stop brain inflammation, there are things that can be done to dampen it. These include flavonoids such as apigenin, resveratrol, catechins, rutin, and curcumin. The providers at Team Health Care Clinic often recommend supplements that contain these natural compounds to help support the brain’s fight against inflammation.

Additionally, the same can be said for supporting proper blood sugar levels. Nutrients including chromium, inositol, and L-carnitine have shown to help with stabilizing blood sugar. We often recommend these supplements to a patient who has poor blood sugar levels. Of course, it is imperative to educate our patients on how to maintain proper blood sugar levels through lifestyle modification. This includes eating a breakfast high in quality proteins and fat, having snacks high in protein during the day to prevent hypoglycemic states, avoiding foods high in sugar, especially before bed, and avoiding or limiting caffeine.

Whether you are hypoglycemic, insulin resistant, or a combination of the two, we have the nutrients, knowledge, and education to help you stabilize your blood sugar and dampen or prevent brain inflammation. The health of your brain is as important as any other organ of your body, if not more, so learn to take care of it. Need help in this journey? Contact us today.

Erik Starr, DC

Erik Starr, DC

Spinal Decompression for Back Pain, Herniated and Degenerative Lumbar Discs

Non-surgical spinal decompression was introduced to Minnesota by Team Health Care Clinic years ago.  Since then, we have continued to successfully perform this treatment protocol for people with back pain with Vertebral Axial Decompression (VAX-D).  In our clinic alone, there have been hundreds of patients that were spared surgery by completing VAX-D services.

Since that time we have seen many clinics come and go claiming they have spinal decompression services.  It was the “wild west” with even simple traction units being touted as spinal decompression. But what is spinal decompression and how is better or different than simple traction?

Spinal Decompression Reduces Pressure on Lumbar Discs

When it comes to spinal decompression, it’s all about the pressure reduction achieved. Much like gauging the air pressure in a car tire, scientists have been able to measure the pressure on a disc in various positions. What they found is as follows:

Vax-D spinal decompression achieves negative pressure on the disc.

Notice that traction does not create a negative pressure on the disc. In other words, traction in the form of inversion tables, intersegmental traction units and many other devices claiming to be spinal decompression, are creating pressure reductions similar to lying down.  No negative pressure means no suction effect and that means little chance of decompressing degenerative and herniated discs.

VAX-D is Superior to Others

Non-surgical spinal decompression uses a machine that is proven to create a negative pressure on lumbar discs. There are few, if any, other thank VAX-D.  Beware —  many will claim they have research that proves negative pressure is achieved. However, when pressed to see the research, a few different schemes are discovered to overstate the research.

One technique is to use VAX-D research as their own.  They will show the research only when pressed for it and explain that the copycat device is similar to VAX-D so they claim it as their own.

A second approach is to do research on cadavers.  Other than the fact that any positive effect from decompression is too late for these subjects, there are obvious flaws in drawing any conclusions from this research.

Our bodies have receptors that create a stretch reflex when a force is applied to it.  For example, if someone is pulling your leg to stretch your hamstring, at some point your muscle will resist the force to avoid injury.  In cadavers, this reflex is absent so the researches can apply any distractive force and find erroneous positive results.  Don’t be fooled by this scheme.

Be an educated consumer and ask questions before agreeing to proceed with your doctor’s recommendation for non-surgical decompression.  Determine how they define “decompression” and ask for research to support their claims.

Finally, investigate its track record and its success rate.  Look past splashy marketing and grand claims. Five years ago, the Twin Cities metro was saturated with full page ads for decompression services. Almost 100% of those marketing campaigns were not able to stand the test of time and are now noticeably absent.

Consider VAX-D for non-surgical spinal decompression.  It is well researched, has a greater than 15-year track record, and is 80% successful in patients that had failed all conservative treatments.  It also has research that confirms it creates negative pressure on the discs of live subjects.

Is it Right for Me?

VAX-D has been a proven “positive negative” for hundreds of our patients. If you have been diagnosed with a lumbar disc degeneration or herniation, consult your provider to determine if VAX-D is right for you.

Joe Bertsch, DC

Joe Bertsch, DC