Trigger Point Injections

What Is a Trigger Point?

A trigger point is a tight, irritable knot within a muscle that can cause localized pain or referred pain (pain felt in another area). These knots develop when muscle fibers contract and fail to fully relax.

Trigger points can form due to:

• Repetitive strain

• Poor posture

• Injury

• Stress-related muscle tension

• Spine conditions that overload surrounding muscles

Unlike joint or nerve pain, trigger point pain often feels:

• Achy or deep

• Tight or cramping

• Tender to touch

• Reproducible when pressed

Trigger points commonly occur in the neck, shoulders, upper back, lower back, and gluteal muscles.

What Is a Trigger Point Injection?

A trigger point injection is a minimally invasive procedure that delivers medication directly into the tight muscle knot.

The injection typically contains:

• Local anesthetic (to relax the muscle and reduce pain)

• Sometimes a small amount of corticosteroid (depending on the case)

In many cases, even the mechanical action of the needle itself helps release the contracted muscle fibers — a technique sometimes referred to as “dry needling.”

The goal is to break the pain-spasm cycle and allow the muscle to reset.

What Conditions Can It Treat?

Trigger point injections are commonly used for:

• Myofascial pain syndrome

• Chronic neck and shoulder tension

• Tension-type headaches

• Postural muscle pain

• Muscle pain associated with spine disorders

• Fibromyalgia (in selected patients)

• Chronic low back muscular pain

They are particularly helpful when muscle tightness is perpetuating pain despite therapy, stretching, or medications.

How the Procedure Is Performed

1. The area is identified through physical examination and palpation.

2. The skin is cleaned.

3. A small needle is inserted into the trigger point.

4. Medication is injected directly into the muscle knot.

5. The muscle often visibly or palpably relaxes during the procedure.

Imaging is typically not required, as trigger points are diagnosed clinically.

The procedure takes only a few minutes and is performed in the office setting.

What Does It Feel Like?

You may feel:

• A brief pinch

• A twitch response in the muscle (this is common and expected)

• Immediate loosening of the tight area

Some soreness afterward is normal and typically resolves within 24–48 hours.

When Will I Feel Relief?

Many patients experience:

• Immediate improvement from the anesthetic

• Continued muscle relaxation over several days

• Improved range of motion

For chronic conditions, a series of injections combined with physical therapy may provide the best results.

How Long Does Relief Last?

Relief duration depends on:

• Underlying cause

• Activity level

• Ergonomics and posture

• Participation in therapy

Trigger point injections are most effective when combined with:

• Stretching

• Strengthening

• Postural correction

• Stress reduction

If the mechanical cause of muscle tension is not addressed, trigger points may return.

Benefits of Trigger Point Injections

• Quick in-office procedure

• Minimal downtime

• Breaks the muscle spasm cycle

• Improves participation in therapy

• Can reduce reliance on muscle relaxants

• Helps distinguish muscular pain from joint or nerve pain

Risks and Considerations

Trigger point injections are generally very safe, but potential risks include:

• Temporary soreness

• Bruising

• Bleeding

• Infection (rare)

• Temporary dizziness

Injections in certain areas (such as upper back near the lungs) require careful technique to avoid rare complications.

Who Is a Good Candidate?

You may be a candidate if:

• Your pain is reproducible when pressing on a specific muscle knot

• You have tight bands of muscle that limit movement

• Conservative therapy has not fully relieved muscular pain

• Your pain pattern suggests a myofascial source

A careful physical exam helps confirm that the muscle, not the joint or nerve, is the primary pain generator.

Frequently Asked Questions

Is this the same as acupuncture?
No. While both use needles, trigger point injections are a medical procedure targeting specific muscular pathology and may include medication.

Will I need more than one injection?
Some patients benefit from a single treatment. Others may require a short series combined with rehabilitation.

Does this treat arthritis?
Trigger point injections treat muscular pain, not joint degeneration.

Reference

American Academy of Family Physicians (AAFP). “Trigger Points: Diagnosis and Management.”
Available at: https://www.aafp.org