Trigger Point Injections

Myofascial pain and trigger points are very common — they occur in about 85% of people at some point in their life.

Many primary healthcare providers and pain providers diagnose and treat myofascial pain regularly, which may include trigger point injections and/or physical therapy and stretching exercises.

There’s nothing you need to do to prepare for a trigger point injection. However, as with any type of treatment, it’s important to discuss your current medications, symptoms and overall health with your provider before getting the procedure.

Trigger points are typically painful to the touch, so you’ll likely experience some pain when your healthcare provider is manually locating the trigger point before the injection.

You may feel a stinging and burning sensation when your provider inserts the needle and medication. When the tip of the needle touches the trigger point, you may feel a brief increase in your pain. Although this may be uncomfortable, this pain is a good sign that the needle is in the correct spot.

Trigger point injections are generally safe and can provide pain relief to people who have been experiencing pain associated with trigger points and have not found relief using more conservative treatments, like over-the-counter pain medication or physical therapy.

Trigger point injections can also provide significant improvement in range of motion and overall muscle functionality, depending on which muscle is affected

A trigger point injection may be right for you if your trigger point pain has not improved with other treatments, including over-the-counter pain medication, heat therapy, massage therapy, myofascial release ad physical therapy.

Providers typically use trigger point injections alongside physical therapy and stretching exercises to alleviate the pain.

This strategy can be particularly beneficial when a trigger point injection is initially used to reduce pain in people who are unable to do physical therapy or stretching due to intense pain. The trigger point injection can allow physical therapy to be more effective.

Before your healthcare provider can recommend a trigger point injection, they’ll need to perform a thorough physical exam and rule out other possible causes of your pain, including:

• Muscle strain.
• Structural causes of pain.
• Issues with your spinal column causing back pain, such as degenerative arthritis, a herniated disk or spinal stenosis.
• Radiculopathy (pain from a pinched nerve).

You can expect the following during a trigger point injection procedure:

• Depending on the trigger point location, you may be sitting or lying down on an exam table.
• Your healthcare provider will cleanse your skin on the affected area with an alcohol pad.
• Your provider may mark the trigger point with a skin marker.
• Once your provider has identified the trigger point by feeling it, they’ll pinch the point between their fingers and stabilize the tissue. This may feel uncomfortable.
• They’ll insert a thin needle attached to a syringe into the trigger point and rhythmically continue needling the area by repeatedly inserting and retracting the needle without completely withdrawing the needle from the muscle or your skin.
• You’ll likely feel your muscle spasm or twitch. Your provider will continue the motion in multiple directions until the muscle twitching has stopped or until the muscle feels adequately relaxed.
• Your provider will then inject the area with a local anesthetic with or without corticosteroid or botulinum toxin.
• The procedure will be over and you’ll be able to go home.

Most people experience pain relief starting between 24 and 72 hours after the trigger point injection procedure. Pain relief typically lasts for about a month. If you’re still experiencing pain after this time, your healthcare provider may recommend additional injections to achieve long-term pain relief.

Trigger point injections are generally safe and carry a low risk of complications. The most common side effect is temporary discomfort or numbness around the injection site. Your healthcare provider may recommend treating this with acetaminophen (Tylenol®) or ibuprofen (Advil®). You can also apply ice packs to injection sites to reduce the risk of bruising.

Complications of trigger point injections, which are rare, can include the following:

• Bleeding.
• Infection.
• Bruising.
• Allergic reaction to the anesthetic agent.
• Vascular (vein) injury.