A trigger point injection can help soothe myofascial pain, especially in your neck, shoulder, arms, legs and lower back.
Trigger points are painful “knots” in your muscles that can be very sensitive to touch/pressure. They may form after acute trauma or by repetitive micro-trauma, leading to stress on muscle fibers. It causes the muscle fibers to be stuck in a contracted state. Sometimes you can feel these knots when you rub your muscle.
Trigger point injections commonly involve injections of local anesthetic with or without corticosteroid, botulinum toxin, or without any injection substance (dry needling).
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Healthcare providers use trigger point injections to help treat myofascial pain. “Myo” means muscle and “fascial” means fascia. Your fascia is the thin, white connective tissue that’s wrapped around every muscle.
The pain and tenderness in myofascial pain are typically due to one or more trigger points. To the touch, trigger points feel like small bumps, nodules or knots in your muscle.
Trigger points can develop in any muscle, but the most common muscle groups that are treated with trigger point injections include:
• Masseter (a muscle in your jaw).
• Levator scapulae (a muscle on the sides of your neck).
• Gluteus medius (a muscle in your hip).
• Quadratus lumborum (a deep muscle in your low back).
• Trapezius (the muscle extending over the back of your neck and shoulders).
• Sternocleidomastoid (a muscle in the front of your neck).
• Temporalis (a muscle on the sides of your head).
Trigger points can cause certain types of pain or issues. For example, trigger points affecting your trapezius muscle may cause tension headaches. A trigger point affecting your piriformis muscle (a muscle in your buttocks) can cause piriformis syndrome — when the piriformis muscle presses on your sciatic nerve. It causes pain or numbness in
your buttock and down the back of your leg.
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 and 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).
After a trigger point injection, you can go home and can actively use the affected muscle. However, you should avoid strenuous activity for the first few days.
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.
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:
What happens during a trigger point injection procedure?
You can expect the following during a trigger point injection procedure:
How long do trigger point injections last?
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.
When should I see my healthcare provider?
If you’ve received a trigger point injection and are experiencing signs of infection, such as a fever or warmth at the
site of the injection, contact your healthcare provider.
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