Trigger Point Injections

What are trigger point injections?

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.

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Trigger point injections commonly involve injections of local anesthetic with or without corticosteroid, botulinum toxin, or without any injection substance (dry needling).

What are trigger point injections used for?

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.

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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.

Who needs to have a trigger point injection?

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.

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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).

How common are 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.

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