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 microtrauma, 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 muscles.

Trigger point injections commonly involve injections of local anesthetic with or without platelet-rich plasma (PRP), peptides, or without any injection substance (dry needling). 

What are Trigger Point Injections used for?

Trigger point injections 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 affecting your sternocleidomastoid muscle may cause vertigo, dizziness, and balance disorders.

Who would benefit from Trigger Point Injections?

A trigger point injection may be right for you if your trigger point pain has not improved with other treatments, including rest, ice or heat therapy, massage, sauna, myofascial release or physical therapy.

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 disc or spinal stenosis. 

  • Radiculopathy (pain from a pinched nerve).

How common are Trigger Point Injections?

Myofascial pain and trigger points are extremely common. Healthcare Providers diagnose and treat myofascial pain regularly, which may include trigger point injections, massage therapy, and IV therapy.

What do I need to do to prepare for Trigger Point Injections?

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.

What happens during a Trigger Point Injection procedure?

What to expect during a trigger point injection procedure:

  • Depending on the trigger point location, you may be sitting or laying 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, peptides, and/or ozone.

  • The procedure will be over and you’ll be able to go home.

How painful are Trigger Point Injections?

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 injections.

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.

What should I expect after Trigger Point Injections?

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. 

It is a good idea to keep post-injection notes regarding any pain following your treatment. This information will be discussed with your provider at your follow up and could help guide further treatments.

What are the benefits of Trigger Point Injections?

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 rest, physical therapy, massage therapy, sauna, IV therapy, peptides, etc.

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

What are the risks and side effects of Trigger Point Injections?

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. Sauna and massage following trigger point injections can help alleviate post-injection discomfort. You can apply ice packs or topical arnica 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.

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 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 provider.

A note from The Wellness Lounge

Trigger point injections are a common and generally safe way to treat myofascial pain caused by trigger points. Although the procedure can be temporarily painful, the injection can provide pain relief for about a month if not longer. If you have a knot in your muscle that isn’t responding to conservative treatment, such as rest, active stretching, massage, sauna, or IV therapy, talk to your healthcare provider about trigger point injections. We can answer any questions you have.

Ketamine Testimonials

  • "I have been fortunate to receive Ketamine infusions for Treatment-Resistant Depression. Since I began this treatment, I have felt much relief from the depression that has plagued me since childhood. I was highly suicidal before I tried this treatment. However, it is not perfect. I’m not “cured”. I think counseling is just as crucial for my treatment as Ketamine is. I do well most of the time but I still have times of deep depression. The difference is that these “down” times do not last too long and I know I will get better. The side effects are tolerable and I don’t worry too much about long-term use. I’m so grateful for this option and my new life!"

    Katie

  • "Hi ! I suffered from chronic pain and depression for 18 years from a cervical fusion. I had 4 IV Ketamine infusions. This drug has been miraculous for me. My pain is 95% gone and I don’t feel depressed! I was told to walk and prioritize movement because it will help the Ketamine to be more effective . This has been a miracle! "

    Susan