Trigger Point Injections

A trigger point injection is an outpatient procedure used to relieve pain by treating areas of muscle that contain trigger points (contracted knots of muscle that form when the muscles do not relax). Often these knots can be felt under the skin.

When stressed through repetitive activity or an injury, muscles often form these trigger points, which can cause significant pain and tightness in the nerves around them. They can also cause a condition known as “referred pain,” which means that the pain is not felt in the knotted area, but rather another part of the body.

Trigger point injections can be used to treat many muscle groups and are especially helpful in reducing or eliminating pain in the arms, legs, lower back and neck. They are also used to treat syndromes and conditions such as tension headaches, fibromyalgia, myofascial pain syndrome (a type of chronic pain involving the tissue surrounding a muscle) and chronic pelvic pain syndrome. Trigger point injections are considered one of the most effective pain treatments available and are often beneficial when other treatments have failed.

Preparing for Trigger Point Injections

Avoid eating solid foods at least four hours before the procedure is scheduled. Clear liquids such as water, coffee, tea or soda are allowed up to two hours before the procedure (if the patient wishes to have mild sedation). Patients should inform their physician of any medications they are currently taking. Bathe or take a shower the morning of the procedure and wear comfortable, loose clothing.

Patients should arrange to have a family member or friend to take them home after the procedure (if they are being sedated). It may be helpful to keep in mind that although the injection may cause discomfort, it is only for a brief time, and the result should be significantly reduced or eliminated pain.

What Happens During Trigger Point Injections?

Injections are given in a physician’s office and usually only take a few minutes. Prior to the injection, a physician will exert gentle pressure on the trigger point area to observe how the muscles react and evaluate the patient’s pain. Patients need to remain still during the injection, since movement can make administering the injection difficult.

Once the painful area has been identified, a physician will sterilize the area and insert a small needle containing anesthetic into the trigger point. The physician will use a topical agent on the skin that will cool the nerves so the patient will not feel the sharpness of the needle. The injection may also include saline or a steroid. If a patient has several trigger points, they may be injected in one visit.

What Happens After Trigger Point Injections?

The injection site may be sore for several days and may have some bruising. Icing the area or taking an over-the-counter pain reliever can alleviate any discomfort.

For a few hours after the procedure, patients should rest or limit their activity, but they can resume regular activity unless instructed otherwise. If there is increased pain or patients begin to experience fever, chills or bleeding at the site (or anything that seems unusual) they should contact a physician.

Possible Outcomes

The steroid stays in the muscle about one month, and during this time the muscle relaxes and the trigger point becomes deactivated. As a result, pain should be alleviated. If the pain returns, further therapy may be warranted.