Trigger Point Injections for Muscle Pain: What to Expect

If a tight, tender “knot” in your neck, shoulder, or lower back keeps flaring up and radiating pain, a trigger point injection may be part of the answer. It is a quick, targeted way to calm the specific muscle knot that is driving your pain. Here is what a trigger point injection is, what to expect, and how it fits into a broader plan to get you moving comfortably again.

What is a trigger point?

Trigger points are painful “knots” in muscles that are “very sensitive to touch/pressure” (Cleveland Clinic). They tend to form “after acute trauma or by repetitive micro-trauma,” which causes “muscle fibers to be stuck in a contracted state.” That constant contraction is what makes the spot ache and, sometimes, refer pain to other areas.

What is a trigger point injection?

A trigger point injection “can help soothe myofascial pain,” most often in the neck, shoulder, arms, legs, and lower back (Cleveland Clinic). What goes in varies: TPIs “commonly involve injections of local anesthetic with or without corticosteroid, botulinum toxin, or without any injection substance (dry needling).” In other words, the treatment can use numbing or anti-inflammatory medicine – or, in dry needling, the needle itself – to release the knot.

What does it treat?

The main target is myofascial pain – pain that comes from the muscles and their surrounding tissue. Because trigger points in certain muscles can refer pain elsewhere, they are also linked to problems like tension headaches and piriformis syndrome (Cleveland Clinic). If your pain is coming from a muscle knot rather than a joint or nerve, a trigger point injection may be a good fit.

How the procedure works

It is a quick, in-office procedure. Your provider will “pinch the point between their fingers and stabilize the tissue,” then “insert a thin needle” and “rhythmically continue needling the area by repeatedly inserting and retracting the needle” (Cleveland Clinic). Medication is injected once “the muscle twitching has stopped or until the muscle feels adequately relaxed.” Most people are in and out the same visit.

Recovery, relief, and how many you may need

Relief is not always instant, but it comes fairly soon. “Most people experience pain relief starting between 24 and 72 hours after” the injection, and “pain relief typically lasts for about a month” (Cleveland Clinic). If the pain returns after that, “your healthcare provider may recommend additional injections to achieve long-term pain relief.” That is normal – trigger point injections often work best as part of a plan rather than a one-time fix.

How Empire approaches trigger point injections

At Empire Minimally Invasive Spine and Pain we use a step-and-ladder approach: we start with the least invasive option that can solve the problem and build from there. For muscle-driven pain, that usually means pairing a trigger point injection with the things that keep the knot from coming back – guided stretching, physical therapy, posture and ergonomic changes, and treating any underlying spine issue. We examine you first to confirm the pain is truly myofascial before injecting, so the treatment is aimed at the right spot. Because we house interventional pain management and orthopedic care under one roof, you do not need a separate referral if your muscle pain turns out to be coming from a joint or nerve. We also treat muscle injuries from work and motor-vehicle accidents and can help coordinate workers’ compensation and no-fault documentation. Learn more on our trigger point injections page.

Is it safe?

For most people, yes. Cleveland Clinic notes that “the most common side effect is temporary discomfort or numbness around the injection site,” while rare complications can include “bleeding, infection, bruising, allergic reaction to the anesthetic agent,” or “vascular (vein) injury” (Cleveland Clinic). Your physician will review your specific risks before treatment.

Frequently asked questions

How long does a trigger point injection last?

Relief usually starts 24 to 72 hours after the injection and typically lasts about a month; if pain returns, additional injections may be recommended (Cleveland Clinic).

What is injected in a trigger point injection?

It commonly uses local anesthetic, with or without a corticosteroid or botulinum toxin – or no medication at all, which is called dry needling (Cleveland Clinic).

What does a trigger point injection treat?

It treats myofascial (muscle) pain, most often in the neck, shoulder, arms, legs, and lower back, and can help with related problems like tension headaches (Cleveland Clinic).

Do I need more than one injection?

Sometimes. Because relief often lasts about a month, your physician may recommend a series of injections, usually alongside physical therapy and other measures, for longer-term relief (Cleveland Clinic).

Sources

• Cleveland Clinic – Trigger Point Injections