Trigger point injections are targeted injections used to treat painful, tight areas of muscle known as trigger points. These tender areas can contribute to localized muscle pain, stiffness, restricted movement, and referred pain that is felt somewhere other than the trigger point itself.
Trigger point injections may be considered when examination suggests that myofascial pain is contributing to symptoms and measures such as stretching, activity modification, physical therapy, or medication have not provided enough improvement.
At Regenerative Spine and Pain Specialists, Dr. Zwade Marshall and Dr. Jennifer Xiong evaluate the pain pattern, muscle findings, neurologic symptoms, prior treatment, and possible underlying causes before recommending trigger point injections.
Request an Appointment or call (404) 618-0995 to schedule an evaluation at our Fayetteville, Marietta, or Atlanta office.
What Are Trigger Point Injections?
Trigger points are tender, tight areas within muscle that can reproduce a patient’s familiar pain when pressed. Some trigger points cause pain directly at the site, while others can produce referred pain in a predictable nearby region.
During a trigger point injection, a small needle is placed into the painful muscle area and medication is injected. The goal is to reduce local pain and muscle irritability so that movement, stretching, and rehabilitation may be easier.
Trigger point injections are used for myofascial pain. They do not treat every cause of neck, back, shoulder, or limb pain and do not correct structural problems such as a disc herniation, spinal stenosis, arthritis, or nerve compression.
Who May Be a Candidate for Trigger Point Injections?
Trigger point injections may be considered when a physical examination identifies tender muscle bands or trigger points that reproduce the patient’s symptoms.
You may be evaluated for trigger point injections if you have:
- Myofascial pain with reproducible muscle tenderness
- Persistent muscle pain or tightness in the neck, shoulders, upper back, lower back, or other muscle groups
- Referred pain that appears to originate from a trigger point
- Pain that limits movement or makes rehabilitation more difficult
- Symptoms that have not improved enough with stretching, physical therapy, activity modification, heat, massage, or medication
Trigger point injections may be less appropriate when the main pain source is a compressed nerve, joint, fracture, infection, systemic disease, or another condition that requires different treatment.
Your provider will review your symptoms, examination, medications, bleeding risk, allergies, medical history, and prior treatment before recommending an injection.
What Conditions Can Trigger Point Injections Help Manage?
Trigger point injections are most often used when myofascial pain is contributing to symptoms.
Myofascial Pain Syndrome
This condition involves painful trigger points in muscle and surrounding soft tissue. Trigger point injections may be one component of treatment along with stretching, exercise, and rehabilitation.
Neck and Shoulder Muscle Pain
Tight or tender muscles in the neck, upper back, and shoulder region may contribute to pain and restricted motion. In selected patients, trigger point injections may help reduce a focal muscular component of the pain.
Back Muscle Pain
Muscle trigger points can occur alongside other causes of back pain. An injection may help when examination suggests that a meaningful part of the symptoms is myofascial.
Referred Muscle Pain
Some trigger points reproduce pain in a nearby region rather than only at the injection site. Treatment may be considered when the referred pattern is consistent with the examination findings.
Trigger point injections are not a substitute for evaluating new weakness, numbness, fever, trauma, unexplained weight loss, bowel or bladder changes, or other symptoms that may suggest a different underlying problem.
What Is Injected Into a Trigger Point?
The medication used for a trigger point injection depends on the treatment plan.
Local Anesthetic
A local anesthetic is commonly used to reduce pain at the trigger point and can help interrupt the cycle of pain and muscle guarding.
Corticosteroid
In some situations, a corticosteroid may be added, but steroid is not required for every trigger point injection. Your physician will decide whether it is appropriate based on the location, diagnosis, prior response, medical history, and treatment goals.
Trigger point injections are different from epidural steroid injections, facet injections, medial branch blocks, and selective nerve root blocks. Those procedures target different structures and are used for different pain generators.
How Do Trigger Point Injections Work?
Trigger point injections are intended to reduce pain and irritability within a symptomatic muscle area.
The needle is placed into the identified trigger point. The mechanical effect of needling the tight muscle area, together with the injected medication, may help reduce local tenderness and allow the muscle to relax.
The goal is not simply to numb the area for a few hours. When the injection is effective, it may make it easier to participate in stretching, physical therapy, strengthening, posture work, or other treatment directed at the factors contributing to the myofascial pain.
Response varies. Some patients notice meaningful improvement, while others experience only temporary, partial, or no benefit.
What Happens During a Trigger Point Injection?
The physician first identifies the painful muscle and trigger point based on the examination. The skin is cleaned, and a small needle is advanced into the targeted muscle area.
Medication is injected into the trigger point. More than one trigger point may be treated during the same visit when clinically appropriate.
The procedure is usually brief. The exact number of injections, muscles treated, medication used, and whether additional guidance is needed depend on the location and treatment plan.
Because the procedure involves a needle placed into muscle, temporary soreness or a bruised feeling can occur afterward.
What to Expect Before, During, and After Trigger Point Injections
Before the Injection
Your provider will review the pain pattern and confirm that trigger points appear to be contributing to the symptoms.
Tell your care team if you:
- Take blood-thinning or antiplatelet medications
- Have an active infection, fever, or recent illness
- Have allergies to local anesthetics, corticosteroids, or other medications
- Have diabetes or another condition that may affect medication choices
- Are pregnant or may be pregnant
- Have had recent changes in your health
Do not stop prescription medications unless the prescribing or treating clinician specifically instructs you to do so.
During the Injection
The physician locates the trigger point, cleans the skin, places a small needle into the muscle, and injects the planned medication.
After the Injection
Mild soreness can occur. Your provider may recommend gentle movement, stretching, heat or ice, physical therapy, or temporary activity modification depending on the treated muscle and your overall treatment plan.
Contact the office if you develop fever, increasing redness or drainage, severe or rapidly worsening pain, shortness of breath, new weakness or numbness, or another concerning symptom.
Risks, Side Effects, and Safety Considerations
Trigger point injections are generally minor procedures, but complications are possible.
Potential risks and side effects include:
- Temporary soreness or increased pain
- Bruising or bleeding
- Infection
- Medication reaction or allergy
- Temporary numbness or weakness near the treated area, depending on the medication and location
- Skin or soft-tissue changes when corticosteroid is used
- Needle injury to a nearby structure
- Failure to improve symptoms
When trigger points are treated near the upper chest, shoulder, or thoracic region, there is a rare risk of pneumothorax, or collapsed lung, if a needle enters the chest cavity. Technique and needle depth are selected carefully to reduce this risk.
Your individual risks depend on the muscle being treated, medication used, bleeding risk, anatomy, and medical history.
How Soon Can Trigger Point Injections Help?
If local anesthetic is used, some patients notice a change in pain soon after the injection. Early numbness or pain reduction from anesthetic does not necessarily predict how long the overall benefit will last.
Other patients notice improvement more gradually as post-injection soreness settles and they return to stretching, movement, or rehabilitation.
The amount and timing of benefit vary, and a trigger point injection does not guarantee pain relief or improved function.
How Long Can Relief From Trigger Point Injections Last?
The duration of benefit varies from person to person. Some patients experience temporary relief, while others may have improvement that lasts longer when the injection is combined with treatment of contributing factors.
Long-term results can depend on:
- The underlying cause of the myofascial pain
- Whether the painful muscle continues to be overloaded or irritated
- Participation in stretching, strengthening, physical therapy, or ergonomic changes
- Whether another pain generator is also present
- The patient’s response to the medication used
Trigger point injections are usually most useful as part of a broader treatment plan rather than as a stand-alone cure for chronic muscle pain.
Can Trigger Point Injections Be Repeated?
Trigger point injections may be repeated in selected patients when the prior injection provided meaningful benefit and examination again identifies symptomatic trigger points.
Repeat treatment is not automatic. Your provider will consider:
- How much relief the previous injection provided
- How long the benefit lasted
- Whether the same trigger point has returned
- Whether physical therapy or other treatment is addressing contributing factors
- The medication used previously and any medication-related risks
- Whether another source of pain should be investigated
If injections repeatedly provide little or only very brief benefit, the treatment plan should be reassessed rather than simply repeating the same procedure.
What Happens If Trigger Point Injections Do Not Help?
If trigger point injections do not provide meaningful improvement, your provider may reassess whether the primary pain source is actually muscular.
Depending on the symptoms and examination, next steps may include:
- Physical therapy or a revised rehabilitation program
- Stretching, strengthening, posture, or ergonomic changes
- Medication adjustments
- Evaluation for a spinal, joint, nerve, or other pain generator
- Additional imaging or diagnostic testing when clinically indicated
- Another interventional procedure if a different source of pain is identified
For example, pain caused primarily by a nerve root, facet joint, or sacroiliac joint requires a different treatment strategy than myofascial pain.
Why Choose Regenerative Spine and Pain Specialists?
Regenerative Spine and Pain Specialists provides comprehensive evaluation and interventional treatment for musculoskeletal, spine, and nerve-related pain.
Our physicians, Dr. Zwade Marshall and Dr. Jennifer Xiong, are Harvard-trained, double-board certified anesthesiologists and interventional pain management specialists.
Our approach to trigger point injections includes:
- Confirming that muscle trigger points are contributing to the pain before recommending an injection
- Individualized selection of the muscles and trigger points to treat
- Medication choices based on the diagnosis and medical history
- Integration with stretching, rehabilitation, and treatment of contributing factors
- Reassessment when the response is limited or symptoms suggest another pain generator
- Care focused on function and realistic treatment goals without promising a specific outcome
Trigger Point Injection Care in Fayetteville, Marietta, and Atlanta
Regenerative Spine and Pain Specialists offers evaluation for trigger point injections through our offices in Fayetteville, Marietta, and Atlanta.
Fayetteville
Our Fayetteville pain management clinic is located at:
874 West Lanier Ave., Suite 250
Fayetteville, GA 30214
Marietta
Our Marietta pain management clinic is located at:
3939 Roswell Road, Suite 240
Marietta, GA 30062
Atlanta
Our Atlanta pain management clinic is located in Buckhead at:
371 E Paces Ferry Rd NE, Suite 802
Atlanta, GA 30305
Evaluation and procedure scheduling may occur at different locations depending on the treatment plan. Our team will confirm the appropriate location when scheduling.
For questions about trigger point injections, call (404) 618-0995 or contact Regenerative Spine and Pain Specialists.
Frequently Asked Questions About Trigger Point Injections
A trigger point injection places medication into a painful, tight area of muscle that reproduces a patient’s symptoms. It is used to help manage selected myofascial pain.
They may be considered for myofascial pain involving muscles of the neck, shoulders, back, or other areas when examination identifies symptomatic trigger points.
A local anesthetic is commonly used. A corticosteroid may be added in selected situations, but steroid is not required for every trigger point injection.
No. Trigger point injections treat painful muscle areas. Epidural, facet, medial branch, and nerve root injections target different structures and are used for different pain generators.
The physician identifies the trigger point, cleans the skin, places a small needle into the affected muscle, and injects the planned medication. More than one trigger point may be treated when appropriate.
Some patients notice a change soon after local anesthetic is injected, while others improve more gradually. The timing and amount of benefit vary.
The duration varies. Benefit may be temporary or may last longer when the injection is combined with rehabilitation and treatment of factors contributing to muscle pain.
Potential risks include soreness, bruising, bleeding, infection, medication reaction, temporary numbness or weakness, skin or soft-tissue changes when steroid is used, injury to a nearby structure, and failure to improve. Pneumothorax is a rare risk when injections are performed near the upper chest or thoracic region.
They may be repeated in selected patients when the prior response was meaningful and symptomatic trigger points are again present. Repeat treatment should be individualized.
No. They may reduce symptoms, but treatment often also includes stretching, strengthening, physical therapy, posture or ergonomic changes, and management of other contributing factors.
Your provider may reassess whether the main pain source is muscular and consider rehabilitation changes, medication adjustments, further evaluation, imaging, or a different treatment if another pain generator is identified.
Regenerative Spine and Pain Specialists offers evaluation through its Fayetteville, Marietta, and Atlanta, Georgia locations. The scheduling team can confirm where your procedure will be performed.
Schedule an Appointment for Trigger Point Injection Evaluation
Persistent muscle pain and trigger points can interfere with movement, exercise, sleep, and rehabilitation. When examination confirms a myofascial component, trigger point injections may be one part of a broader treatment plan.
Dr. Zwade Marshall and Dr. Jennifer Xiong can evaluate whether your symptoms are primarily muscular or whether another spine, joint, or nerve-related problem may be contributing.
Request an Appointment online or call (404) 618-0995 to schedule with Regenerative Spine and Pain Specialists.
Patients can also review our financial options or contact our office with questions before scheduling.