Trigger points are areas of muscle that are very tight and painful to touch. These areas can occur in any muscle of the body, but are generally in the upper and lower back muscles and shoulder muscles. They are small areas of intense muscle spasm.

Trigger point injections are done when muscles are painful to touch and movement of an extremity (usually the arm) is painful. By injecting a muscle with a local anesthetic and steroid solution, pain is reduced and movement is increased. The medicines initially numb the area to reduce pain. The steroids provide long-term reduction of inflammation and pain.

Trigger point injections are usually performed in one of the examination rooms. You will normally be seated in a chair, or you may lie down if the pain is severe. The tender areas are located and marked. Each area will be cleansed with alcohol before the medication is injected. Each injection site will be massaged briefly to spread the medicine. Sedation is not routinely given for trigger point injections. If none is given, you may drive yourself home when feeling well enough to leave.

• The procedure may not totally eliminate your pain.
• You may experience bruising at the site of injections.
• Small risk of bleeding or infection at injection sites.
• Very rarely a needle can puncture the lung causing the lung to collapse or puncture the intestine causing an abdominal peritonitis (infection). Both of these conditions could require surgery to repair.
• Rarely, reactions to the local anesthetic drugs can cause flushing, ringing in your ears, or in very rare instances, seizures.
• Allergic reactions to medications may cause your heart and breathing to stop or may cause death.

• You may experience soreness at the injection site.
• If you notice increased redness, swelling or fever over the next several days, call The Pain Treatment Center or call your doctor.

A single session of trigger point injections will usually decrease pain significantly. However, it is not uncommon for pain to return after some period of time. Our recommendation is to then return for further injections. To be most effective, trigger point injections should be combined with programmed exercises. Your pain management doctor can discuss types of exercises with you. Your doctor may also recommend that you schedule an appointment with our Behavioral Medicine doctors to discuss stress management techniques. You may also be asked to stop smoking.