What is a myofascial trigger point injection?

A myofascial trigger point injection is a minor procedure to treat a painful area in a muscle, called a trigger point. Trigger points are tight knots or bands of muscle or connective tissue that are painful to touch. They can also send pain to other body parts and cause muscle spasms and weakness. 

A myofascial trigger point injection involves injecting a long-acting anesthetic, and sometimes an anti-inflammatory medicine, into the trigger point. Myofascial trigger point injections can relieve your pain and improve mobility for several days or weeks, or even longer. You can also repeat these injections as needed to maintain results.

Trigger points commonly occur in the buttocks, back and neck, but can affect almost any body part. Trigger points can be active or latent. Latent trigger points cause muscle weakness and stiffness, but generally cause pain only with pressure. Active trigger points cause pain even at rest. Trigger points can also cause other symptoms, such as headaches and eye pain.

A myofascial trigger point injection is a minor procedure, but it still involves some risk. It is only one method used to treat painful muscles. Discuss all of your treatment options with your doctor to understand which options are right for you.   

Why is a myofascial trigger point injection performed? 

Your doctor may recommend a myofascial trigger point injection to control pain from active trigger points. Your doctor may only consider a myofascial trigger point injection when other treatments have failed to relieve your symptoms. Ask your doctor about all of your treatment options before deciding on myofascial trigger point injection.

A myofascial trigger point injection can also help control pain enough to start a physical therapy, exercise therapy, or rehabilitation program. These programs are usually necessary to resolve the trigger point and keep it from coming back.

Causes of trigger points include: 

  • Acute injuries, including direct hits, strains, twisting or tearing of muscles
  • Chronic muscle clenching, including tension from mental or emotional stress
  • Inactivity, including being bedridden, sedentary or deconditioned
  • Overuse injuries, including repetitive motions from daily activities and activities such as typing, using a mouse, playing a sport, or cradling a telephone
  • Poor body mechanics, including having poor posture and using furniture with poor design
  • Sustained muscle overloading, including heavy lifting, carrying loads with unequal weight distribution, and wearing body armor

Who performs a myofascial trigger point injection?

Many types of healthcare providers perform myofascial trigger point injections, including doctors, nurses, and allied health professionals. Doctors who commonly perform myofascial trigger point injections include:

  • Family medicine doctors specialize in the prevention, diagnosis, treatment, and ongoing care for a wide range of diseases, disorders and conditions that affect all areas of the body.
  • Pain medicine doctors specialize in diagnosing, treating and managing pain and a range of painful disorders.
  • Physical medicine and rehabilitation doctors specialize in muscle, bone, and nervous system conditions that affect physical and mental ability.

How is a myofascial trigger point injection performed?

Your myofascial trigger point injection will be performed in an outpatient setting. A myofascial trigger point injection involves the following steps:

  1. You will lie down on a procedure table.
  2. Your provider will locate the trigger point and clean the overlying skin. 
  3. Your provider will pinch the trigger point between two fingers to keep it in place. This will prevent it from sliding away from the needle.
  4. Your provider will insert the needle into your skin and guide it into the trigger point.
  5. Your provider will inject medicine into the trigger point once the needle is in place.
  6. Your provider will stretch the muscle to its full length and may massage the area.
  7. You will likely return in a few days so your doctor can evaluate your pain.
  8. Your doctor may prescribe a series of injections, spaced many weeks apart if needed.