Trigger point injections (TPIs) target the tight, tender muscle knots that drive myofascial pain, placing medication directly into the painful band to ease spasm and help restore comfortable movement.
OVERVIEW
What a trigger point injection is and how it works
A trigger point is a taut, hyperirritable band within a muscle — often felt as a firm “knot” that is painful to press and can refer pain to nearby areas. These myofascial trigger points can keep a muscle in a low-grade state of spasm, restrict motion, and feed a frustrating cycle of pain and tightness. A trigger point injection interrupts that cycle by placing a small amount of medication directly into the knotted muscle fibers.
At Columbia Pain & Spine Institute in Gresham and Portland, Oregon, our physicians use a thin needle to enter the trigger point and inject a local anesthetic, sometimes combined with a small amount of corticosteroid. The anesthetic relaxes the muscle and quiets the pain signal, while a steroid, when used, can reduce local inflammation. In some cases the needling itself — with or without medication — helps deactivate the trigger point.
TPIs are part of our joint & soft tissue injection program and are most often considered when stubborn muscle pain has not responded to stretching, physical therapy, heat, or oral medication.
Commonly treats
DIAGNOSTIC & THERAPEUTIC
A treatment that can also help locate the source of pain
Trigger point injections are primarily therapeutic — the goal is to relax the muscle and relieve pain. They can also be partly diagnostic: if injecting a specific knot reproduces and then eases your familiar pain, it helps point to the muscle as the pain generator rather than an underlying joint or nerve. That information guides the rest of your care plan, including targeted physical therapy and stretching.
YOUR PROCEDURE
What to expect
Before
Your physician examines you and locates the trigger points by feel, pressing to find the taut, tender bands that reproduce your pain. The procedure is done in the office, and no sedation or fasting is required. Let us know about blood thinners or allergies beforehand.
During
You are positioned to relax the target muscle. A thin needle is inserted into the trigger point and a small amount of local anesthetic, sometimes with a steroid, is injected. You may feel a brief twitch or cramp when the needle contacts the taut band. Several points can be treated in one visit, and the injection itself usually takes only a few minutes.
After
You can typically get up and go home right away, with no driving restriction since sedation is not used. The treated muscle may feel sore or bruised for a day or two. Gentle stretching and movement are often encouraged to help keep the muscle loose.
Image guidance, duration, and recovery
Many trigger point injections are guided by palpation alone, since the physician can feel the knot directly. When a muscle is deep or near important structures, ultrasound guidance may be used to help place the needle accurately. The visit is brief — usually well under 30 minutes including preparation — and most people return to normal activities the same day, easing back into vigorous exercise as soreness settles. Relief from the anesthetic may begin quickly, while any benefit from a steroid can take several days to develop. Your physician will advise whether a single injection or a short series fits your situation.
FAQS
Frequently asked questions
Does a trigger point injection hurt?
Most people feel a quick pinch and sometimes a brief muscle twitch or cramp as the needle enters the knot. The discomfort is short-lived, and the local anesthetic begins to relax the muscle soon after. Mild soreness at the site for a day or two is normal.
How long does relief last?
It varies. Some people feel better for weeks or months, while others get shorter relief and benefit from repeat injections combined with stretching and physical therapy. Because myofascial pain has many causes, lasting results usually come from addressing the underlying triggers, not the injection alone.
How is this different from a steroid joint injection?
A trigger point injection targets a knot within a muscle, whereas a major joint injection or small joint injection delivers medication into a joint space. If your pain comes from an inflamed tendon, a tendon injection may be more appropriate. Your physician will determine which structure is causing your pain and recommend the right approach.