Trigger point injections

What are trigger point injections?

A trigger point injection is the administration of certain drugs directly into areas within muscles or fascia (the protective material surrounding many muscles of the body) that are sources of pain. This type of muscular pain may be a symptom of a variety of conditions.

The affected areas are also known as trigger points, as they are “points” of tightness, tenderness, or discomfort in a specific muscle that may affect movement, normal function, or the quality of life of people affected by them. The drugs included in trigger point injections may be local anesthetics such as lidocaine or procaine.

A more novel approach is to inject Botox (or botulinum toxin A) into a trigger point. This medication inhibits muscle contraction at a cellular level, which may contribute to the symptoms mentioned above. These injections are regarded as an effective treatment for pain or discomfort emanating from a trigger point.


The development of trigger points is associated with conditions in which tightened bands of muscle tissue are formed by abnormal contraction, resulting in increased muscular tension. The formation of trigger points may also be associated with a range of factors and other conditions, including:

How trigger point injections work

A trigger point injection procedure is typically carried out in a pain clinic or similar facility.

The patient will be asked to sit or lie in a position in which the muscle(s) carrying a trigger point may be accessible to the doctor or pain specialist. The trigger point may be located and visualized using technology such as ultrasound. The skin above this area is cleaned, and the needle delivering the medication is inserted.

The injection can cause initial reactions such as sudden pain or spasm in the muscle(s) being treated. However, these are temporary. Optimal trigger point injections may require multiple injections of the same area. This ensures complete coverage of the affected muscle(s) by the drugs and thorough deactivation of the trigger point.

The average trigger point injection procedure lasts several minutes. After a completed injection procedure, the patient may be advised not to strain or over-use the treated area. The physician or specialist may also advise light exercise or stretching of the relevant muscle to contribute to the long-term remission of the trigger point while the tissue is relaxed by the injection.

Are there risks?

Common side effects include bleeding or infection in the skin or other tissue through which a needle has been inserted. These risks may be avoided by keeping the area clean and bandaged after a procedure. Patients who suffer from blood clotting disorders or who take medications to reduce clotting may not be suitable candidates for trigger point injections due to the risk of excessive blood loss.

These injections may also be unsuitable for pregnant women and those with increased body mass (which may obscure or obstruct a clear injection path to certain muscles). Local anesthetic medications are associated with adverse effects such as numbness or discomfort in the chest, temporary headache, and sensory problems. Botox is a diluted form of a bacterial neurotoxin. Therefore, side effects associated with this drug include muscle weakness, respiratory distress, or difficulty in swallowing.

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