Trigger Points

Trigger points are painful areas of muscle that are tender. They may feel like tight bands or knots when pressed. Pressing on the trigger point will “trigger” pain at the area of pressure and often in other areas. For example, pressing on a trigger point at the top of the shoulder may send pain down the arm or up to the neck.

Trigger points are overactive muscle areas that can come from stress, over-use of the muscle, problems with the spine or posture. They can often be treated by improving posture, reducing stress, and with exercise. If these treatments do not correct a painful trigger point, your doctor may want to treat the problem with a trigger point injection.


During the treatment, your doctor will mark the skin over the point, clean the skin, and insert a fine needle through the skin into the trigger point area. This may cause a small “twitch.” It tells us that the trigger point has been reached. The needle going in may cause some discomfort.

Most doctors will inject a small amount of medicine to numb the trigger area. You may feel some burning at this time. The action of the needle going in, is what causes the trigger point to relax.

Most treatments take about ten minutes. When the treatment is over, a small amount of pressure will be applied to stop any bleeding.


The risks of trigger point injections are very small, about the same as with any injection. Some patients may have brief bleeding at the site of the injection.

After the Injection

You should feel relief right away after the treatment. The medicine will also numb any pain from the shot. Numbness from the medicine will last 4-12 hours or until the medicine wears off. You may then feel some soreness, as you might after a flu shot. You can stretch the muscle, use ice or cold packs, or take pain medicine to treat this soreness. Ask your provider what you can safely use.

Within 1-2 days, the soreness should fade, but the trigger point relief should last. There should be less pain than before. While these treatments do not always work, most patients get relief for days, weeks, and sometimes months.

Some patients may get full relief after one procedure. If a trigger point returns, these treatments may be done every few weeks to months, if needed.

When you are pain free, stretch the treated muscle, do your exercise program, and take steps to keep the trigger point from coming back.