What conditions are treated with trigger point injections?

Trigger point injections are used for myofascial pain syndrome — including neck and upper back pain (trapezius, levator scapulae trigger points), low back pain (gluteal, paraspinal trigger points), headache (suboccipital, temporalis trigger points), shoulder pain, and hip pain. They are also useful for piriformis syndrome producing sciatica-like symptoms.

How quickly do trigger point injections work?

Many patients feel immediate relief during or after the injection. Some experience an initial 24–48 hour period of soreness as the muscle recovers, followed by sustained improvement. Results are typically noticeable within 3–5 days.

How often can trigger point injections be repeated?

Trigger point injections can be repeated every 4–6 weeks as needed, though the goal is always to reduce frequency over time as the underlying myofascial condition improves with manual therapy and other supportive treatments. Most patients require 2–4 sessions for meaningful long-term improvement.

Trigger Point Injections | Dr. Roslyn Migdale

Overview

Trigger point injections (TPIs) are a cornerstone treatment for myofascial pain syndrome — the condition caused by hyperirritable knots (trigger points) in muscle and fascia that produce local tenderness and referred pain patterns. A trigger point injection delivers local anesthetic (with or without corticosteroid or saline) directly into the trigger point, mechanically disrupting the taut muscle band and chemically reducing the inflammatory milieu within it. Dr. Migdale's exceptional background in manual therapy — as a certified massage therapist and Graston/ART practitioner — gives her a sophisticated understanding of trigger point anatomy and referral patterns that translates directly into more accurate injection targeting.

What Makes Trigger Point Injections Effective

Trigger points are maintained by a local energy crisis within the muscle — a cycle of abnormal acetylcholine release, sustained sarcomere contraction, and local ischemia. Needle disruption of the trigger point (whether with injection or dry needling) breaks this cycle mechanically. The addition of local anesthetic provides immediate relief and reduces the post-injection soreness. The combination of Dr. Migdale's hands-on palpation skills and injection precision makes her particularly effective at accurately targeting trigger points.

The Procedure

Trigger point injections are performed in the office. The trigger point is carefully located by palpation — Dr. Migdale identifies the taut band and the point of maximum tenderness. The skin is cleaned and a fine needle is inserted into the trigger point. Local anesthetic is injected as the needle is repositioned to treat the full extent of the taut band. The procedure takes 10–20 minutes depending on the number of trigger points treated. Patients typically feel immediate relief, sometimes followed by post-injection soreness for 1–2 days.

Best Results: Injection Plus Therapy

Trigger point injections work best as part of a comprehensive treatment plan. Dr. Migdale combines injections with manual therapies (Graston, ART, myofascial release), stretching guidance, and where applicable, medical acupuncture. Addressing perpetuating factors — posture, ergonomics, sleep, nutritional deficiencies — is essential for long-term resolution.

Overview

What Makes Trigger Point Injections Effective

The Procedure

Best Results: Injection Plus Therapy

Frequently Asked Questions