Trigger Point Injections at Glasgow Hospital

What are trigger point injections?

Trigger point injections are a treatment for muscle pain caused by trigger points, small, tender knots that form when part of a muscle fails to relax properly. The injections usually contain a local anaesthetic, often with a small amount of steroid, and are given directly into the affected muscle.

What conditions do trigger point injections treat?

Trigger point injections can help with pain caused by tight muscle knots, often in your shoulders, neck or back. Other muscles commonly affected include your jaw, hip and the sides of your neck.

They're sometimes used for conditions linked to widespread muscle tightness, such as tension headaches or fibromyalgia, and are often given alongside other treatments like physiotherapy.

What are the benefits of trigger point injections?

Trigger point injections can relieve pain and help your affected muscle relax, and may also improve your range of movement. Many people notice at least some improvement, though how long relief lasts varies from person to person.

Are there different types of trigger point injections?

Most trigger point injections use a fine needle to deliver a local anaesthetic, often combined with a small amount of steroid, directly into the knot. Some hospitals also offer dry needling, where the needle is used without any medication, relying on the physical stimulation to help release the muscle.

If trigger points keep coming back or standard injections only help briefly, botulinum toxin (Botox) can sometimes be used instead, since it keeps the muscle relaxed for longer, often several months, though this isn't right for everyone.

What happens before trigger point injections?

Trigger point injections are usually only considered after 4 to 6 weeks of other treatments, such as physiotherapy or medication, haven't given enough relief. You should tell your doctor if you have an infection anywhere on your body or skin, as your treatment will need to be delayed until this has cleared.

You'll be asked to sign a consent form to confirm you understand the treatment and agree to go ahead, and you can wear loose, comfortable clothing that's easy to adjust for the area being treated.

What happens during trigger point injections?

Trigger point injections are usually done in an outpatient clinic and take around 30 minutes in total. The process generally follows these steps:

1. You sit or lie down, depending on which muscle is being treated.
2. Your doctor cleans the area and may mark the trigger point with a skin pen.
3. They locate the trigger point by feeling for it, then pinch and stabilise the area between their fingers.
4. A thin needle is inserted into the trigger point and moved gently within the muscle; you're likely to feel a brief spasm, twitch, or increase in pain, which doesn't last long.
5. This is repeated until the muscle feels relaxed or stops twitching, and the process may be repeated at several trigger points in the same session.

What does recovery from trigger point injections look like?

Most people go home shortly after their injections, sometimes within an hour or two. You can usually get up and walk normally straight away, and can use the treated muscle as normal, though it's best to avoid strenuous activity for a few days.

Pain relief is often immediate, but it can also take a few days to feel the full effect, and some people notice a temporary increase in pain for 24 to 48 hours before this settles. If needed, a nurse may call you 6 to 8 weeks later to check how you're getting on.

What are the risks and complications of trigger point injections?

Mild tenderness, bruising, or temporary numbness at the injection site is common, and usually settles within a few days. Painkillers such as paracetamol or ibuprofen, and an ice pack to reduce bruising, can help.

Infection is uncommon but possible; contact your GP or NHS 111 if the area becomes warm, red or increasingly sore, or if you feel hot and unwell. Skin discolouration is a rare risk when injections are given close to the skin, and is most often seen in brown or black skin.

Very rarely, there can be an allergic reaction to the local anaesthetic used, or a minor injury to a blood vessel near the injection site. If a trigger point near your ribcage is being treated, there's also a small risk of affecting the lung beneath, though this is uncommon.