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Trigger Point Steroid Injection

Texas Pain Management Institute offers a variety of minimally invasive pain treatment procedures that we have perfected to help you achieve pain relief. Our treatments have been proven effective and are on the cutting edge of science related to pain reduction. Our goal is to improve every patient’s overall function and thus restore a better quality of life.


Trigger point injections (TPI) may be an option in treating pain for some patients. TPI is a procedure used to treat painful areas of muscle that contain trigger points (knots of muscle that form when muscles do not relax). These trigger points can often be felt underneath the skin and cause pain when pressed upon. Trigger points may cause several different types of pain and can occur almost anywhere. The most common sites for TPI are the neck, back of head and shoulders. Trigger points in these areas can cause headaches, neck pain, shoulder pain and can be exacerbated by stress or anxiety. Trigger points in the lower back may cause back pain, or pain into buttocks or legs due to nerve irritation.

Conditions commonly treated with trigger point injections:

  1. Muscle Spasms
  2. Tension Headaches
  3. Fibromyalgia
  4. Myofascial Pain Syndrome- chronic pain in tissues surrounding muscles

The procedure:

(please refer to our Pre-procedure Instructions for specifics)

Trigger point injections are typically done in the office and require no sedation. You will be asked to remove clothing in the painful area. Your physician will identify the trigger points by palpation (feeling the knots under the skin). Sometimes these may be marked with a pen as there are often multiple trigger points causing the pain. Once identified, the skin will be cleaned with an alcohol based solution. The trigger points are then injected with a solution of bupivicaine (numbing medication) and a small amount of steroid. Multiple injections can be performed at one time. Once the needles are removed, a bandaid will be placed over injection site. No further care is required.

What to expect after procedure:

There are no real limitations after trigger point injection. Use of the painful area is encouraged and may actually help spread the medication through the muscle. Many patients will feel immediate pain relief and improved function immediately. Some patients may not experience relief for 3-5 days. The pain relief can last anywhere from a few weeks to several months. The injections can be repeated at 2-3 month intervals, but should not be done sooner due to excessive steroid administration.

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