Trigger Point Injections


An estimated 50 million Americans, or 20% of the entire population1, are living with chronic pain. In fact, chronic or acute pain is the most common reason adults seek medical care. Unfortunately, acute and chronic pain can lead to a decreased quality of life, opioid dependence, and diminished mental health in the form of anxiety and depression. 

Most often, the pain is felt in soft tissue areas, such as the lower back, neck and shoulders, hips, legs and buttock area. If you or a loved one are experiencing chronic pain, Sierra Neurosurgery Group offers treatments to address your symptoms.  

There are many options for interventional chronic pain treatment. These include trigger point injections, epidural steroid injections, nerve blocks, radio-frequency ablations (RFA), facet joint injections, spinal cord stimulation, and intrathecal pump placement.

Symptoms of Chronic Pain


Chronic pain is defined as pain that has been present for at least 12 weeks. The pain varies and may feel dull or sharp and may cause a burning or an aching sensation in the back, neck, limbs or feet. It may occur on one side or both. Other symptoms of chronic pain include throbbing, stabbing pain, tingling, weakness, and numbness. The intensity and presence of severe chronic pain may also lead to psychological symptoms such as depression, anxiety and fear. 

Types of Chronic Pain


Chronic pain may be caused by a variety of different stressors including spinal injury or stenosis, headaches, post-surgical pain, post-trauma pain, lower back pain, cancer pain, arthritis pain, neurogenic pain (caused by damaged or compressed nerves in the spine or neck), and psychogenic pain5. Two very common types of chronic pain that are treated by trigger point injections are fibromyalgia and tension headaches.

Fibromyalgia is a disorder indicated by universal musculoskeletal pain accompanied by fatigue, sleep, memory, and mood issues. Researchers believe that fibromyalgia increases pain by compromising the manner in which your brain and spinal cord process painful and non-painful signals.2

Tension Headaches typically range from mild to moderate pain that’s often described as a tight band around the head. Tension headaches are the most common type of headache, but the research behind the cause of the headaches is murky at best. The two types of tension headaches are episodic tension-type headaches and chronic tension-type headaches. 3

Selecting Your Interventional Pain Management Specialist 


The diagnosis and treatment of chronic pain can be emotionally and physically challenging. The selection of a pain management team is an important part of your treatment. We recommend you seek a specialist with Board Certification in Anesthesiology, followed by additional fellowship training in Pain Management. Interventional Pain Management specialists focus on treatments vs. medications, which merely mask the pain. Location, insurance coverage, nurse support and your patient experience are also key considerations.  Do not hesitate to ask questions and address concerns when selecting an interventional pain management specialist.  Here are a few questions to ask:

  1. What is the physician and nursing team’s overall approach to treatment?
  2. What experience does the clinician have in the treatment of chronic pain?  How big a part of his/her practice is it?
  3. Does the physician have any board certifications?  If so, in what?
  4. How is the diagnosis made?
  5. How is a treatment plan developed?  Who is involved?
  6. Where are procedures like Trigger Point Injections or Facet Joint injections done?
  7. Where can I read reviews from your verified patients?

Treatment Options for Chronic Pain


Treatment options differ based on the type and location of the chronic pain, duration of your symptoms, your age and overall health, and other therapies that may have been tried. Treatments may include trigger point injections, medications, lifestyle changes, and supportive physical therapy. 

Common medications to treat chronic pain are non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin, Aleve, etc.) and acetaminophen (Tylenol, etc.). For severe cases of arthritis, COX-2 inhibitors such as Celecoxib are commonly used. Antidepressants and anti-seizure medications have been found to help patients who also experience psychological symptoms.1 The strongest pain medication is also potentially the most detrimental to your long term health: Opioids such as hydrocodone, oxycodone, or fentanyl.  Interventional pain management specialists will work with you to try to reduce or eliminate this category of medications. 

During a Trigger Point Injection, the board-certified anesthesiologist carefully inserts a thin needle through the skin into sensitive portions of the muscle. The insertion of the needle into a trigger point area causes the muscle to relax. Then an anesthetic mixture is injected which causes the trigger point to relax. If the trigger point does not relax completely after the first injection, the physician may adjust the needle’s position and give additional injections.4

For the best outcomes, treatment is a partnership between the clinical expert, the clinical care team, you and your support system, including family and friends. Patient education videos on Trigger Point Injections and many other pain management procedures can be viewed at sierraneurosurgery.com/pain-management-video-library.



  1. “Products – Data Briefs – Number 390 – November 2020.” Centers for Disease Control and Prevention, Centers for Disease Control and Prevention, 4 Nov. 2020, https://www.cdc.gov/nchs/products/databriefs/db390.htm.
  2. “Fibromyalgia.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 26 Oct. 2021, https://www.mayoclinic.org/diseases-conditions/fibromyalgia/symptoms-causes/syc-20354780.
  3. “Tension Headache.” Mayo Clinic, Mayo Foundation for Medical Education and Research, 29 Sept. 2021, https://www.mayoclinic.org/diseases-conditions/tension-headache/symptoms-causes/syc-20353977.
  4. “Trigger Point Injection (TPI) for Muscle Pain Relief.” WebMD, WebMD, https://www.webmd.com/pain-management/guide/trigger-point-injection.
  5. “Chronic Pain: What Is It, Causes, Symptoms & Treatment.” Cleveland Clinic,          https://my.clevelandclinic.org/health/diseases/4798-chronic-pain.