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Procedural Pain Clinic

We provide procedural pain interventions such as trigger point injections, knee injections (intra-articular  steroid and viscosupplementation), Botox for migraine, and medial/lateral epicondylitis steroid injections. This is not a fully fledged pain clinic, but we offer procedural pain interventions.

Trigger point injection (TPI) facts

Medical Author: Catherine Burt Driver, MD  

Medical Editor: William C. Shiel Jr., MD, FACP, FACR ​​

  • Trigger points are focal areas of muscle spasm, often located in the upper back and shoulder areas.

  • A trigger point injection involves the injection of medication directly into the trigger point.

  • Trigger point injections can be used to treat a number of conditions including fibromyalgiatension headache, and myofascial pain syndrome.

What is a trigger point?

Trigger points are focal areas of spasm and inflammation in skeletal muscle. The rhomboid and trapezius back muscles, located in the upper back and behind the shoulder areas, are a common site of trigger points. Trigger points in these areas can cause neck painshoulder pain, and headache. In addition to the upper spine, trigger points can also occur in the low back or less commonly in the extremities.

Often there is a palpable nodule in the muscle where the trigger point is located. The area is tender, and frequently when pushed, pain radiates from the trigger point itself to an area around the trigger point. Trigger points commonly accompany chronic musculoskeletal disorders such as fibromyalgia, myofascial pain syndrome, neck pain, and low back pain.  They may also occur with tension headache and temporomandibular pain.  Acute trauma or repetitive injury can lead to the development of trigger points.


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