Pain Management
Trigger Point Injections
Releasing Muscle Knots for Pain Relief
Tight, painful muscle knots—called trigger points—can cause localized pain or radiating discomfort into the back, shoulders, neck, and even the head. These points are often associated with muscle tension, injury, or chronic pain conditions. Trigger point injections (TPI) relax these knots, improve circulation, and relieve pain. At Desert Spine and Pain, neurosurgeon Dr. David L. Greenwald, M.D., FAANS, FACS offers precise, image-guided trigger point injections to help patients find relief and return to active living.
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What Are Trigger Point Injections?
In simple terms: A small needle delivers anesthetic, sometimes with steroid, directly into the muscle knot to release tension and reduce pain.
Scientifically: TPI involves intramuscular needle insertion into palpable taut bands of skeletal muscle fibers. Injection of local anesthetic (lidocaine/bupivacaine) ± corticosteroid interrupts the abnormal feedback loop causing sustained contraction and nociceptive signaling.
Conditions Treated
Myofascial pain syndrome
Chronic neck and back pain from muscle spasm
Pain related to chronic pain syndromes
Tension headaches and shoulder/neck muscle knots
Muscle spasm after spinal injuries or surgery
The Trigger Point Injection Procedure: Step by Step
Plain-English Overview
Preparation: Done in-office or outpatient setting.
Localization: Painful knot is identified by palpation.
Injection: A small needle injects anesthetic (sometimes with steroid).
Release: Muscle relaxes, relieving pain and restoring mobility.
Recovery: Bandage applied; no downtime required.
Surgeon-Level Detail
Identification: Palpation of taut band reproducing pain; trigger point marked.
Needle technique: 25–27G needle inserted into muscle knot; repeated “peppering” technique to disrupt contraction.
Medication: Local anesthetic (lidocaine/bupivacaine) ± corticosteroid injected in small volumes.
Dry needling option: Some injections may use only needling (no medication).
Closure: Bandage applied; stretching encouraged afterward.
Benefits of Trigger Point Injections
Immediate relief of localized muscle pain
Restores range of motion and flexibility
Quick, in-office procedure
Can be repeated if muscle knots return
Complements physical therapy and stretching programs
Risks & Limitations
Temporary soreness or bruising at injection site
Infection or bleeding (rare)
Pain relief may be temporary if underlying condition persists
Multiple sessions may be needed for lasting benefit
Recovery Timeline
Day 0: Resume normal activity; mild soreness possible
Days 1–2: Relief begins as muscle relaxes
Weeks 1–2: Improved mobility and function
Months: Injections may be repeated as needed for chronic pain
Why Choose Desert Spine and Pain?
Expert neurosurgeon-led care: Dr. Greenwald ensures injections are accurate and safe
Minimally invasive: Quick, outpatient treatment with no downtime
Comprehensive pain care: Trigger point injections combined with PT and lifestyle strategies
Compassionate support: We explain every step, easing patient anxiety about procedures
Frequently Asked Questions
What is the difference between trigger point injections and dry needling?
Both use a small needle, but injections deliver medication, while dry needling relies on the needle alone to relax the knot.
How quickly will I feel relief?
Many patients feel better immediately, though full effect may take a day or two.
How long does relief last?
Relief may last weeks to months. Repeat injections are safe if pain recurs.
Are trigger point injections safe?
Yes. Risks are rare and include mild soreness, bruising, or temporary discomfort.
How does Desert Spine and Pain perform TPIs differently?
We use neurosurgical precision and imaging guidance when needed, ensuring injections are targeted and effective.
Dr. David L. Greenwald, MD
Neuro-Spine Surgeon
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If chronic muscle pain or tension is interfering with your comfort or mobility, trigger point injections may offer the fast, targeted relief you need. Dr. Greenwald and his compassionate team will evaluate your symptoms, identify the source of discomfort, and determine whether this treatment is right for you. Every step you take toward relief brings you closer to comfort, flexibility, and better spine health. Schedule your consultation today and let Dr. Greenwald help you restore movement and ease muscle-related pain.
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Dr. David L. Greenwald, M.D., F.A.C.S.
Neurosurgeon | Spine Surgeon | Regenerative Medicine
Dr. David L. Greenwald, MD, FACS, is a board-certified spine surgeon with extensive experience performing trigger point injections to relieve muscle pain and tension caused by tight or irritated muscle fibers, often referred to as “knots.” These trigger points can develop from muscle overuse, stress, or spinal conditions that cause chronic strain. Using precise, image-guided techniques, Dr. Greenwald injects a small amount of anesthetic and sometimes steroid medication directly into the affected muscle to relax it, improve blood flow, and reduce pain. This minimally invasive treatment can provide rapid relief and restore range of motion, making it an effective option for patients throughout South Florida suffering from neck, back, or shoulder pain linked to muscle tension or spasms.
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