Overview
Trigger points are small, sensitive areas within a muscle that can feel tight, tender or rope‑like. In the thoracic region, they often develop due to poor posture, prolonged sitting, repetitive strain, stress‑related tension or following injury. These knots can cause sharp or aching pain, restrict movement and sometimes radiate discomfort around the ribs or into the shoulder blades.
A trigger point injection involves placing a small amount of local anaesthetic—sometimes combined with other medications—directly into the affected muscle band. This aims to relax the muscle fibres, reduce pain and allow more effective stretching and rehabilitation.
Who this treatment helps
Trigger point injections may be considered for people with:
- Localised mid‑back muscle pain
- Tight, tender knots that do not release with stretching or massage
- Pain aggravated by posture, lifting or twisting
- Muscular tension following injury or strain
- Referred pain around the ribs or shoulder blades
- Persistent symptoms despite physiotherapy or medication
A consultation is required to confirm suitability and rule out other causes of thoracic pain.
What is a Trigger Point Injection?
A trigger point injection is a minimally invasive procedure that targets specific muscle knots. The injection is placed directly into the tight band of muscle, causing it to relax. Local anaesthetic provides temporary numbing, while the mechanical effect of the needle can help release the knot.
Ultrasound guidance may be used in selected cases to improve accuracy, especially when deeper thoracic muscles are involved. The procedure is performed by a consultant pain specialist.
What to expect during the procedure
- Your consultant identifies the trigger point through examination and palpation.
- The skin is cleaned and the area is prepared.
- A fine needle is inserted into the trigger point.
- Local anaesthetic is injected, and the muscle may twitch briefly as it relaxes.
- The needle is removed and gentle pressure is applied.
- You may be advised to stretch the area afterwards.
- You can usually go home shortly after the procedure.
The procedure typically takes 5–10 minutes.
After the procedure
- Mild soreness or bruising at the injection site is common and usually settles within a day or two.
- Many people notice improved movement and reduced tightness shortly after treatment.
- Gentle stretching and heat may help maintain the benefits.
- Normal activities can usually be resumed the same day.
- Your consultant may recommend physiotherapy to support long‑term improvement.
Benefits
- May reduce muscular mid‑back pain
- Can improve posture and movement
- May ease pain radiating around the ribs or shoulder blades
- Supports rehabilitation and physiotherapy
- Quick procedure with minimal downtime
- Can help confirm whether muscle tension is contributing to symptoms
Possible risks and side effects
Trigger point injections are generally safe. Possible effects include:
- Temporary soreness or bruising
- Mild bleeding at the injection site
- Light‑headedness
- Rarely, infection
- Very rare irritation of nearby structures
Your consultant will discuss individual risks during your assessment.
When to consider other options
If symptoms persist or if muscle tension is not the primary cause of pain, your consultant may discuss:
- Thoracic facet joint injections or ablation
- Thoracic nerve blocks or PRP
- Thoracic epidural injections
- Physiotherapy or posture‑based rehabilitation
- Medication review
- Combined approaches for persistent thoracic pain
Safety note
Please inform your consultant if you take blood thinners, have allergies, diabetes, active infection, are pregnant, or have had previous reactions to local anaesthetic. You may need someone to drive you home depending on how you feel after the procedure.
Arrange a consultation to discuss whether trigger point injections may be appropriate for your mid‑back pain.