What steroid is used for trigger point injections?

October 11, 2025 •

3 min read

According to Healthgrades.com, approximately 10% of people experience trigger points, which are painful muscle knots. For long-lasting relief from these trigger points, healthcare providers often use a corticosteroid, along with a local anesthetic, in a trigger point injection.

Quick Summary

Trigger point injections for myofascial pain often incorporate a corticosteroid, such as triamcinolone, to reduce inflammation and relax muscle knots. The specific steroid used and its dosage depend on the treatment goals and individual patient factors.

Key Points

Common Steroids: Triamcinolone, methylprednisolone, and dexamethasone are frequently used corticosteroids in trigger point injections.
Anti-inflammatory Action: The primary function of the steroid is to reduce the inflammation within the muscle tissue, which helps relax the painful trigger point.
Extended Relief: Corticosteroids provide longer-lasting relief than the immediate but temporary numbing effect of a local anesthetic.
Localized Side Effects: Side effects are typically temporary and localized, such as soreness or bruising, with rare systemic effects due to minimal absorption.
Limitations: The frequency of steroid injections should be limited to avoid potential tissue damage, and alternatives like anesthetic-only or dry needling exist.
Comprehensive Treatment: Trigger point injections are most effective when combined with other therapies, like physical therapy, to address underlying causes and prevent recurrence.

Common Steroids Used in Trigger Point Injections

Trigger point injections (TPIs) typically involve a local anesthetic, like lidocaine, and often a corticosteroid to provide pain relief and reduce inflammation. Common corticosteroids used for this purpose include triamcinolone, methylprednisolone, dexamethasone, and sometimes cortisone. The choice of steroid is based on factors such as the desired duration of action and the patient's specific needs.

Triamcinolone

Triamcinolone (e.g., Kenalog) is a widely used corticosteroid in TPIs due to its longer-lasting anti-inflammatory effects. Its prolonged action can help the muscle relax and heal over a longer period, offering extended relief from pain and tightness.

Methylprednisolone

Methylprednisolone is another frequent choice for TPIs. It is known for its ability to provide fast, targeted pain relief alongside its anti-inflammatory properties.

Dexamethasone and Cortisone

Dexamethasone is a potent anti-inflammatory agent sometimes used in TPIs. Cortisone can also be an option, although it may be considered less effective for certain muscle knots compared to other corticosteroids. These steroids help reduce irritation in the muscle and fascia, promoting relaxation of tight muscle bands.

How Corticosteroids Help with Trigger Point Injections

Corticosteroids in TPIs primarily work by reducing localized inflammation. Trigger points are often inflamed due to muscle overuse or strain. Injecting a corticosteroid directly into the trigger point helps decrease swelling and irritation, allowing muscle fibers to relax. This process helps break the cycle of pain and muscle tension, providing an opportunity for the muscle to heal and for the patient to engage in therapies like physical therapy. TPIs often combine a local anesthetic for immediate numbing and pain relief with a corticosteroid for longer-term anti-inflammatory effects.

Potential Side Effects and Risks of Steroid Use in TPIs

While generally safe, TPIs with steroids have potential side effects, although serious complications are uncommon. Many side effects are temporary and localized to the injection site, such as soreness, bruising, or minor bleeding. Other potential temporary effects include facial flushing, insomnia, or jitters. Patients with diabetes should be aware that steroid injections can temporarily elevate blood sugar levels. Unlike oral steroids, localized injections typically don't cause long-term systemic side effects like weight gain. However, repeated steroid injections into the same area can potentially lead to tissue damage or thinning of the skin and fat. Healthcare providers consider a patient's medical history, including recent steroid use, when determining the need for steroids.

Comparison of Common Steroid Choices


Steroid	Key Characteristics	Common Rationale for Use
Triamcinolone	Longer-acting anti-inflammatory effect	Best for extended relief and chronic conditions.
Methylprednisolone	Provides fast-acting, targeted pain relief	Optimal for patients needing rapid symptomatic improvement.
Dexamethasone	Potent anti-inflammatory agent	Used to reduce significant inflammation.
Cortisone	Effective anti-inflammatory properties	Suitable for general use, though often shorter-acting than triamcinolone.

Conclusion

Triamcinolone, methylprednisolone, dexamethasone, and cortisone are common steroids used for trigger point injections. Their main role is to reduce inflammation in trigger points, helping to relax muscle knots and provide longer-lasting pain relief than anesthetics alone. The choice of steroid depends on the patient's condition and desired relief. While generally safe with primarily localized side effects, repeated steroid injections are limited due to potential tissue damage. TPIs are often part of a broader treatment plan, including physical therapy, to address underlying causes and prevent recurrence.

For more information on the distinctions between different types of injections, you can visit the Hospital for Special Surgery's educational page on the topic.

Alternatives to Steroids in TPIs

In some situations, steroids may not be used in TPIs. Alternatives include injecting only a local anesthetic like lidocaine, particularly for acute trigger points or when steroids are contraindicated. Dry needling, which involves inserting a needle without medication, can also release muscle knots. Some providers might use non-steroidal medications like ketorolac (Toradol), though corticosteroids are more common. The decision on medication or technique is made by the healthcare provider based on individual needs.

Recovery and Long-Term Management

Following a TPI, patients can usually resume normal activities relatively quickly, but strenuous activity should be avoided briefly. Post-injection care may involve gentle stretching, heat or ice, and over-the-counter pain relievers for soreness. Long-term success often depends on addressing the underlying causes of trigger points, such as poor posture or muscle imbalances. Physical therapy is frequently recommended to help prevent recurrence.

Frequently Asked Questions

Triamcinolone is one of the most common steroids used in trigger point injections, often favored for its longer-lasting anti-inflammatory effects.

Yes, trigger point injections can be done with only a local anesthetic, or in the case of dry needling, with no medication at all. The decision depends on the patient's condition and the provider's judgment.

Steroids reduce pain by targeting and decreasing the localized inflammation within the tight muscle knot. This allows the muscle to relax, which can break the cycle of muscle tension and pain.

Common side effects are temporary and may include localized soreness, bruising, or facial flushing. For diabetic patients, a temporary increase in blood sugar can occur.

No, a trigger point injection targets a specific muscle knot, whereas the term 'cortisone shot' often refers to an injection into a joint to treat conditions like arthritis. Cortisone can be used in a TPI, but it is not the only option.

The frequency of steroid trigger point injections must be determined by a healthcare provider. They are typically limited to prevent potential tissue damage, and if they don't provide long-term relief, alternative treatments should be considered.

Trigger point injections are used to treat myofascial pain syndrome, tension headaches, fibromyalgia, and other conditions involving painful, tight muscle knots.