From the Research
The upper back muscles that commonly require trigger point injections include the trapezius, rhomboids, levator scapulae, and the supraspinatus muscles, as identified in the most recent study 1 from 2024. These muscles frequently develop myofascial trigger points—hyperirritable spots within taut bands of skeletal muscle that cause pain when compressed. Trigger point injections typically involve injecting a local anesthetic such as lidocaine (1-2%) or procaine, sometimes combined with a corticosteroid like methylprednisolone or triamcinolone, directly into these painful knots. The procedure is usually performed in a clinical setting where the healthcare provider identifies the trigger point by palpation and then inserts a small needle to deliver the medication. Some studies, such as 2, have explored the use of ultrasound-guided techniques for improved accuracy and safety in administering these injections. The injection works by disrupting the pain cycle, reducing inflammation, and relaxing the muscle fibers. Patients may experience immediate relief, though multiple sessions spaced 2-4 weeks apart are often needed for optimal results, as supported by the review of clinical research progress in treating myofascial pain syndrome with trigger point injections 1. Following the injection, patients should apply ice to reduce soreness, avoid strenuous activity for 24-48 hours, and perform gentle stretching exercises as recommended by their healthcare provider to maintain the therapeutic effect and prevent recurrence. Key considerations for the procedure include the anatomy of the posterior compartment of the neck, where several neurovascular structures are located nearby the trapezius and levator scapulae muscles, highlighting the importance of precise techniques like those described in 3. Overall, trigger point injections can provide significant relief for patients suffering from myofascial pain syndrome in the upper back muscles, with the most recent and highest quality evidence 1 supporting their efficacy and safety. Some older studies, such as 4 and 5, while informative, do not directly pertain to the current best practices for trigger point injections in the upper back muscles, and thus are not prioritized in this recommendation.