Two injections, two different problems
Trigger point injections treat trigger points: small, tight bundles of muscle fibers that stay locked up, hurt when pressed, and often send pain somewhere else. A knot in the upper back that causes headaches, a band in the lower back that refers pain into the buttock, or a tight shoulder that will not loosen with stretching are typical. They come from repetitive strain, poor posture, stress, old injuries, and chronic conditions such as fibromyalgia and myofascial pain syndrome.
Joint injections treat pain and swelling inside a joint, most often from osteoarthritis, bursitis or a flare after an injury. A corticosteroid (cortisone) with a local anesthetic is placed into the knee, shoulder, hip, or a smaller joint such as the elbow, wrist, ankle or thumb, to calm inflammation from the inside.
Both are done in the exam room at either clinic without sedation, and you drive yourself home.
How our pain physicians do it
- Finding the spot. For a trigger point, the doctor feels for the knot and the twitch it gives when pressed, and marks it. For a joint, the doctor confirms the diagnosis from your exam and any imaging, and uses ultrasound guidance when it helps place the needle accurately, particularly for the hip and shoulder.
- The injection. A trigger point gets a small amount of local anesthetic, sometimes with a steroid. Several sites can be treated at one visit. A joint injection uses a slightly larger needle, and the skin over the joint is numbed first.
- The course. Trigger points usually need two to four sessions, spaced a few weeks apart, alongside stretching and, where needed, medication. The same joint is not injected with steroid more often than every three months, and typically no more than three or four times a year, to protect the cartilage.
- What comes next. If a joint keeps flaring, the doctor may discuss gel injections for the knee, PRP for a tendon, a nerve block, or a referral to orthopedics.
Does insurance cover it? Trigger point and joint injections are covered by Medicare, Aetna, Blue Cross Blue Shield and Cigna when medically necessary, which means the doctor has documented the diagnosis and the reason for the injection. Medicare covers up to three trigger point sessions in a three-month period. Medicare Advantage and some commercial plans ask for prior authorization before a repeat series, and our front desk handles that before you are scheduled. Read more about insurance and self-pay.
What to expect
- Before you come in, we verify your insurance and ask for photo ID, your medication list and any imaging reports. Tell us if you take a blood thinner or have diabetes, because steroid can raise blood sugar for a few days.
- At the consultation, the doctor examines you, explains what is causing the pain and whether an injection is the right first step. Many patients have their first injection at this visit.
- The injection itself takes a few minutes. You feel a pinprick and pressure, and for a trigger point a brief cramp as the muscle twitches and then lets go.
- Afterward, you sit for a few minutes and then leave. Mild soreness at the site for a day or two is normal. Use ice, avoid heavy exertion for 24 to 48 hours, and keep gently moving.
- Follow-up is in two to six weeks so the doctor can measure the relief and decide whether to repeat, add another treatment, or stop.
| What it treats | Muscle knots in the neck, shoulders and back; arthritis and bursitis in the knee, shoulder, hip and small joints |
|---|---|
| Visit length | A few minutes for the injection; 30 to 45 minutes including the consultation |
| Typical course | Trigger points: two to four sessions. Joints: one injection, repeated no sooner than three months |
| Downtime | None beyond taking it easy for a day or two |
| Coverage | Covered when medically necessary; prior authorization sometimes needed for repeats |
What it feels like and how long it lasts
Trigger point relief often starts within minutes because of the anesthetic, then settles over the next day or two as the muscle relaxes. Some patients need only one session; those with a chronic condition may return for maintenance. Steroid joint injections usually take two to five days to work, and relief lasts weeks to several months. Results vary, and the doctor records the relief each time so the next decision is based on evidence.
Does it hurt?
Most patients describe a pinprick and a few seconds of pressure or cramping, and it is over in minutes. Joint injections are numbed first.
Can I have more than one area treated at the same visit?
Yes for trigger points; several knots are commonly treated in one session. Steroid joint injections are usually one joint per visit.
How many cortisone injections can I have in the same joint?
No more often than every three months, and typically three or four in a year. Beyond that, repeated steroid can weaken cartilage and tendon, so the doctor will suggest a different approach.
What if the injection does not help?
The doctor documents the response and moves to the next step: a nerve block, gel injections for a knee, PRP for a tendon, StemWave at Davie, or a referral for imaging or a surgical opinion.
Which clinic offers these injections?
Both. Trigger point and joint injections are performed at Davie for Broward County and at Boynton Beach for Palm Beach County.
Does Medicare cover trigger point injections?
Yes, when medically necessary, up to three sessions in any three-month period. Medicare Advantage plans may require prior authorization for a repeat series. The front desk confirms your coverage before scheduling.