Trigger point injections may help selected patients with myofascial pain, muscle spasm, tension headache, pelvic pain, TMJ overlap, or chronic muscle guarding.
Learn how Dr. Siefferman performs trigger point injections to relieve muscle pain, reduce tension, and improve movement as part of a personalized treatment plan.
Our team organizes conditions and treatments into related zones of expertise to make it easier to explore the care paths most relevant to your symptoms and goals.
Use the zone tags above to browse dedicated pages for each focus area, including services, providers, and what to expect during treatment.
Hi, I’m Dr. Jason Siefferman, an interventional pain specialist and medical director at Manhattan Pain Medicine. Trigger points are areas of muscle that have become contracted and stuck in a contracted state. This generally happens for one of two reasons.
Either there was primary overuse of that muscle, meaning we’re doing something with our bodies repetitively in a way that just stresses that muscle so it just gets stuck in that contracted state, or that muscle is guarding something and that muscle is tight to protect another structure.
In either of these situations, when we press on that muscle, there may be a zingy referred pain. There’s usually a taut band that’s very sensitive. If we want to get rid of it, we have to mechanically break it up. This is not something that will go away on its own. We use a needle very much like acupuncture into that muscle to get a twitch response. We know that that muscle is released because of the twitch response.
And if we don’t get a twitch response, then it wasn’t a trigger point. Once we release the muscle, if it’s good, if it doesn’t come back, then that’s it. It’s done. If it does come back, then there is some primary process driving that muscle contraction. And rather than perform trigger points again every other week, we really want to understand what’s driving it and fix that
Trigger point injections are targeted procedures used to treat selected painful muscle knots, irritated muscle bands, or myofascial pain patterns. They may be considered when muscle tension, spasm, guarding, or referred pain contributes to symptoms in the neck, back, shoulders, jaw, pelvis, hips, or other areas.
At Manhattan Pain Medicine, trigger point injections NYC care begins with diagnosis-first evaluation. The goal is to determine whether the painful muscle is the primary pain generator or whether it is compensating for another issue, such as joint instability, nerve irritation, spine pain, pelvic floor dysfunction, headache disorder, TMJ dysfunction, hypermobility, or complex chronic pain.
MPM specialists evaluate whether trigger point injections may be appropriate by mapping the patient’s pain pattern, muscle tenderness, referral pattern, movement limitations, posture, biomechanics, prior treatments, and related diagnoses.Muscle pain may be primary, but it can also be secondary to hypermobility, EDS, joint instability, pelvic floor dysfunction, TMJ dysfunction, piriformis syndrome, tension headache, spine pain, nerve irritation, fibromyalgia, or chronic pain sensitization.
MPM reviews the broader clinical picture before recommending injections, acupuncture, pelvic floor trigger point injections, Botox, medication management, rehabilitation, ultrasound-guided procedures, pain psychology, or another coordinated pathway.
Jason W. Siefferman, MD
Medical Director | Interventional Pain Management | Headache Medicine
Luis Aranguren, MD
Interventional Pain Management
Tayyaba Ahmed, DO
Physical Medicine & Rehabilitation | Pelvic Pain
Adam Rosenberg, PA-C
Board-Certified Physician Assistant
Jordan Shankle, PA-C
Board-Certified Physician Assistant
Patients often search for trigger point injections in Manhattan when tight, painful muscles keep returning despite stretching, massage, physical therapy, heat, medication, acupuncture, ergonomic changes, or prior injections. Trigger points may feel like localized knots, taut muscle bands, or tender areas that refer pain into the head, jaw, shoulder, back, pelvis, hip, or leg.
MPM approaches trigger point injections as one part of muscle and pain generator mapping, not as a general muscle shot or permanent cure. For some patients, injections may help reduce muscle irritability enough to support movement, therapy, rehabilitation, or function. For others, repeated trigger points may signal that another driver needs attention, such as joint instability, hypermobility, pelvic floor dysfunction, TMJ dysfunction, posture, repetitive strain, nerve irritation, central sensitization, or unresolved spine or joint pain.
Trigger point injections fit across several MPM Zones of Expertise because myofascial pain can overlap with pelvic pain, headache, musculoskeletal pain, hypermobility, and complex chronic pain. A patient may have muscle guarding from EDS or joint instability, pelvic floor dysfunction, piriformis syndrome, TMJ dysfunction, tension headache, neck and back pain, fibromyalgia, or chronic pain sensitization.
MPM uses trigger point injections within a coordinated, diagnosis-first framework. The injection may help reduce selected muscle-related symptoms, but it is rarely the entire answer. Treatment planning may also include pelvic floor trigger point injections, acupuncture, botulinum toxin injections, ultrasound-guided procedures, rehabilitation, pain psychology, medication management, headache care, TMJ evaluation, or nerve-focused care. The goal is to match treatment to the actual pain generator and the patient’s broader clinical picture.
Before trigger point injections, MPM reviews the pain pattern, suspected muscles, prior treatments, medications, risks, alternatives, and post-procedure instructions. The clinician identifies the painful muscle bands or trigger points and places a small needle into the targeted area. Depending on the plan, the injection may include local anesthetic, saline, or another medication when clinically appropriate.
Patients may feel brief pressure, soreness, twitching, warmth, temporary numbness, or a short pain flare after treatment. Relief may be temporary and can vary based on the diagnosis, medication used, muscle irritability, and underlying drivers. Some patients may not respond. MPM reviews the response to determine whether trigger points appear clinically meaningful and whether additional care should focus on rehabilitation, pelvic floor therapy, headache care, TMJ care, Botox, acupuncture, or another pathway.
These guys are the best. I've been going here for over 6 years and their familiarity with my Schwannomatosis (most ppl have never even heard of it - its rather rare) and their ability to diagnose my CRPS quickly and accurately and then treat it like I was merely getting a flu shot is just incredible...
Highly recommended for those who need Pain Management. Everyone at Manhattan Pain Medicine is extremely nice and helpful. I have had very good interactions with both Dr. Siefferman and Dr. Louis. All of the staff is very responsive. 5 stars.
The providers at Manhattan Pain Medicine are exceptional. I wish I had found them 30 years ago!
I genuinely can’t say enough good things about the team at Manhattan Pain Medicine. I have MCAS, EDS, and an inflammatory autoimmune disease, and I’ve basically been searching for answers since I was a kid. I had years of unexplained inflammation markers, chronic pain, and allergic reactions despite...
I have a complex medical history and have seen a lot of doctors over the years. Dr. Mikaberidze and Dr. Siefferman each took the time to really listen and understand everything I had been dealing with. I also appreciated how they work together and communicated about my care. I left with a plan that...
Sharing my gratitude for the pleasant experience last week during my visit, the medical team provided great care and also treated my session as a learning experience, I left my session with a wealth of knowledge. A big thank you to the kind, and professional staff who welcomed me to the office as a...
I cannot say enough good things about Manhattan Pain Medicine. From the moment I walked in, I felt truly cared for and taken seriously. Dr. Nino Mikaberidze, Director of Rheumatology, is exceptional — knowledgeable, compassionate, and incredibly thorough. She takes the time to listen, explains every...
Dr Siefferman is the most thorough, patient doctor I have even been to. Currently I travel from miami to nyc to see him because his bed side manner and desire to help is incomparable.
ZocDoc
This practice is wonderful. I have been a patient of Dr. Siefferman’s since 2019 and he’s extremely helpful and kind. He has brought in a Rheumatologist who is also great. They handle very complex pain issues and always try to find new ways to help me.
Dr. Siefferman is an incredible doctor! He is extremely diligent and knowledgeable. It feels like you are his only patient. He invests a lot of time and effort into your injuries and concerns. I did not find these wonderful qualities with other pain specialists before, who were always rushed and som...
ZocDoc
Dr. Siefferman is a doctor who combines the old world bedside manner of doctors from my childhood (60 years ago) with a sta te of the art embrace of modern technology. It is always a pleasure to have an appointment with him...always has options and solutions to my medical issues. He is truly the doc...
ZocDoc
Dr. Siefferman is a genius. He is very informed and listens attentively.
ZocDoc
Dr. Siefferman and his entire team continue to be efficient, dedicated, and driven by precision and a genuine desire to give fantastic care. Will always recommend.
ZocDoc
Doctor Siefferman is fantastic. Have been seeing him for 5 years. Couldn’t recommend more.
ZocDoc
Dr. Siefferman is the ONLY doctor who has ever been able to diagnose my pain and treat it. He is hands down the best
ZocDoc
Trigger point injections are targeted injections placed into selected painful muscle knots, taut bands, or irritated myofascial areas. They may be used when muscle pain, spasm, guarding, or referred pain contributes to symptoms. The injection may include local anesthetic, saline, or another medication when clinically appropriate. At MPM, trigger point injections are considered only after evaluation of the broader pain pattern, because muscle tightness may be the main pain source or a response to another issue.
A trigger point is a tender, irritated area within a muscle or fascia that may feel like a knot, tight band, or sensitive spot. Pressing on it may cause local pain or pain that refers to another region, such as the head, jaw, shoulder, back, pelvis, hip, or leg. Trigger points may develop after overuse, injury, posture strain, stress, guarding, joint instability, nerve irritation, pelvic floor dysfunction, or chronic pain sensitization.
Trigger point injections are intended to reduce irritation in a selected muscle area and may help interrupt a cycle of pain, guarding, and restricted movement. The needle placement and injectate may help calm the irritated muscle band and support improved movement tolerance. Relief varies and may be temporary. MPM also evaluates why the trigger point developed, because lasting improvement often depends on addressing biomechanics, rehabilitation, nerve irritation, joint instability, pelvic floor dysfunction, or other contributors.
Trigger point injections may use local anesthetic, saline, corticosteroid in selected cases, or another medication depending on the clinical situation. Not every trigger point injection requires steroid. MPM selects the approach based on the muscle target, diagnosis, safety factors, prior treatment response, and treatment goals. Medication choice is reviewed before the procedure, including potential risks such as temporary numbness, pain flare, local anesthetic effects, or steroid-related side effects when steroid is used.
Trigger point injections may help selected patients with myofascial pain when painful muscle bands or trigger points are contributing to symptoms. They are not a cure for every myofascial pain condition. MPM evaluates whether pain is truly muscle-driven or whether it reflects joint instability, spine pain, nerve irritation, pelvic floor dysfunction, TMJ dysfunction, headache disorder, fibromyalgia, or central sensitization. This helps determine whether injections should be used alone or as part of a broader plan.
Trigger point injections may help selected neck or back pain patients when irritated muscles, spasm, or guarding are meaningful contributors. However, neck and back pain may also come from discs, joints, nerves, spinal stenosis, instability, posture, inflammatory disease, or central sensitization. MPM evaluates the pain generator before recommending treatment. If trigger points are secondary compensation, the plan may also involve rehabilitation, medication management, spine evaluation, ultrasound-guided procedures, or nerve-focused care.
Trigger point injections may be considered for selected tension headache or headache-adjacent pain patterns when neck, shoulder, scalp, or jaw muscle tension contributes to symptoms. They do not replace headache diagnosis. Headache may also reflect migraine, cluster headache, TACs, occipital nerve irritation, TMJ dysfunction, cervical spine pain, or secondary headache causes. MPM reviews headache pattern, neurological symptoms, red flags, and muscle referral patterns before recommending trigger point injections.
Trigger point injections may help selected TMJ-related muscle pain when jaw, temple, neck, or facial muscles are contributing to pain or referral patterns. TMJ symptoms can also come from joint inflammation, disc issues, dental factors, bruxism, orofacial dystonia, trigeminal neuralgia, headache disorders, or cervical contributors. MPM evaluates whether muscle trigger points are central to the pain pattern or whether Botox, dental care, orofacial evaluation, headache care, or another pathway may be more appropriate.
Trigger point injections may help selected pelvic pain patients when muscle spasm or myofascial pain contributes to symptoms. Pelvic floor trigger point injections are more specialized and require careful pelvic pain evaluation. Pelvic pain can also involve pudendal neuralgia, pelvic dystonia, endometriosis, PGAD-related symptoms, nerve entrapment, orthopedic factors, or central sensitization. MPM determines whether pelvic floor trigger point injections, standard trigger point injections, nerve blocks, medication management, or pelvic floor therapy may be appropriate.
Trigger point injections may be considered when piriformis muscle irritation, spasm, or guarding contributes to buttock, hip, or sciatic-type pain. However, symptoms similar to piriformis syndrome can also come from lumbar disc disease, sciatica, sacroiliac joint dysfunction, hip pathology, peripheral nerve irritation, or pelvic mechanics. MPM evaluates the full pain pattern before selecting trigger point injections, ultrasound-guided injections, nerve blocks, physical therapy, or another treatment approach.
Trigger point injections use a needle to target painful muscle areas and may include local anesthetic, saline, or another medication. Dry needling typically uses a needle without medication, while acupuncture is based on a different treatment framework and may target broader pain modulation. These approaches may overlap in patient goals but are not the same. MPM considers diagnosis, symptom pattern, prior response, and treatment goals when deciding which option may fit.
Trigger point injections usually use local anesthetic, saline, or selected medication to treat irritated myofascial areas. Botox or botulinum toxin works by reducing muscle overactivity through chemodenervation and is generally considered for different patterns, such as dystonia, chronic migraine, TMJ-related muscle overactivity, pelvic floor spasm, or persistent muscle overactivity in selected patients. MPM determines whether the pain pattern is better matched to trigger point injections, Botox, rehabilitation, acupuncture, or another treatment.
Ultrasound guidance may be used for selected trigger point injections when it supports anatomical precision or safety, especially near deeper muscles or sensitive structures. Many superficial trigger point injections may be performed based on exam and anatomy. Ultrasound does not guarantee relief, but it can help in selected cases. MPM decides whether ultrasound guidance is appropriate based on the location, depth, surrounding anatomy, diagnosis, and procedural goal.
Relief varies by patient, muscle target, medication used, diagnosis, and underlying pain drivers. Some patients may feel temporary improvement for hours or days, while others may have longer relief. Some patients may not respond. If relief is short-lived, MPM reassesses whether muscle guarding is secondary to another issue, such as instability, nerve irritation, pelvic floor dysfunction, TMJ dysfunction, spine pain, fibromyalgia, or chronic pain sensitization.
Risks may include pain flare, bruising, bleeding, infection, allergic reaction, temporary numbness or weakness, dizziness, vasovagal reaction, local anesthetic toxicity, steroid-related side effects when steroids are used, incomplete relief, temporary relief only, or no relief. For injections near the chest, neck, or upper back, rare but serious risks may include pneumothorax or injury to nearby structures. MPM reviews risks and safety factors before treatment.
Trigger point injections may not be appropriate when symptoms suggest infection, major trauma, neurological deficit, unstable spine or joint pathology, inflammatory disease flare, untreated pelvic or abdominal condition, or another diagnosis that should be evaluated first. They are not a replacement for physical therapy, pelvic floor therapy, headache evaluation, TMJ evaluation, imaging, nerve blocks, surgery, medication management, or emergency care when needed. MPM recommends treatment only when the clinical pattern supports it.
Before care begins, our team helps patients understand the practical side of treatment, including insurance verification, out-of-network benefits, cost-share estimates, self-pay options, and billing questions. We believe patients should have as much clarity as possible before moving forward.
If you are considering trigger point injections in NYC for muscle pain, myofascial pain, neck or back pain, tension headache, TMJ overlap, pelvic pain, piriformis syndrome, hypermobility-related muscle guarding, or complex chronic pain, MPM can help determine whether this treatment may be appropriate. Your evaluation will consider your symptoms, diagnosis, exa
Trigger point injections are targeted procedures used to treat selected painful muscle knots, taut bands, or myofascial pain patterns. A trigger point may feel like a tight, tender, or irritated area in a muscle. Pressing on it may cause local pain or refer pain to another region, such as the head, jaw, shoulder, back, pelvis, hip, or leg.
At Manhattan Pain Medicine (MPM), trigger point injections NYC care begins with diagnosis-first evaluation. The goal is to determine whether the muscle is the primary pain generator or whether it is guarding because of another issue, such as joint instability, hypermobility, pelvic floor dysfunction, TMJ dysfunction, nerve irritation, spine pain, headache disorder, or complex chronic pain sensitization.
Trigger point injections place a small needle into selected painful muscle areas. Depending on the clinical plan, the injection may include local anesthetic, saline, corticosteroid in selected cases, or another medication. The goal may be to reduce muscle irritability, improve movement tolerance, and help interrupt the pain and guarding cycle.
Relief varies. Some patients experience short-term improvement, some have longer benefit, and some do not respond. MPM uses the response to help determine whether the muscle target is clinically meaningful and whether additional treatment should focus on rehabilitation, biomechanics, nerve pain, joint instability, pelvic floor dysfunction, headache care, or another driver.
Trigger points may develop after injury, overuse, surgery, repetitive strain, posture changes, physical stress, or prolonged guarding. They may also appear in patients with hypermobility, EDS, joint instability, pelvic floor dysfunction, piriformis syndrome, TMJ dysfunction, tension headache, fibromyalgia, or chronic neck and back pain.
In these cases, trigger point injections may help temporarily reduce muscle-related symptoms, but lasting improvement often depends on addressing the reason the muscles keep tightening. For example, a patient with hypermobility may have muscles that overwork to stabilize joints. A patient with pelvic floor dysfunction may have pelvic and hip muscles that guard reflexively. A patient with TMJ dysfunction may develop jaw, temple, neck, and shoulder trigger points as part of a broader orofacial pain pattern.
Trigger point injections may be considered for selected tension headache patterns when neck, shoulder, scalp, or jaw muscles contribute to pain. They may also be considered for TMJ-related muscle pain, especially when jaw or temple muscles refer pain into the face, head, or neck. These symptoms still require careful differentiation from migraine, cluster headache, TACs, trigeminal neuralgia, or other headache and facial pain conditions.
For pelvic pain, trigger point injections may be considered when muscle spasm or myofascial pain contributes to symptoms. Pelvic floor trigger point injections are more specialized and require pelvic pain evaluation. For piriformis-related pain, injections may be considered when the piriformis muscle appears to contribute to buttock, hip, or sciatic-type symptoms. Similar symptoms can also come from spine, hip, sacroiliac, pelvic, or nerve-related causes.
Trigger point injections, acupuncture, dry needling, Botox, and ultrasound-guided procedures are not interchangeable. Trigger point injections usually target painful muscle areas with medication or fluid. Acupuncture may support pain modulation through a different treatment framework. Botox reduces selected muscle overactivity through chemodenervation and may be considered for conditions such as dystonia, chronic migraine, TMJ muscle overactivity, or pelvic floor spasm in selected patients.
Ultrasound guidance may be used for selected trigger point injections when the muscle is deeper or near sensitive structures. It does not guarantee relief, but it may support anatomical precision in appropriate cases.
Trigger point injections are not a cure for chronic pain, fibromyalgia, EDS, hypermobility, pelvic pain, TMJ dysfunction, tension headache, piriformis syndrome, sciatica, or neurologic disease. They are one possible tool when myofascial pain is clinically meaningful.
Risks may include pain flare, bruising, bleeding, infection, allergic reaction, temporary numbness or weakness, dizziness, vasovagal reaction, local anesthetic toxicity, steroid-related side effects when steroids are used, incomplete relief, temporary relief only, or no relief. For injections near the chest, neck, or upper back, rare but serious risks may include pneumothorax or injury to nearby structures.
Patients should seek urgent evaluation for fever, spreading redness, severe swelling, chest pain, shortness of breath, fainting, new weakness, new numbness, bowel or bladder dysfunction, saddle anesthesia, sudden severe headache, severe pelvic or abdominal pain, suspected infection, severe allergic reaction, major trauma, or rapidly worsening symptoms.
For selected patients, trigger point injections may be a useful part of a coordinated pain care plan. MPM’s role is to determine whether the muscle target is appropriate, why the muscle is irritated, and how the injection fits into longer-term treatment.
