A trigger point injection (TPI) is a short procedure in which a regulated practitioner places a small amount of solution, often a local anaesthetic, into a tight, tender spot in a muscle. At Skin Art MD in Burnaby (Metrotown), trigger point injections are offered by a naturopathic doctor, and every visit starts with an assessment. Brief needle discomfort and a few days of soreness are common; individual responses vary.
This guide explains, as of October 2026, what a trigger point is, what the visit involves, what to expect afterwards, who may need to wait or see a medical doctor instead, how the injections can sit alongside physiotherapy and massage, and how coverage usually works in BC.
What is a trigger point?
A trigger point is a firm, tender spot within a band of muscle that can feel like a knot and may refer discomfort to nearby areas. They are commonly described in the neck, upper back, shoulders and lower back.
Trigger points are usually identified by a hands-on examination rather than by imaging. The same kind of discomfort can also come from joints, nerves, discs or conditions unrelated to muscle, which is why an assessment comes before any injection. A tender spot is a finding to look into, not a diagnosis on its own.
Who performs trigger point injections at Skin Art MD?
At Skin Art MD, trigger point injections are performed by Dr. Ekaterina Krantsevich Riehl, BSc, ND, a registered naturopathic physician in BC, who carries out the procedure herself.
Naturopathic doctors in BC are regulated by the College of Complementary Health Professionals of BC (CCHPBC). According to a CCHPBC notice dated January 5, 2026, separate certifications for certain advanced injection procedures ended on April 1, 2026; naturopathic doctors may practise in that scope if they meet all applicable College standards, limits and conditions. The same notice indicates that prescriptive authority certification is still required for an ND to prescribe. You can look up any naturopathic doctor on the public registry at cchpbc.ca.
Our front desk speaks English and Chinese. Naturopathic consultations are conducted in English, so you are welcome to bring a family member or friend to help with interpretation if that is more comfortable for you.
What happens during a trigger point injection visit?
The process starts with a 15-minute naturopathic consultation or screening; the injection itself is a separate, short procedure booked once the assessment supports it.
1. Screening or first visit (about 15 minutes). The naturopathic doctor reviews your health history, current medications and supplements (especially anything that affects bleeding), allergies, previous injections, and what you hope to address. The area is examined by touch. If something suggests the discomfort is not muscular, or that other investigations are needed, you will be advised to see your family physician first.
2. Agreeing on a plan. If trigger point injection is a reasonable option, the practitioner explains what will be injected (a local anaesthetic or other solution chosen after assessment), how many sites may be involved, what the risks are, and what alternatives exist. You give informed consent before anything is done, and you can ask questions or decline at any point.
3. The injection. The skin is cleaned, the trigger point is located by touch, and a fine needle is used to place the solution into the spot. Each site typically takes a few minutes. Areas over the chest wall and upper back need extra care because the lung lies close underneath; this is one reason the procedure is performed by a trained, regulated practitioner.
4. Follow-up. You will be told what to watch for afterwards and when to check in. Whether further visits make sense depends on how you respond and on the plan agreed with your practitioner.
What does a trigger point injection feel like, and what are the side effects?
Most people feel a brief pinch or sting from the needle and sometimes a short muscle twitch. Afterwards, temporary soreness at the site for a day or a few days is common.
Commonly reported effects include:
- Soreness or aching at the injection site, similar to after a hard workout.
- Bruising or a small amount of bleeding, more likely if you bruise easily or take medications that affect clotting.
- Temporary numbness in the area, if a local anaesthetic is used.
- Light-headedness, especially in people who feel faint around needles. Let the practitioner know if this has happened to you before.
Less common but important risks include infection at the site, an allergic reaction to the solution, and, for injections over the chest wall or upper back, a rare risk of the needle entering the space around the lung (pneumothorax). Seek urgent care if you develop shortness of breath, chest pain, spreading redness, warmth, pus or fever after an injection.
Practitioners commonly suggest keeping activity light for a day or so, applying gentle heat or ice as you prefer, and continuing any stretches you have been given. Individual responses vary, and your practitioner will give advice specific to your situation.
Who should not have trigger point injections, or should wait?
Trigger point injections may not be suitable for everyone. The screening visit is where these questions are worked through.
Tell the practitioner if any of the following apply:
- Bleeding disorders or blood thinners. Anticoagulants and some antiplatelet medications raise the chance of bleeding and bruising. Do not stop a prescribed medication on your own; this is a conversation to have with your prescriber.
- Infection or broken skin at or near the planned injection site.
- Pregnancy or breastfeeding, or if you may be pregnant. The choice of solution and the decision to proceed need extra consideration.
- Allergies, particularly to local anaesthetics, antiseptics or latex.
- Fear of needles or a history of fainting, so the visit can be arranged lying down.
- A recent injury, unexplained symptoms, or symptoms that are getting worse, which call for a medical assessment first.
How do trigger point injections fit with physio, massage and exercise?
Trigger point injections are usually considered one part of a broader plan, not a stand-alone answer. Many people continue with physiotherapy, registered massage therapy, chiropractic care or a home exercise program at the same time.
Practical points:
- Let your other practitioners know you are having injections so they can schedule hands-on work around the sore days.
- Posture, workstation set-up, sleep and activity levels all influence muscle tension, and they are worth discussing at the screening.
- If you already have a physiotherapist or massage therapist, your naturopathic doctor can work alongside them rather than replacing them.
Is a trigger point injection covered by insurance or MSP in BC?
Coverage depends on who performs the procedure and on your own plan. MSP does not generally pay for naturopathic visits, but many extended health plans include a naturopathic benefit.
- Extended health plans. Many group and individual plans reimburse naturopathic visits up to a yearly or per-visit limit. Whether a trigger point injection performed by an ND is reimbursed, and how it is billed, varies by insurer. Call your insurer or check your benefits booklet before you book, and keep your receipts.
- MSP. MSP may cover a limited number of visits to certain practitioners for eligible premium-assistance recipients. Check the current rules with Health Insurance BC (gov.bc.ca).
- Physician route. When a medical doctor performs a trigger point injection, it may be billed to MSP in some circumstances. Ask your family physician whether this route is available to you; for some people it is the more practical option.
We would rather you make an informed choice than be surprised by costs. Ask our front desk for a receipt format that suits your insurer.
When should you see a medical doctor or go to urgent care instead?
Some symptoms need a medical assessment, not a trigger point injection. Call 911 or go to the nearest emergency department for chest pain, trouble breathing, or sudden weakness.
See a medical doctor or urgent care promptly if you have:
- Numbness, tingling or weakness in an arm or leg, or changes in bladder or bowel control.
- Pain after trauma, such as a fall, sports injury or car accident.
- Chest pain, pressure or shortness of breath, even if it seems muscular.
- Fever, night sweats or unexplained weight loss together with pain.
- Severe headache that is sudden or different from your usual headaches.
- Pain that keeps getting worse or wakes you at night.
HealthLink BC (8-1-1) offers advice from a nurse at any hour if you are unsure where to go. Keeping your family physician informed about any injections you receive is always a good idea.
Frequently asked questions
How long does a trigger point injection appointment take?
The first step is a 15-minute consultation or screening. The injection visit itself is usually short, often under half an hour depending on the number of sites.
What is injected during a trigger point injection?
A local anaesthetic or other solution chosen after assessment. Your practitioner will explain the options and the reasons for the choice before you consent.
How sore will I be afterwards?
Temporary soreness for a day or a few days is common, sometimes with a small bruise. Individual responses vary.
How many sessions will I need?
There is no fixed number. Any further visits are discussed at follow-up, based on how you respond and on your overall plan.
Can I go back to work the same day?
Many people return to desk work the same day. Strenuous exercise is often deferred for a day or so; follow the advice given at your visit.
Do you speak Chinese?
Our front desk speaks English and Chinese. Naturopathic consultations are in English.
Booking
To find out whether trigger point injections are a reasonable option for you, start with a 15-minute screening. You can learn more about our naturopathic medicine service or book a naturopathic appointment at Skin Art MD in Burnaby (Metrotown), serving Greater Vancouver.
