A review of recent research suggests that the use of trigger point injections are successful in relieving the acute pain of musculoskeletal headaches. Patients with the chief complaint of headache commonly present to the emergency department (ED) and are often treated with multiple intravenous medications including narcotics. The success of outpatient treatment with trigger point injections can be applied to the acute care setting for improved patient outcomes and decongestion of the ED. This article will address the problems of intravenous medication therapy and discuss the benefits of trigger point therapy as management for musculoskeletal headaches specifically in the ED. In addition, discussion aims to provide tools for the nurse practitioner to integrate this skill into clinical practice.