MYOFASCIAL PAIN -v- DISC PAIN…

As most of my readers know I suffer from chronic back pain after four previous spinal fusion surgeries only alleviated the pain for a matter of years before it came back.

Nowadays spinal fusion is not used as the first choice for prolapsed discs with pain management being the first treatment and only if nerves are compressed is it used as another option.

The problem with spinal fusion especially if you have more than one surgery is the pressure it puts on the disc below and above your fusion.

Another condition which you can also suffer from after any type of surgery is Myofascial Pain Syndrome which is a chronic painful muscle disorder and is common if you have experienced a muscle injury. Over time these myofascial restrictions can lead to poor biomechanics, altered structural alignment, compromised blood supply and pain. Other causes of myofascial pain are injuries to an intervertebral disc, general fatigue, repetitive motions, and some medical conditions.

It is characterised by the myofascial trigger points and the symptoms include persistent or worsening pain, deep and aching muscle pain, tender knots located in the muscles and pain after exercise or sporting activity.

Myofascial Pain Syndrome (MPS) is the name given to pain caused by trigger points and fascia (connective tissue) adhesions in the body, usually in muscle tissue, and inflammation in the body’s soft tissues.

Myo = muscle
Fascia = the main connective tissue in the body
Release = to let go, ease pressure

Treatments include anti-inflammatory medication, pain killers, physical therapy, stretching, massage therapy and trigger point injections.

A trigger point injection is either a cortisone injection or dry needling. Pain relief is quick and helps in continuing physical therapy. Trigger point injections can also be used for people suffering from degenerative disc disease.

Understanding the cause of your pain is an important step to finding an effective solution. It may involve a series of sessions and an at home program to keep the area strong.

Disc pain can come from a disc bulge or prolapse but you can also get myofascial pain which could be treated conservatively instead of surgery. Fibromyalgia patients can also suffer from myofascial pain. According to history, Sir William Gowers introduced the term fibrositis for a common, but idiopathic, localized form of muscular rheumatism that is now recognised as myofascial pain syndrome in 1904. And, despite the intervening years, it still constitutes the largest group of unrecognised and undertreated acute and chronic pain problems. Some people (like myself) have also been told they could have Fibromyalgia, previously named ‘fibrositis’.

My neck and arm pain have been giving me a lot of problems since last summer and after extensive tests, MRI’s, ct scans and more it was decided that a nerve block would help with the pain. There is never any guarantee with any injection but they hope to give the patient a few months of pain relief.

Nerve block injections into your neck for a disc bulge can be quite dangerous as they are quite tricky to do and they go through the front of your neck. I had this injection about six weeks ago. It’s not a very nice injection (if any are) but I knew the pain consultant had hit the spot and soon felt total relief. Unfortunately, it was short lived and only gave me pain relief for a few weeks. Not all the pain has come back but most of it as did the pins and needles.

I then had another appointment at the pain clinic and after looking at my MRI’s etc I was given a quick check where my pain consultant felt that the pain I now have could well be myofascial and not from the bulging disc so he has booked me in for a series of steroid injections in my shoulders.

I guess with any spinal pain after you have had all the tests it’s then worth trying alternative treatments well before you resort to surgery which is something I have always said I would avoid having.

 

TRIGGER POINT INJECTIONS FOR CHRONIC PAIN FROM MUSCLES…

 

 

Chronic pain can come from painful areas of muscle that contain knots of muscle that form when the muscles do not relax (trigger points). People suffering from Fibromyalgia, Myofascial Pain, Back Pain, Headaches and other muscle problems fall into this category.

TPI (Trigger Point Injections) are used to treat the muscle pain in arms, legs, lower back, and neck. As most of my followers will know my facet joint injections were stopped due to funding and have been replaced with TPI’s.

You may be offered a sedative before the procedure as this relieves anxiety and helps your relax although I’ve never needed nor been offered this. A consultant or health care professional using a small needle injects local anaesthetic which sometimes includes steroid into the trigger point.

The reason for this is that it makes the trigger point inactive and the pain alleviated and for some can result in quite a substantial relief. I have one either side of my spine into my glutes muscles which seem to really get tight due to my disc problems.

You are soon allowed home after this procedure but you need a friend or relative to pick you up and stay with you for the first 24 hours after the injection(s). The pain may initially feel worse than before you had the injection, but that’s quite normal and is mostly temporary and settles within three to four days. I always think that if the pain is worse then you know for sure that they have hit the spot.

Some other problems can be an infection, bruising, loss of sensation or muscle weakness but are hardly ever present and all treatable. Another side effect which I get every time is facial flushing from the steroid which only lasts a day or two then settles down again.

Although slightly unpleasant the benefits out way the short discomfort you feel as I can reduce my pain relief quite a bit over the next few weeks. My facet joint injections worked better but any type of pain relief is better than none and some people have great benefit from these.

Because I can soon feel the benefit from this I have been looking into acupressure point therapy and myofascial release therapy and hope to find someone local who practices this.

 

HEALTH TIP…

roses

Roses are believed to have a mild sedative and anti-depressant properties so infuse rose hip and a few drops of rose extract in hot water for a morning drink which will keep your mood upbeat as the winter closes in.

BAROMETRIC PRESSURE AND FIBROMYALGIA…

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Fibromyalgia sufferers are affected by the ambient pressure especially if it goes down suddenely. If a storm approaches the pressure drops, causing the air in our joints to expand.

Barometric pressure is a measurement of the weight that is exerted by the air all around us. When its a lovely sunny day then the barometric pressure tends to be quite high.

The change in the weather can effect us all, even air conditioning units can disrupt muscle aches and pains.

CUTTING DOWN ON MEDICATION…

pills

I’d read on a few forums that it can be quite hard to come off opioids but I was still determined to cut my quantity down by at least half.

The first side effect I had was the shakes, which I knew was nothing to worry about and would settle down.

Then came the pains from places I’d not had pain from before, in particular in my right foot which is still giving me a lot of problem.

Then the headaches which seem to always arrive in the middle of the night, but I’ve found doing the acupressure points or using the roller ball works for this.

Lastly (at least I hope so) has come the ‘chronic fatigue’, which is nothing like I normally suffer from, but ten times worse. All I want to do is sleep, from the minute I wake up, I just want to go back to sleep again. By late morning I can’t wait for the afternoon to come so I can go for my rest which has now extended to two hours instead of my usual one.

I can only presume it’s my bodies way of trying to manage the pain on it’s own without the help of the opioids which I have cut down from 450mg to 100mg so that is a massive drop. However, I have had the odd 50mg when I’ve been desperate but I’ve managed on paracetamol most of the time.

It’s only 10 days so it’s early days yet but I’m really pleased with my progress except for the chronic fatigue which I really do hope will lift soon.

If you suffer from chronic fatigue, how do you cope with it?