Trigger Point Pain

[Debi0530]

I understand that there is no cure for trauma to nerve and muscle damage. In the mean time my quality of life
has plummeted. I have little sleep. I am forced to take serious medication. I use a tens unit, portable traction
and meditation plus strength exercises. The issue is the debilitation that the constant pain has on my life.

Is there any other continued treatment that can give me relief? It has been 10 months since I was run over
by 80,000lb transfer truck. Drugs mask pain and the pain limits my desire to do anything because of the risk of
hurting even more. I have been told it is fibromyology symptoms. Will these symptoms go away at some point?
Does massage therapy help? Hypnosis? All are at my cost because for some reason this injury isn't considered
serious since I have no disc or herniation in my upper neck C5, C6 area.

I have lower back pain as well. I cannot lye down to sleep in bed. I must sleep in a chair and I very seldom go
into a deep sleep. I get over tired which causes my actual muscle pain to get more intense. I am taking 10 mg of
Opana every 12 hours and may take 3 Loritab 750 mg when I experience breakthrough pain.

Will acuppuncture, acupressure or massage therapy help me relax these muscles more?

[Debi0530]

Love Tai Chi. I wonder what exercises you find most beneficial?
Right now I need to help myself loosen up. I am so very tight I can barely get my
jeans on, have to lay on the floor. Think Yoga would be better than Tai Chi?

Neck pain is at the base and sides this is the trapezoid muscles different than
the injury I have had in the past where it was the muscles involved with back and forth
trauma. These are down into my chest wall and my upper should back area. Any
suggestions for pillow support? I am sleeping in a chair right now. I cannot lie down
just hurts so very much. Even with a sleep number bed.

Yoga ball got any idea if that would help me stretch and strenghten? Going to check
out Pain Management. I have difficulty knowing when I've done too much. Weird but
I get to doing something and I check out..... push myself think I'm fine and later....
I am truly wishing I hadn't done what I chose to do. Guess I am just finding new
boundaries and it is trial and error. It drives my husband a little crazy. Example
trimming bushes. If I do something above my elbow line I get a consequence no Loritab is going to relieve. Guess we each learn what limits have to be changed. Right now
just writing to you my shoulders have said enough. I couldn't get back to the PC
for a day or two because I can't sit here for long without cramping. Trying to set up
a wireless AT&T card so that I can use the PC in my chair and I won't feel that I am
cut off from people who are experiencing something like I am. Certainly feel lucky
compared to some of the experiences that I have read. I am thankful not to feel
so alone

[Debi0530]

Aboslutely looking for Pain Management great suggestion.
I am trying meditation that I used in the past but I think I need some coaching.
Thanks for the suggestion

[Debi0530]

Thank you so much for writing me. It is very lonely. My husband and my daughter
have a very difficult time hearing that I hurt. They don't know what to do so they would
prefer to believe that I am somehow who I used to be. I work with that handicap.
I say handicap because I try to believe that my pain isn't real that I can just push
through it somehow. That usually gets me into trouble. I generally have to then sit
or lie down for a day or two so I remain silent and keep my feelings to myself.

We have a lovely 70 acre horse farm. This is a place that requires constant maintenance and I love being physical. Right now my involvement is limited. I do something that
is limited and take satisfaction with that, A year ago I walked the fields for 6 or 7 hours
spraying weeds, picking up wood, repairing fences, tending to the horses, blanketing and such, not an option right now.

I have found a Doctor who is East Indian and she has totally connected with what she
recognizes as Fibromyolgia. Her choice for now is to break the cycle. I am open to
walking, or stretching. She is not an Osteopath but she is open to my seeing anyone
who will help me regain some quality of life. I feel guilty taking the medication because
my daughter feels that I am abusing the medication. My doctor stresses that I am taking it as she has prescribed it and that presently I still feel uncomfortable but at least the Opana, Loritab and Lidocaine Patches do help a little. I cannot sit at the computer for
more than 20 minutes. I am trying to work with a wireless set up, a lap support for my PC so that I can reach out to people for I haven't anyone in my immediate circle to
talk to about their experiences and options that I have not tried.

I get that I am extremely lucky to have 80,000 lbs run over me and be alive. However,
just sitting in a chair trying to look at pictures of wedding gowns my daughter would like me to see takes endurance. My only daughter is getting married. My husband travels
all the time and I must be extremely creative about how I try to do what I can and contribute to our daughters happiness and excitement about her marriage which is in May. I get frightened for I have people who will be coming into our world. They will want to be there for her as I will and I don't want it to be about me. Thank you for your suggestion. I will look into Osteo physicians who are listed as the best for nerve injury such as mine. I can't believe that I am still trying to tell myself that I am making more of this than I should. I should somehow snap out of it. Why is that have you experienced
that feeling?

I forget which day it is. I show up a day late or I have two or three days pass by and I am  unsettled by it. I know it isn't the drugs. I think it is because of lack of sleep. I rest
when I can. I put on the old heating pad, get into the chair that supports me and read.
I go to that which is truly fantastic about my life. Then again sometimes pain just takes
me so low that there are days when I just can't get up. My husband could use a great
cooked meal and company when he is out on the tractor, I think he understands but
our families do lose out don't they? How do you cope with that?

[OtisDaMan]

Always sorry to hear that another person has joined the club. We all appreciate what it means to be in ongoing pain, and the impact that it eventually has upon quality of life. I will try to address your questions below. All the best.

For me it was laproscopic surgery which caused (somehow) thoracic back pain stabbing through to the sternum, and a gagging reflex gone mad. After 10 years one doctor has agreed that it might be nerve damage. Like you, I have no visually discernible injury that the doctors can connect to the pain I suffer. This lack of obvious injury can make some doctors quite sceptical; however, many are willing to form that bond of trust necessary for a good doctor-patient relationship. Don't be afraid to move on if one doctor isn't up to the task of providing quality care.

For me personally, a consequence of the daily pain is that there are muscles in my upper back and through my neck that are nearly always contracted. It is virtually impossible for me to relax them without medication. As with you, part of the battle is finding something to release and relax the muscles and ligaments.

I have sustained myself through a combination of Tai Chi (exercises are great, although I don't believe the hocus pocus chi related stuff though), pilates, daily walking and various pain medications. I have also made good use of massage provided by a physiotherapist rather than a dedicated masseur. A physiotherapist is cheaper (go figure) and can provide extra aid. Quite some time ago I used a headache clinic which provided trigger point therapy, and that did help quite a bit to loosen up the neck for a while. Anyway, my rule is to steal what helps and drop the rest.

In your situation, after 10 months, you probably have chronic pain. While each case is different, once someone has chronic pain it tends to stay with them, although it may reduce somewhat over time - it depends on so many factors. Generally speaking, chronic pain is not directly related to an injury, in the sense that the original injury may have healed as best as it is ever going to, while the nerve damage remains.

Two things I recommend for dealing with life once chronic pain is a partner: i) exercise daily, or at least frequently enough that it is a habit; ii) ensure that social contact is also a habit; if single, then it is doubly important.

With regards to chronic pain and exercise: it may hurt to exercise, but that rarely means that any further damage is being done. Only you can eventually find the balance point between pain and exercise. However, I would recommend some simple dynamic stretches and walking as part of a daily routine. Finally, while doctors might not like it, my opinion is that if you need pain medication to get started on exercise, I would say it is more important to exercise than to worry about whether you need medication to do it. Just don't fall for the trap of over-indulging in exercise while free from pain - choose a limit and stick close to it. The goal is to have a *stable* routine, not a boom-bust cycle of exercise and more severe pain.

Medications that I've used with some success include: doloxene (doctors don't like this one and it is a weaker pain killer, but it worked for me); tramadol (but side effects eventually made me give up on it); oxycodone (worked, but only prescribed a total of 20 5mg pills - yes, 20 ever ever!); pregabalin (aka lyrica, an anti-convulsant that oddly enough is effective at blunting nerve pain). Did try intravenous fentanyl once, as part of a double blind drug infusion test, and it worked well.

Here in Australia doctors are incredibly conflicted over prescription of strong opioids/opiates for chronic pain - especially if it is physically "undiagnosed." Some seem to have a habit of subscribing to the "psychological causes of all less obvious conditions", by which I mean they are often more willing to believe the patient's pain is all in the head due to a bed-wetting incident as a four year old (insert your embarrassing early childhood event here), rather than due to errant surgery or a ruddy big truck colliding with you. Don't let it get you down if you run into this type of doctor. I will add that a psychologist may be able to help with managing to live with pain, mainly by providing a guiding hand in re-establishing a stable, if different, life. However, if they search for psychological reasons for having continuing pain, then I don't rate them very highly. Life is too short to waste on those sort of games.

With medications the best advice I can give you is to study up on them, be aware of the most severe side effects before taking them, and don't assume that the doctor is familiar with the details of a given medication. Every medication fails to work for some people, so don't be surprised to find that some do nothing while others have side effects. All medications that work for you will be a trade-off between benefit and costs (including side-effects). Finally, if fibromyalgia is a factor in your pain, then the anticonvulsants tegretol (carbamazepine), gabelin (gabapentine), and lyrica (pregabalin) are definitely worth considering. At least one of them may work well for you.

Regards.

[Tuckamore]

Hi Debi,

I hear you and I am so very sorry that you are in such pain and having difficultly sleeping. I am glad you found the Pain Management Forum of MedHelp. We are here to support you and offer our suggestions.

I too was suffered a very traumatic MVA accident some years ago, I nearly did not survive. My little sports car was hit by a loaded dump truck. I have muscle and nerve damage plus a multitude of other injuries. My muscle and nerve pain did get a bit better plus I have learned ways to deal with it. After my multiple wounds healed  and the repairs were completed (over 20 surgical procedures) they could no longer "see" any damage. Finally after a few years of complaining of pain I was DX with myofascial pain syndrome (that later proved to be a wrong DX) and sent on my way. My life was forever changed. But you will learn to deal and cope with these changes.

Some years later I happened to see a Internal Medicine DO (Doctor of Osteopathy) for a routine medical problem. She recognized my pain and has been a God-sent. She finally DX my condition(s) and I am being treated. I encourage you to find a DO that is a new graduate. They are usually found in any clinic.

I have tried message therapy, Acupuncture, TENS Unit, PT (4 times), trigger point injections, Touch Therapy, steroid injections and probably other approaches that escape me at this moment. Nothing worked or if it did it was very fleeting. I must take pain medications and muscle relaxants. I will take them for the rest of my life, as many other members at MH must do. It may be that you are not on the correct combination of medications to help control your pain. Are you in a Pain Management Clinic??? Or being seen by a PMP?? If not they may be of some assistance. There are good pain management therapists available also. I encourage you to make an appt to be seen by one.

Your life is not over. It has changed and you will have to make adjustments but it will be good again, just different from before your accident. Please keep in touch and let us know how you are doing. All of us experience pain and have had to adjust our lives. We are here when ever you need support or suggestions from our experiences. I will look forward to your next post. Take care, Tuck

[Mollyrae]

Hello and welcome to MH.

I am sorry to hear of the constant pain that you experience on a daily basis. There are a few things you mention that I might help with. The first is the Fibromyalgia. This debilitating disease comes and goes..Some days are better than others. I understand that if you have been diagnosed with Fibro, you will always have it. There is no cure for it at this point, only medications to ease the symptoms.
Second is your back pain. I think you should be re-evaluated for your pain. There are numerous pain medications out there and you and your Doc must find the right one for you. It's quite possible that the regiment your taking now is not effective enough and need at least an increase. Have you thought about using a Fentanyl Patch? It is a 72hr pain patch that gives you round the clock relief. You might want to ask your Doc about it.

I am not a big believer in Accupuncture or pressure as well as Message Therapy, I'm sure others will respond with information regarding it.
I am not aware of too many other continued pain relief treatments that are offered but the web is always a good place to start.
Take care and good luck in the future...
Mollyrae