Muscle Knots and pain

[corky21]

I have complex cysts and some mild enlargement and one antibody test show a small number. I am taking Armour but just 1.5 grains now for 5 months. I believe I got these tight knots in my back and hips from low thyroid problems and also emotional problems and feeling stressed from low adrenals. My holistic doctor won't agree to up my dose and told me to go down in my hydrocortisone from 15 to 10. I did that for a weeks, but have decided to go back up and I'm now at 20mg. I still have these weird awful muscle pains from these knots. The pain just moves around. I can get around and then boom out of the blue I have bad pain one side of my buttock/hip or the other. I have done P/T and also many chiro treatments for 2 slightly bulging discs and I still have these pains. I can feel the tender points and I believe it's all trigger related.

Has anyone found they had these tight triggers while also suffering low thyroid or hashis? Did those problems go away with good therapy on them and the right dose of Armour?

I also take Malic Acid, magnesium, alpha lipoic acid, fish oil, glucosomine, large quantities of the B's, calcium, reservertol and a heavy duty multi. And still have problems.

Anyone have this ever get rid of it on proper dose of Thyroid?

[corky21]

I am now with a trigger therapist who studied with Janet Travell and also published her own book on Trigger therapy (Donna Finando). I've seen her about 8 times now and some areas of the triggers are better, but the pain I get behind my hips near the sacrum at mid day, a burning/aching feeling, and also from just standing for 15 minutes or longer, that pain in that area is not going away.

I'm also finally up to 3 grains of Erfa (Nature Thyroid) and some things are better, I can do more and want to mentally, but I do get the pains still. I do think the thyroid dose may be helping along with the trigger therapy. But I'm not getting anywhere with the mid day pain in the back of the sacrum.

[LazyMoose]

Even though Armour was reformulated (and now on long backorder), I have never heard of increased pain from this med. I have no experience with lodoral. Can you be you sure this increased pain is from the Armour?

*****Did you ever try Synthroid T4  with Cytomel T3 (synthetic version combo of Armour)?******

The additional T3 in  wasn't the sole reason for my muscle recovery but it was a huge noticeable help. Cytomel helped me also with muscle pain but It gave me a slight headache that would not go away.

It is my experience that when hypo body pain gets out of control (sounds like your case), thyroid med alone sometimes is not a total cure but part of the puzzle. All of that talk of trigger point release has been proven to help some people whose muscle pain is out of control. Sleep quality is also a factor, and a vicious circle if you suffer poor sleep.

Is there some physical daily routine that is partially responsible for the pain?

To break the cycle you need to try different things. Most docs just what to give muscle relaxants, good for flair ups but not long term. A really good start is to find a good Physical Therapist or Massage Therapist that can possibly find the muscle group responsible for the start of this pain.

"The Trigger Point Therapy Workbook" by Clair Davies is the best $19.95 I ever spent. Really. Anyone with muscle pain for whatever reason will benefit by reading this book.

It takes time, but remember doing the same thing with no results gets you no results.

By playing detective and learning you can figure it out.

[insearchofhealth]

LazyMoose, corky21,
I am new on this forum because I found your email exchange of May 2009.  I was actually doing a such muscle pain and hypo to see if there was any connection. I have been suffering for the last 6 years from a pain in the left buttock.  Only 4 months ago was I diagnosed with hypo. I was given Iodoral and Armour but when I take the meds my muscle pain increases!  I enven recently got diagnosed with tendinitis of the gluteus medius.  Very painful!  So, here I am not being able to take treatment for hypo.  Any suggestion would be appreciated.

[corky21]

You really know your stuff. I do have one leg longer than the other. And the chiro I went to mentioned it but every time I went for an adjustment she never mentioned it again. The massage therapist at my gym (just got back) said the same as you, to go easy with the tennis ball on those areas. He said my leg was longer and I told him I broke it when I was 2 (46 years ago) and he said that explains that. Also my right hip besides being higher than the left is also a little to the front. So I have a lot of imbalance going on there. He also found 2 real bad spots in my neck/shoulder area.

He also said all my problems with anxiety over these pains and stress are making me worse; this I know for sure. But it's hard to get it out of your head when for a few hours you're okay, then bam, now you are not. It's a hard cycle. Anyway even though I lose and get down for weeks, I do get back up and try to exercise and find a way out of this.

Tomorrow I see a different chiro, a bit younger, that does muscle/trigger and strengthening and stretching. I will pick his brain tomorrow and see if he works out. But this massage guy at my gym knows a lot and I like him.

You have been such a great help to me. I have not found one person on the internet that could relate at all to what I'm feeling. I'm truly, truly grateful you answered my cry.

May all good things come to Lazymoose! :)

Colleen

[LazyMoose]

Getting out of the initial muscle spasms is the first step. At this point, you may want to avoid situations that you know will give you pain, and resting periods are best. Be careful as to not exercise to much until the spasms decrease. Maybe a massage therapist can get the spasms to decrease at this point, and go a little lighter on the trigger point release. Heat loosens up tight muscles, but ice, gel pacs (at night) cool down the inflammation. The sacrum can be pulled a little sideways with  back muscle issues causing a lot of pain and making long leg appear shorter that the other- a good chiro should be able to notice this.

Alternating heat / cold on the back in the shower is another trick, finish on as cold as you can handle for a few seconds. Rolling your spine over a softly deflated basketball or soccer ball can feel good once the initial tenderness subsides. Gently sitting / rolling legs out torso at upright angle with  a tennis ball under the pirformis and glutes area can help the trigger point there instantly. Very small, deep and painfull triggers in the gluteus medius and gluteus minimus (side of hip / thigh junction). You wont even be aware of this till you roll on a tennis ball.

One step at a time. Depending how long you have been this way depends how long it will take. Once you see improvements you will overall feel better. You have to be your own 'detective' , try different techniques and different professional care if you can afford it.  Even when the pain is gone I would suggest finding what muscle ISOLATION exercises will work for you, from a PT that understands this, as preventive maintainence.  If they don't practice / teach muscle isolation strengthening they are wasting you time and money! For this reason, I think younger PT's are better.

Be careful increasing  thyroid meds without doing labs. I am not the expert in this area by no means. I know body pain, all other thyroid stuff I am learning here. Post labs here and others will help with other technical thyroid questions!

[corky21]

You are an angel. You or the first person I've found that knows what I'm talking about. I had a scare yesterday. I used the tennis ball against the wall (can't do it laying down) I went just the left side from the back of the sacrum all the way to the edge of the hip and it hurt so bad. I did if for about a minute or two and then had the heating pad on that area for awhile. I repeated that again an hour or so later. Then I tried to walk across the street in the park with my 9 year old son and 30 minutes in the worst spasm in that area. I cried and said we had to walk back home slowly. Then I thought let me do the ball again. So when I got home I did it again and then the heating pad. Then after that, an awful burning pain close in near the discs. I was way down depressed. Drank 2 glasses of wine at dinner and felt almost suicidal. Then I had this weird twitching in that whole area all night long. Now I'm up getting him ready for school and the burning pain behind the sacrum is better and just a little twitch here and there. I'm supposed to see the massage therapist at the gym for 30 minutes today. I will tell him to go easier on that side today and to work the right side.

Is the twitching normal? Also I'm on Armour which has the T3 but my doctor is keeping me at 1.5 grains. I've started to increase myself by 22.5mg a day and I plan to increase again in a few days by another 22.5mg. I also take 20mg of HC.

My theory is that my thyroid and of course the menopause (I lost an ovary a few years ago) kept me in a tense emotional state and that and the low hormones have to have caused these knots. I never knew I had them either. I've only just begun to think of this as the cause as I have read the Travell Trigger Point book in the bookstore several times and always felt maybe it's that and not just the bulging disc.

But my pain has been controlling my life now for about 3 years.  I have used Tumeric and Bromeline and a supplement called Zyflamend in the past but it didn't help. I also take Osteo Bi-Flex which has Boswellia. I do take at least 500mg of Magnesium  a day and calcium and fish oil, and malic acid, and alpha lipoic acid, coq10, iron, and many others. Maybe I should take the Zyflamend again?

When I use that tennis ball I can feel pain in one long area from the back of the sacrum and all the way to the side of the hip, and it seems sometimes the pain is worse near the hip. Should I keep doing that rolling and then use the heating pad after a few times a day?

Tomorrow I see a new chiro to talk about these triggers. He says he does trigger work and muscle rebalance. I don't want any more adjustments. I had 20 and so far maybe I have some relief from the bulge, but the pain in the hips/buttocks is still there and to me that means triggers and someone has to work them out for me.

When should I use exercise? I stretch (knees to the chest) after the heating pad and and legs to the side stretch also to stretch the hips/pirformis. Also I read that after working on triggers it's best to use heat. What about ice? My chiro says ice is the best.

And the worst thing is the anxiety.  I have to go on a school walking trip in 2 days and I'm terrified that what happened yesterday will happen then and I won't be able to walk. Should I not go? Should I go and bring my heat wraps and Aleve and hope for the best? I get so afraid that I'll get one of those real bad spasms in the whole back that knock you on the ground. My husband said go and then just ask to wait in the gift shop area or somewhere where you can sit and bring a book and wait for them to finish.

I can't believe I found someone who knows exactly what I'm talking about. And, I don't want to take pain pills either, I take them as a last resort. I always knew something was causing this and I had to find the cause. The P/T mentioned trigger last summer and I knew a bit about them, but never focused 100% on that issue. Then after months more of pain and no relief from the chiro I started to focus 100% and I did find this chiro nearby a few days ago. And I found you too. So I'm going to keep using that tennis ball every day now for sure.

Thank you so much for helping me out.

[LazyMoose]

The more I learned about trigger points and hypothyroidism, the more I began to notice referred pain- the muscle causing pain can be in an opposite area you feel the pain. This requires patients and detective work on your part to find it. I am still finding these referred areas myself! Don't give up. I could not ski for six years without major back/hip flareups and resulting nerve pain. This spring I skied three times, each time a little more. I had two herniated discs and muscle trigger point induced adult scoliosis. I am even back to mountain biking on rough single track trails every week now - like I did before my hypo symptoms took over my life!

At my mid point I would feel OK before exercise, but part way through one side of my hip, back, or one knee or ankle (still on occasion) would hurt for what seemed to be no reason. - A sign that there were referred trigger points I had not not found yet. Long walks would do this to me. Biking is easier on the hips for simple daily exercise and if you start hurting, just coast more.  

The outer thigh feels very tight on a lot of people with hip and or back pain. Lots of trigger points there. Gently slowly roll on a tennis ball on your side , ball between outer thigh and floor. It will hurt at first. Increase weight in time and you will feel results. Most knee pain is triggers above the knee inside of the thigh. Most foot pain (labeled plantar faciatis) is small very deep trigger points on the bottom of the feet and most importantly and ignored by foot doctors- trigger points on the lower legs that pull on foot muscles and tendons.

To answer your question: If you can afford and know someone who can release trigger points, that's great! You can learn from them and duplicate what they did only using the floor and a tennis ball or Theracane ($45). Fact is the deeper knots (they exist!) you need to find on your own, only YOU can feel your pain. Once trigger points are gone you need to re-strengthen individual muscles using specific muscle isolation strengthening. No nutrients can get into a knotted muscle (like a knot in a garden hose!). Trying to strengthen muscles with knots (trigger points) does not work very well. If you do this in combination, release triggers just before exercises and (very important!) before bedtime.

For back and neck restrengthening, muscle isolation is important, with proven results. Most of the 'gym' machines do not isolate muscles. One brand does, ask if they have Med-X lumbar and neck machines only available at certain PT clinics.

I congratulate you on your efforts to fix your pain. Most people give up, take pain meds and there quality of life sufferers. You can get better, but you have to understand the whole picture! Remember to take 'hypo' vitamins talked about on this great forum (magnesium most important). And for some people need T3 in their meds to rebuild muscle. I, and many others have noticed a difference with T3 as opposed to only T4. Turmeric and Bromeline (pineapple top enzyme) are natural and reduce inflammation. About 2 of these are equal to the typical 200mg NSAID of whatever brand. NSAIDs can promote ulcers and GERD - did with me.

Give it time, took me three years of trying to solve my muscle pain mystery. Doctors kept insisting Thyroid had nothing to do with muscle pain (way wrong!). Muscles are organs and Thyroid effects all organs! For many it is the root cause! I wish more PT's and chiropractors were aware of this as well.

There almost needs to be a separate thread on muscle pain with thyroid issues as it can be complicated for some.

[corky21]

I've read through the Trigger Point Manuals and I do use a tennis ball myself and then a heating pad after once in a while. The first P/T's never used trigger massage on me. They just gave me a few exercises. Then last summer the P/T I went to was using is elbow all around my hips/glutes and it hurt, but then after a day or two I get bad spasms where I couldn't walk, so I stopped that P/T. Then I just suffered along for months. Then this past March I went to a chiro and did 20 treatments. I felt some small improvements but not where I get those pains around the glutes/hips. Now I'm seeing a massage therapist at my gym who was pressing in all those painful areas and he seems to know a bit about it. Tomorrow I'm going to another chiro that listed trigger therapy and muscle work as one of their skills, but  I don't think I want anymore adjustments.

I was thinking the same as you, that I need to get these sore spots to go away and also get my Armour up to a good level. I'm at 1.5 grains now for 3 months.

Did you find with your triggers that you could be out and about and then for no reason you'd get a bad pain in one of those areas? I am afraid to go anywhere because all of a sudden I'll get pains. My husband said it's b/c I keep thinking about pain every day and if I stop then I won't get these pains anymore. But I don't believe that. I think that you can go fine and not think about it and then it comes and you can't stop feeling awful and depressed.

So I should keep working with someone on the triggers and also do P/T stretches and exercises at the same time?

[LazyMoose]

This question comes up now and then. I used to be very athletic so muscle and joint pain really affected my life - the doctors could not figure out the problem. Its amazing doctors don't associate muscle pain with the thyroid or possibly the type of thyroid med you are taking. I don't know if the trigger points will go away from thyroid meds alone. T3 helped me after being on only T4 for years. In my case, the proper thyroid med may reduce new trigger points from forming, but old, reoccurring trigger points must be delt with individually, as the muscle is in an unhealthy state. It can be a long process (months). My carpel tunnel from triggerpoints in my forarms is now 75% better after six months of trigger release. I had it for 15 years though!. A year ago I had trigger points all over my body, now  75% better! No pain meds anymore either. Have you learned how to 'release' trigger points all by yourself? There are workbooks on trigger points and just as important, referred pain, in bookstores. Tools used are Theracane, tennis ball, golf ball, and your thumbs.

Another interesting point. Physical therapy  for muscle imbalance / tightness (and chiropractic for that matter) has a much better success rate if trigger point release is also practiced during or before the course of PT treatment. To strengthen damaged muscle you must first release trigger point knots. It is very difficult and possibly painful to rebuild damaged muscles with knots in them. Knots cannot stretch, only the muscle around it can. A knotted muscle is a damaged muscle! - and knots can 'pull' on other nearby muscles.

Also some bulging discs can go away (absorbed in the body) if the cause from muscle imbalance/knots pulling the vertebra out of alignment is corrected. Backs are the hardest to fix. There is a lot of referred pain in the low back from glutes, hamstrings, and thigh muscles and even lower leg muscles - remember, they connect to each other.

I hope some of this helps you, dont give up on the pain!