INJECTIONS

Note: This content is not intended as and is not a substitute for professional medical advice. (See full Disclaimer.)

Trigger Point (TrP) Injections

My Personal Experience:

Trigger point (TrP) injections are shots of pain-reducing medication (e.g., steroid and numbing medicine) injected into a TrP, which is a taut band of muscle or fascia that is painful or can radiate pain to other locations in the body. After five months of pain and no relief from drugs or physical therapy, in 2006 my orthopedic surgeon injected cortisone (a steroid) and lidocaine (a numbing medicine) into one of my particularly painful TrPs. The shot had the immediate and amazing effect of reducing my pain


For the first time in months I felt human again. But the relief only lasted a few hours. A month later, my neurosurgeon gave me a similar shot that lasted two days. It felt like he hit the dead center of the sensitive TrP. The shot hurt much more than the first one but the result was much better. I was in tears for two days because I couldn't believe how good I felt after months of such constant and debilitating pain.


Immediately after the second shot, my pain level, measured on a scale of one to ten, dropped from an eight to the one- to two-range. But the effect only lasted a couple of days. Then my pain was back up to the sevens. I was disappointed it didn't permanently reduce my pain to tolerable levels.


Four months later, my new physical medicine and rehabilitation (PM&R) doctor diagnosed me with Myofascial Pain Syndrome and begin giving me multiple TrP injections. They also worked incredibly well, but only for a week or so at a time. I continued to get two or three TrP injections at each doctor's visit (ranging between a week and two months apart) over a period of seven months.  

Soon the effectiveness wore off and I was having side effects from the steroids (continuous menstrual period for a full month). My PM&R doctor hadn't initially mentioned that that might be a side effect, and I didn't find out until after I rushed to the gynecologist who subjected me to various unpleasant tests only to find nothing gynecologically wrong with me. Later my PM&R doctor told me steroids can disrupt a woman's menstrual cycle. 


The TrP injections were great while they lasted, and even had an overall effect of bringing down my pain from daily average pain of about eight to about five. They also helped me realize that I could feel normal again and that my body somehow had the ability not to feel pain. The shots helped me know that my body wasn't permanently damaged and helped me believe I could get better. But unfortunately, the shots didn't bring my pain down to tolerable levels. Plus, because they contained steroids, my doctor didn't advise them as a long-term solution anyway. 


A couple years after getting the TrP injections, I was rear-ended in my car and my doctor gave me a TrP injection with only lidocaine and no steroid, but it didn't help reduce my pain. 


For the TrP injections I got in 2006, I couldn't figure out how I could get so much relief for a short period of time and why my body couldn't stay like that. What I didn't know at the time was that my body was stuck in a near perpetual state of bracing in a primordial attempt to protect myself from unconsciously perceived danger caused by past traumas. Yes, it's really true (see Trauma & Chronic Pain tab). 


Apparently, the shots could reduce my pain (by increasing blood flow and reducing inflammation around my TrPs and fascia) enough to temporarily override my brain signals that were telling me to be on guard, but they couldn't stop those signals completely. 


It turns out, I'd have to do that myself. The neuroplasticity of the brain means it is possible to alter conditioned neurological signals, but that doesn't mean it's easy. Using mind-body approaches (e.g., John F. Barnes myofascial realease [JFB-MFR] treatment therapy, reading about the mindbody, letting go), I eventually made significant progress. 

Rating: (+)

BOTTOM LINE: Initially helpful, but eventually became less effective and had unacceptable side effects.


My Ratings Key:

-----------------------------

(+++) Most effective

(++) Effective

(+) Somewhat effective 

(-) Not effective or hardly effective 

(--) Not effective or partial negative impact 

(---) Not effective and negative impact 

(+/-) Unsure or some positive and some negative impact 

(?) Don't know because I haven't tried at all or enough

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Note: Described here is one of the many approaches I've tried or considered trying for healing my chronic myofascial pain.


This content is not intended as and is not a substitute for professional medical advice. (See full Disclaimer.)

Dry Needling

My Personal Experience:

Dry needling is similar to trigger point (TrP) injections, except no medicine is used. Proponents of dry needling say that the physical act of getting the needle, not the medicine, into the trigger point is what deactivates or helps release the TrP. 


I decided to stick with the traditional TrP injections (no pun intended) since both my physical medicine and rehabilitation doctor and one of my physical therapists told me dry needling uses thicker needles and would hurt more because it doesn't use any numbing medicine (e.g., lidocaine). After all, who wants more pain?  


I haven't tried dry needling, but since TrP injections helped reduce my pain from a daily average level of eight to about five, I suspect dry needling could have some positive effects (and without the side effects from the steroid, such as disrupting menstruation or other more widely known side effects of steroids). 


However, when I had a TrP injection without the steroid I didn't feel pain relief (but that was also after the shots had already become less effective even with the steroid). Nonetheless, the TrP injections were not enough to eliminate my trauma-based chronic pain (see My Journey). Mind-body approaches are what have helped me the most since the shots.

Rating: (?)

BOTTOM LINE: Haven't tried, but might be somewhat helpful (similar to TrP injections but without side effects).


My Ratings Key:

-----------------------------

(+++) Most effective

(++) Effective

(+) Somewhat effective 

(-) Not effective or hardly effective 

(--) Not effective or partial negative impact 

(---) Not effective and negative impact 

(+/-) Unsure or some positive and some negative impact 

(?) Don't know because I haven't tried at all or enough

------------------------------


Note: Described here is one of the many approaches I've tried or considered trying for healing my chronic myofascial pain.


This content is not intended as and is not a substitute for professional medical advice. (See full Disclaimer.)

Facet Joint Injection

My Personal Experience:

This is when a doctor injects a steroid into the facet joint in your spine (a small joint located between and behind adjacent vertebrae that provides for both stability and fluid movement of the spine). The injection is conducted under X-ray so the doctor avoids hitting the spinal cord.  


I had a facet joint injection in my neck in 2009 after my pain spiked up when I was rear-ended in my car three-and-a-half years after my initial disc rupture and subsequent surgery. After the car accident, I was having pain in new locations around my neck and head, so the doctor wanted to rule out any injury to the facet joint. 


The injection only worsened my pain for several days and the doctor concluded that my facet joint was not the source of my pain.

Rating: (---)

BOTTOM LINE:  Made my pain temporarily worse.


My Ratings Key:

-----------------------------

(+++) Most effective

(++) Effective

(+) Somewhat effective 

(-) Not effective or hardly effective 

(--) Not effective or partial negative impact 

(---) Not effective and negative impact 

(+/-) Unsure or some positive and some negative impact 

(?) Don't know because I haven't tried at all or enough

------------------------------


Note: Described here is one of the many approaches I've tried or considered trying for healing my chronic myofascial pain.


This content is not intended as and is not a substitute for professional medical advice. (See full Disclaimer.)

Other Injections (Prolotherapy)

My Personal Experience:

Prolotherapy, also referred to as proliferation therapy or regenerative injection therapy, involves injecting an irritant, usually a sugar solution—dextrose—into a joint, tendon, or ligament to stimulate healing (connective tissue growth) and reduce pain. Prolotherapy focuses on patients with joint pain or laxity in ligaments or tendons. 


It does not claim to reduce myofascial tightness, which is what I’m looking for in a treatment for myofascial pain syndrome.


Dextrose prolotherapy has not been proven to be effective for chronic pain, myofascial pain or chronic low back pain (American Pain Society, Prolotherapy.org, Mayo Clinic, Spine-Health.com).


I’ve spoken with people who had positive experiences with prolotherapy in treating their pain, but not those with myofascial neck problems like mine. I also know people who have had very bad experiences with it, especially when their problems weren’t tendon- or ligament-related.


Platelet Rich Plasma (PRP) therapy is another type of prolotherapy where a person’s platelet-concentrated blood plasma is injected into an injured and painful site (e.g., joint) to help initiate repair of tendons or ligaments and to intensify the body’s healing process.


Since my myofascial pain syndrome isn’t related to joint, ligament, or tendon pain, but rather oxygen deprivation of soft tissue (fascia) surrounding my muscles, and evidence hasn’t shown efficacy of prolotherapy for myofasical pain, I don’t think injecting an irritant or platelet-rich plasma into my body will help me


Treatments I’ve found to work best are those that help reduce fascial tightness such as John F. Barnes Myofascial Release therapy (JFB-MFR), heat (e.g., heat patches, hot tub), and/or moderate exercise such as walking/jogging or biking

Rating: (?)

BOTTOM LINE: Haven't tried and don't expect to.


My Ratings Key:

-----------------------------

(+++) Most effective

(++) Effective

(+) Somewhat effective 

(-) Not effective or hardly effective 

(--) Not effective or partial negative impact 

(---) Not effective and negative impact 

(+/-) Unsure or some positive and some negative impact 

(?) Don't know because I haven't tried at all or enough

------------------------------


Note: Described here is one of the many approaches I've tried or considered trying for healing my chronic myofascial pain.


This content is not intended as and is not a substitute for professional medical advice. (See full Disclaimer.)