I have several knots in my back and shoulder and they have caused a sharp pain in my right arm. I have been unable to sleep for more than 2 hours at a time and my chiro suggested trigger point injections to try and relieve the knots.
I have had problems with this in the past but never to this extent. I am supposed to be doing TTT on Friday but I haven’t worked out since last Thursday and just to jog hurts my arm right now. In order to go to work I have to take 2 advil and I also take it before I go to bed to try and get comfortable enough to get some sleep. I’m a little pissed at myself for letting it go this far but usually in a couple of days it passes. I’ve had this for 6 days now. Anybody ever get the trigger point injections before?
I have received them, and they are something I offer in my practice.
They can be quite effective for relieving actual ‘trigger points’ which have their own unique presentation.
In my experience, one injection can relieve pain by about 50%, but typically it takes several injections (along with regular stretching, etc) to completely resolve them. The longer you’ve had the trigger points, plan on longer resolution.
I would advise that you request procaine as the injectate, not cortisone.
My suggestion, based on my professional experience is, for acute TrP pain is to find someone that is skilled in ART or Myofascial Release. Also, I personally have had exceptional results with patients with recurrent TrP’s using kinsiotex taping along with MRT. Spydertech has pre cut tape for most common conditions. Check them out.
On the long term you may consider the cause of the TrP’s. Ussually it’s a chronic position or postural issue. The first place that comes to mind is fit on your bike. You may want to get it checked. Also, do you train in the TT position? I find it helpful to limit training on the on the Tri bike. Most volume should be on your road bike. My rule of thumb is about 80% total volume on the road bike, measured in time not miles. Two benefits: one, you don’t beat up your good equipment and two, you get a positive training effect. So when you get on the TT bike you feel very fast.
Yea it’s my posture in my p/u truck that’s the major cause of all of this. I drive 45k per year kinda hunched over reaching for the wheel. I’ve moved my seat up and try to sit up more but I still fall back on my old position from time to time.
I think it’s lydocaine? that they are going to use tomorrow. It not cortisone I’m sure of that.
Once I get past this episode I need to do more to prevent it in the future. More stretching and massage.
Thanks
I have a two herniated discs in my upper neck, and I was receiving trigger point injections for the pain. They lasted anywhere from 6 to 9 months. I’ve been to all kind of PT and Chiro and find that the injections are the only thing that works for me. Most recently I had an epidural injection in September of last year and the pain is still gone, however, the numbness in my fingers is still there. I"m currently in PT and trying to see how long I can go without getting the injections again. They definitely work for me, and I will continue doing so until they don’t work anymore. I’ve been advised by a neuro spine doctor to avoid surgery as long as possible.
Hey Laurie, After another rough night of little sleep I’m going this afternoon to try the injections. Did you experience immediate relief?
And what percentage of movement did you have after the shots?
Also, do you think it would be possible for me to train this weekend?
injections really work for true long term (chronic) nasty tps. Happy to hear you’re doing litocain (sp?). There are a couple of methods that help, injections is at the chronic end. Spray and stretch (same product) helps, not as impactive.
I’ve been watching several patients I can’t fix with nmt (neuromuscular therapy) and mr (myofascial release) get better results with dry needling. I’m not a nice girl so when I’m referring over to pt it’s because many things need to be addressed - how they got there and how to prevent what you can to not be there again. With the dry needling it’s a accupuncture needle they shove into the heart of the tp and plunge it. Really nasty ones they have to add electrical stim onto the needle. Sometimes it’s a one and done and others it’s several sessions.
I’m sure you’ve read up on tps to know about satellite tps - ones that are caused in the pain pathway but in a different location - reactive only bc of how nasty you let the one get. Hopefully you’re not at that point, because that gets really ugly fast.
If you know your posture is crap, and you’re not successful at changing it, at least strengthen your rhomboid and latts that are most likely being overstretched from hunching (guessing here on the visual - have your doc or pt advise), and stretch both pecs (minor and major) and coracobrachialis.
With the numbness pattern you’re describing, how you drive, and your sport of choice - I’d be looking into tps in your scalenes too.
Hope you feel better, and are able to incorporate maintenance on yourself so you don’t find yourself back at this point again.
My wife is board certified Pain Medicine doc, has been doing these for almost 10 years. Have seen a huge number of patients get relief from very debilitating conditions (car wrecks, etc.) incl. elite level athletes. She works on me two or three times a year when I ramp for IM. Expect to receive a series of treatments spaced over several weeks if you have severe problems. Don’t be surprised if other triggers come to light once the main, most painful ones are released. Regular massage sessions after therapy will prevent triggers from coming back.
“I’m sure you’ve read up on tps to know about satellite tps - ones that are caused in the pain pathway but in a different location - reactive only bc of how nasty you let the one get. Hopefully you’re not at that point, because that gets really ugly fast.”
This is what I have I think. It started in my upper back in the usual spot but now the pain is in my right arm about 5 " below the top of my shoulder. The back feels fine. I mean lights out pain when trying to get out of bed. This morning I got over onto my stomach and had to slide out of the bed. Three advil later and I am at work trying to take it easy. App. for 5:30 tonight.
Also agree I need to get a regular massage, stretch, maint. set up. This is the worst it’s ever been and I don’t want to go thru this again if I can help it. Wish I was in Atlanta…Thanks for the feedback.
Man you’re a mess! Concerned for u over the use of advil and masking symptoms as you continue to torture your body. Once you get stabilized just plan on a regimen to stay healthy. I forgot to mention foam roller, and laying on top of it supine. The roller should be under your spine coccyx to back of head and dropping arms out on the side, this is a very basic stretch and with your posture behind the wheel one I would implement at the end of the day. If u don’t have a roller you can use a thick rolled up towel as a substitute, no excuses.
I don’t know where u live, but ask your fellow athlete for a solid referral for a good therapist (my practice is nearly 90% ref base). If however you find yourself in Jacksonville over memorial day weekend I’m going down to take care of all the crossfit kids at regionals, in June at lake nantahala, and pretty much every month for the rest of the year traveling somewhere. if you find yourself at an im event go see the art guys/gals, even if u feel good as tps take a long time to cause neural interruption.
When u get in with a good therapist expect to feel like you are falling apart, as our job is to find things you didn’t know you had. From the sound of your bod you’d be a fun challenge.
Again hope u find some resolution so u can go forward with maintenance.
Hahaha…Considering my past love for Percodans ( percocets are for wimps ), I don’t feel stopping the advil will be a problem…
I wish I had a few perc’s last night that’s for sure…
Are you saying that it hurts when you do your thing? I have someone who fits that bill nearby but I got lazy and cheap and figured a regular massage was all I needed. I will take your advice once I get out from under this knot of muscles. Can’t wait for 5:30.
well advils a joke on your system. If your in pain it’s going to hurt, a good hurt. Typically sore for at least 24-48 hrs is norm with therapy massage (not a goal but a reality). That type of work is not for evrybody, and after a session or two you’ll know if that therapist is for you. After several sessions and once your in maintenance mode then the sessions are easier and the body responds better…just like exercise. It’s almost 5:30 hopefully less pain for you soon!
Man you’re a mess! Concerned for u over the use of advil and masking symptoms as you continue to torture your body. Once you get stabilized just plan on a regimen to stay healthy. I forgot to mention foam roller, and laying on top of it supine. The roller should be under your spine coccyx to back of head and dropping arms out on the side, this is a very basic stretch and with your posture behind the wheel one I would implement at the end of the day. If u don’t have a roller you can use a thick rolled up towel as a substitute, no excuses.
I don’t know where u live, but ask your fellow athlete for a solid referral for a good therapist (my practice is nearly 90% ref base). If however you find yourself in Jacksonville over memorial day weekend I’m going down to take care of all the crossfit kids at regionals, in June at lake nantahala, and pretty much every month for the rest of the year traveling somewhere. if you find yourself at an im event go see the art guys/gals, even if u feel good as tps take a long time to cause neural interruption.
When u get in with a good therapist expect to feel like you are falling apart, as our job is to find things you didn’t know you had. From the sound of your bod you’d be a fun challenge.
Again hope u find some resolution so u can go forward with maintenance.
I felt I needed to point out the irony in this statement! Just sayin’…
Bursitis in my shoulder is the diagnosis. I had thought about that because my dad had it from time to time. I got a small shot of steroid for that and it feels a little better already.
I got the litocain? for my back and the knots behind my shoulder.
She said my posture is a huge negative and I must do something about it pronto or I will continue to have problems.
She said I may feel better by Friday. That would be very welcomed by me. I need some sleep.
Thanks for the replies everybody.
i have received dry needling to relieve pain in low back and tendinitis of knee. It has done wonders…had pains for close to two years but now things are really progressing as i have also included the egosgue method (google for books and site) which basically addresses body alignment issues. Also use massage tools on my own muscles…including TP massage baller.
dry needling is a little bit painful in back area, moreso in the bigger muscled areas like the quads and calves. i started mid april and have gone once a week on average and will be thru next week.
