Trigger point injections

So today I tried an injection vaginally near my piriformis muscle, right side. Also external right lower abdomen. She said give it 48 hours to work. Its been burning a little now after a couple hours. Is it normal to have pain after this? I would think it would be instant relief. We are just grasping for straws at this point. My doc told me if this doesnt help we can retry in a month and then try gabapentin. I am about ready to give in to the pain and to start seeing a pain psychologist to learn how to deal with a lifetime of chronic pain.

18 Replies

  • Did anyone tell you it was pirifirmis muscle causing problem? My pain Dr said you would have hip pain if it were Piriformis muscle.

    Has anyone said you may have Levator Ani Syndrome and Pudental Neuralgia? The PN cannot be labeled the cause unless they have ruled out other anatomical conditions.

    Did Dr give you pain medication? I function well on Tramadol50. I take 200 mg of Gabapentin around 5:00 pm. Most people take more than this but you have to build to a stronger dose. My GP wanted me to try 300 mg 3 times a day. It totally knocked me out.

    The only way to manage PN is find meds to relieve symptoms. Unfortunately there is no cute I am aware of. Rocky68

    Are you in the US? Paul Harkins is good pain Dr in NC

  • Its not piriformis muscle that is the problem. My nerve pain is deep in that area so that is why she injected there. Just to see if I get relief. My muscles pelvic floor are all working fine now. Definitely not pudendal nerve. Ig this block doesnt help then I will try Gab. I am on amytriptyline right now. Is there a possibility that meds could cure nerve pain eventually and could get off meds?

  • I suppose if it is compressed nerve and muscles would relax enough a person might be able to get off medication.

    I have no pelvic issues either. Rectal spasms, burning and low back pain. Dr still says it is Pudental. The Gabapentin has gotten rid of burning. My pain is just uncomfortable feeling when sitting or Laying down. No stabbing or female parts pain. No pain evacuating. I resisted meds too but found I was becoming depressed from feeling bad all the time

  • How long did it take for Gab to ease your symptoms? I want to stay on amytriptyline but she said I cant be on both

  • I got relief from burning in just a few days. It is an inexpensive drug but you may want to begin with 100mg. Capsules to see how you tolerate it. My GP wanted me to take 900mg from the beginning. I hamper increased to 300mg at night only to see if more relief is offered. I weigh 114 so I guess weight would make a difference. Just something to discuss with your Dr. Amitriptylene did not help me at all. Rocky68

  • Amytrip only helps me sleep. Do or did you have a lot of anxiety with your discomforts? It seems like I keep a high anxiety level all the time.

  • Wow-- I took both elevil and gabapentin. Btw, if you take gabapentin it should be titrated up VERY slowly-- like one added dose PER WEEK.

    I live in Virginia and saw Dr. Andrew Goldstein (he doesn't take insurance-- very $$$) but he doubted my Dx. Until he examined me that is. I got the PN lidocaine injections-- result? Yeah, sex ONCE, but lost bowel and bladder control.

    Nothing's free right? I have vascular Ehlers Danlos btw, and I have a LOT of physical anomalies to begin with. Labral tears bilateral, cam + pincer impingement both sides too. I've given up on any PN fix....but Hydroxyzyne (aka Atarax) helps with bladder spasms, and is a very mild anti anxiety med too.

    In my own case, 3 yrs ago I was told that I had an ovarian remnant from my abdominal hysterectomy. Wrong!! The STAPLES from 1990 had migrated! Imagining is OFTEN WRONG!

    My own sister was wheelchair bound and had been told (at MD Anderson in Houston) that her inability to stand was hypochondriosis. Yeah sure.

    Eventually she found an OLD neurologist who actually LOOKED at her spine with HIS EYES, and he SAW a ridge. Meningioma! HELLO!! She'd been blown off for 3+ years.

    If at Cleveland Clinic a doc is a jerk-- move on to someone actually INTERESTED in helping you.

  • Rocky68,

    That's so interesting that you fall asleep at 900mg of gabapentin per day; I took up to 3,000mg and didnt feel the least bit tired, but I didnt feel any benefit at all either. It's so weird how all of our body chemistries are so different. I also have tried the Tramadol before, and felt zero response with that too, even with 2 pills. Also I didnt notice a thing with vicodin either. And just a bit with percocet. So I actually take methadone for my PN and myofascial pain and it works amazing for me - it just erases about 50 - 80% of the pain, depending on whether I take 5 or 10 mg - and I dont feel any different - like no loopiness as long as I don't take more than 10mg at a time. The one bad thing is that if I forget to take a dose and 10 or more hours go by, I start to have a withdrawal feeling (start sweating or feel cold and feel kind of like Im getting the flu), so one becomes chemically dependent on it. But Im obviously highly tolerant of pain meds so have to take it to get pain relief. Now benzos like valium knock me out at half of the lowest made dose!

  • Yes I did have a lot of anxiety. Partially because My husband is very dependent due to his health issues. They say stress can really aggravate problem. I also could bit sleep since I felt I need to evacuate once I Kaye's down at night.

    I would continually go to bathroom although there was no need to do so. I have always been healthy and active so to be uncomfortable every day and going to so many Drs and explaining to my family why I couldn't do certain things was depressing. It was not unusual to burst into tears.

    Once I accepted this is a chronic condition and took Clonazepam for anxiety I am much better. Gabapentin will help with burning but you will need Tranadol and anti anxiety meds. Get some Miralax or stool softness for your constipation when taking meds rocky68

  • Don't mean to take up so much if your time with these replies but have you gotten a coccyx pillow with the actual coccyx cutout and a handle? I use this everyday and it goes everywhere with me. I also find relief lying on a pallet on floor. I also do stretching exercises. If you have severe spasms you might want Dr to prescribe valium suppositories. My body could not tolerate them. I have not heard of anyone experiencing sensation of having urge to go to bathroom like I experienced. That was alleviated by nerve block. Thank goodness. Rocky68

  • I also do Valium 10mg in cocoa butter suppositories VAGINALLY, 3x a day....,

  • I've had trigger point injections - one internally in my levator ani and hundreds externally in my glutes (not at once). With the butt ones I usually didnt have too much soreness, but once in a while I would, so I just wouldnt sit the rest of the day. I vaguely remember complaining of burning once or twice. I never had one in my abdomen, but if that's the one that's burning on you Im not surprised - it seems like it would be one of those really sensitive areas. When I had the internal one, when it was being done I felt like I was lit on fire and I screamed for a couple of seconds yelling "stop! Stop! Im burning!" But the intense burning went away quickly, but I said no more and we stopped after that one. The muscle felt tight/spasmed for the rest of the day but not really a burning feeling. But I could definitely expect that some would have a burning feeling. Im sure it will go away after a day or two.

    As I mentioned to Rocky, I took a heavy dose of gabapentin and I had zero change - like no pain relief but no side effects. I take methadone for my nervy pain and it's just amazing. Ive tried pretty much everything and so I didnt think even the methadone would help, but it did. I started with a very small dose (2.5 mg, which is half of a tiny 5mg pill), and now 5 years later I usually 5mg in a dose, so one whole tiny pill. And I take it 3 times per day, every 8 hours, and it cuts my pain by more than half. Xanax helps a lot too since it's a great muscle relaxer (and also helps my anxiety I get sometimes), but it makes me very drowsy even at the lowest dose :( so I have to limit it a lot.

  • Look into prolotheraphy it has helped me. Gabapentin helps me as well along with vaginal suppositories with gabapentin lidocaine and Valium. I'm in pool therapy, 3 years into this and I'm 80% better. Had hysterectomy for endometriosis which caused several peripheral nerve issues.

  • Trigger points injections with botox give you off and on pain at first. Also you may feel the injection points for a day afterwards. I'll be getting my 2nd trigger points injections the end of February. I'm getting 100cc. How much are you getting total ?

    Good luck. The pain has ruled my life for a very long time. It's baby steps to feel relief.

  • Not sure why, with the proper management, you can't take both gabapentin and amytryptiline? Some people do really well with gabapentin, huge dose and response range. I took 300 mg. for one week only, dropped my blood pressure to 68/47 (: It is very depressing to focus on the possibility of years of medications. I do better staying present, concentrating on today's treatment and opportunities. Not everyone can manage this, but modified movement in warm pool has helped overall with my various chronic pain and disability.

  • I wanted to check to see if you have received any relief from injections. I have been on 900mg if Gabapentin for five days. Searching internet I found it takes five to seven days to experience relief.

    I have felt some relief with burning and tightness. I have had some pain in sacrum and starting wearing a sacrum stabilizer around house to see if that helps

    I found if I take my Tramadol50 at same time I take Gabapentin I feel a little loopy. If I take just Gabapentin I have no problems and feel comfortable driving. A couple if days I had to take only one Tramadol so I feel Gabapentin does help with pain.

  • No relief from injections. Maybe I just need to be more patient. I feel I am improving but slowly. Its been a year and that worries me that the discomfort is still there.

  • I have been fighting this for six years. I am calling Dr tomorrow to see if I should increase Gabapentin or if he wants to switch me to Lyrica. I have no pelvic issues. Just spasms in buttock area, burning in inner thighs and back legs as well as low back pain. A friend suggested I should see Neuroligist and request a Myeligram. I am just tired of bouncing from one Dr to another. Rocky68

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