Update: Myofascial Pain Syndrome: I had posted (I... - PMRGCAuk

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Update: Myofascial Pain Syndrome

Missus835 profile image
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I had posted (I believe to PMRPro) a few days ago about my symptoms with regard to trigger points or fascia issues in my back. My daughter went over my back gently yesterday. There is a muscle just below the ribs on the right side which is so spasmed it can be seen as swollen above my spine (I have pics of the cross view). I believe it's pulling on my spine, which tends to want to give out.

There are trigger points like someone jabbing you with a hot knife, but she can move the fascia. I'm using cold/hot packs on the muscle, as we believe this is causing lower back pain (pelivic girdle) as well, although not sure. The cold seems to help as does the hot as long as you're using it. Flexeril does nothing to relax this muscle.

My thought was to send pics to rheumy tomorrow through my pharmacy to say "look this is what's going on; what is there to help" because had she actually examined my back when I was there last week, she would have detected this obvious bulge, and I could not lie on her table. I cannot fathom why she has not sent me for an MRI. There is so much going on and she just skims over anything I say (per usual). I would think there would be some kind of shot into the muscle which might help?

I would upload the pics to this post, but unsure how to do so. This post may have been posted in the IBS forum in error.

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Missus835
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PMRpro profile image
PMRproAmbassador

I doubt an MRI would persuade her otherwise to be honest unless she had identified it with a physical exam AND you have something called hypolordosis where the spine doesn't have the normal curvature that gives you the slight hollowing of your midback,

ncbi.nlm.nih.gov/pmc/articl...

My doctors use something called neural therapy to relax the back muscles - doesn't work instantly and isn't a permanent solution unless whatever the underlying cause is can be sorted out. Mine is partly due to a scoliosis - but the muscle spasm makes that worse too! Diagnosis for me has always been with a hands-on exam.

Have you got a local good chiropractor or osteopath?

Missus835 profile image
Missus835 in reply to PMRpro

I do have a former chiro who is excellent. Money is an issue at this point as not working. He may be willing to have a look though. Worth a try Pro. Thank you.

Missus835 profile image
Missus835 in reply to PMRpro

Amazing info in that link. I'm going to try to forward it either to my former neurologist or the pharmacist so they can send it on to my dud of a rheumatologist.

HeronNS profile image
HeronNS

When I started seeing my current miracle physiotherapist she discovered my back muscles were, as she said, "like bricks". She said sometimes people get such spasmed muscles in their back it can cause fractures! I had no idea. At the time I'd just about reached 7 or 8 in my pred dose about six months into the pred journey, but I'd had PMR a lot longer, and had experienced back pain off and on for many years.

She treated it by doing "dry needling". I went every few days and she gradually worked her way up my spine from base to neck until she was satisfied the muscles were properly behaving themselves. The dry needling apparently resets the electrical signals in the nerves which are causing the muscle spasm. This was the winter of 2015-16 and I haven't had that problem since.

I know money is an issue. Call your MLA!

Missus835 profile image
Missus835

Well I know these muscles are hard enough to make it feel like my spine is about to give way. If it cracked a rib, I would not be surprised. I'm going to try my chiropractor who was working on me prior to PMR diagnosis. He was always willing to work with me money-wise. Had dry needling on my neck at one time. I think I just didn't do it for long enough. Ice packing it at the moment. Unsure if it's doing anything but making it feel better. Never a dull moment eh. Thanks Heron.

PMRCanada profile image
PMRCanada

I have been following your posts with interest.

First off I hope whatever treatments you explore provide some much-needed relief. Sounds like you have such painful symptoms in your back which is difficult to deal with physically and mentally, especially without much support from your rheumy.

I am dealing with my second bout of muscle spasms under my left shoulder blade that is especially painful when I breath in. Voltarin and Tylenol does not help but hubby’s “muscle gun” (which has different attachments and strengths, and basically “pounds” wherever it’s applied) seems to help. Heat/cold offers no relief. I’m home pouting because I’ve missed my twin grandson’s 3rd birthday party today, but I’m just to uncomfortable to attend (sigh).

The first time I experienced this was about a month ago when sleeping overnight at a friend’s place, on a hard, single bed (in an awkward position). This time it was after two stressful days in a row. Family woes Friday that caused worry and stress followed by the discovery of a homeless fella found sleeping in our neighbours backyard that joins with ours last night, which triggered my PTSD for the first time in over 5 years (I had a few bad experiences in the downtown location of my former workplace). I also awoke with an ear ache and slightly sore jaw this a.m.

The bit of reading I’ve done on MPS mentions that stress can impact trigger points/fascia by causing tension and tightness in related muscles. The muscle under my left shoulder blade tightens up like it’s being wound up and twitching follows. Are my recent stressful days and return of muscle tightness a coincidence?? Would muscle relaxers help? My recent bloodwork was fine and I’m at 6.5mg pred with no PMR symptoms.

I’ve copied a bit from an article about MPS prevention below:

“To prevent myofascial pain syndrome from becoming an ongoing condition, practice healthy lifestyle habits that promote good spinal muscle health. Regularly stretching and exercising (to keep muscles warm and mobile) and keeping stress under control (to prevent tension from building up in your muscles and fascia) makes it harder for trigger points to activate and cause pain.”

Missus835 profile image
Missus835 in reply to PMRCanada

I feel you, literally. My lower back has been an intermittant recurring problem for months (even years), but has decided to act up again over the last 4 weeks. Left groin, hip and thigh going numb. Actually it's the entire pelvic girdle which is affected as we speak. The back muscle is spasmed so much that it is rising above the spine. Last night tried rolling it with a ball (need a slightly harder ball), but was able to press on trigger point #1. With PMR any pain in the back that has arisen in the past is between my shoulder blades, but this is not that. I'm on 30 mg. of Pred about to drop to 27.5 tonight (because the rheumy wants me to "get off that Prednisone". She wants me to drop 5 mg. every 2 weeks. If stress is a factor in this, then that would be my main factor. I've been off work for almost 3 months because of pain and brain fog and soon must go back, or lose everything I've worked for.

I wish I had your husband's muscle gun, but can't shoot myself in the back. LOL. My daughter took almost 2 years of massage therapy and her funding was cut, so she could not finish, but she does have magic hands. I'm going to coerce her into working on me. She felt around the other morning. Fascia is moving, but trigger points are like hot knives. Heat/Cold packs work while you're sitting against them and then nothing. I do think cold works better though. Muscle relaxers do not work (except to put you to sleep, which may not be bad if you can't sleep).

Deep breaths are difficult. Straightening up in the morning - next to impossible so I bend over a chair until it is possible. My walker is a bit too high for early morning. Set out all my morning stuff at night. Pills, kettle, coffee, etc.

Missing most of the fun of this beautiful weather we've been having in Nova Scotia the last week. I can walk around a store for awhile and then I have to sit. My rollator needs to be adjusted because I find myself leaning forward at the wrong angle when pushing it.

I'm so sorry you missed the twins' birthday party, but I get it totally. I'm in the process of hiring my grandteens to give my apartment a good cleaning (I will pay). Trying to teach them that if you work, you get paid. All the best and keep us updated. :)

PMRCanada profile image
PMRCanada in reply to Missus835

Geez, I really feel for you, especially as your whole hip girdle is involved. Keep using the cold pack and hopefully your daughter’s magic hands help. I can’t imagine the pressure of work timelines combined with your rheumy setting you on such a fast taper. I can only manage .5mg drop every 6 weeks.

I’m better this morning but am going to try to incorporate some gentle stretching every day and perhaps make an appt with my GP to investigate what this might be given it has occurred twice now. I’ve never had back issues…in fact played 9 holes of golf (with a cart), last Thursday. Perhaps that irritated if but I had no pain swinging the golf club repeatedly. I was picking up and playing with the twins on Friday, but that is a common, weekly occurrence. I’m also going to look into some type of meditation to calm myself mentally to combat stress. And of course I’ll continue with the “muscle gun” and perhaps the ball roller treatment. Fingers crossed.

Missus835 profile image
Missus835

It is all a bit much eh. I can see where golf would irritate when you consider where the swing comes from. Delayed Onset Muscle takes a day or two to kick in.

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