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Old 08-19-2008, 05:08 AM   #1
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Cmpgirl - Question about myofacial

Cmpgirl,

I know you've probably already covered this, but I've got a couple of questions about chronic myofacial pain. First, how is it diagnosed? Is there a definitive test(s) or is it mostly process of elimination? Does it usually involve swelling in the affected areas? I've got a lot of swelling in the front rib area on that side, and if I don't take the flexeril on time the muscle spasms are awful. I'm going to the PM doc today with no expectation other than to try to get a specific diagnosis for the ribs. I don't think "inflamed intercostal nerves" is it, especially since there has been no trauma.

Tigg.

 
Old 08-19-2008, 09:32 AM   #2
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Re: Cmpgirl - Question about myofacial

Hey Tigg, No problem at all. First, unfortunately, there are no tests at this time to diagnose CMP. It is generally done by the doc assessing symptoms and by physical examination. (My doc could feel where the fascia had become thick and ropey and was in knots in different areas of my body, at my first appointment with him) This is why it is so important to have a doc who understands what myofascial pain is. Even though it has recently been upgraded from a syndrome to a disease, there are a lot of docs out there who still see it as a bogus or "wastebasket" diagnosis.

The thing is, that when the fascia becomes diseased, it gets thick and ropey and loses all of it's elasticity. It sort of siezes up and can cause all kinds of pressure/impingement on the organs, the muscles, the joints and the nerves. So you can have every one of those types of pain, as opposed to say just muscular or just nerve pain. I have all types of damage to my muscles, joints, nerves and the surrounding tissue. The swelling and the spasms are classic symptoms of CMP.

There is also no real cure or fix for CMP. It is hard to treat with many of the usual pain management modalities, like PT and injections. There is no way to repair the fascia or rebuild the damaged muscle or joints, etc. I've been through the entire gamut over the years and what has ended up working best for me are the meds, myofascial release therapy, aqua therapy and limiting my physical activities.

I hope this was helpful, and if you have any questions please just ask. I'll be praying for ya girl. Hugs, CMP/MM

 
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Old 08-19-2008, 10:51 AM   #3
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Re: Cmpgirl - Question about myofacial

Hi there cmpgirl, how are you doing?. Before I came to this board I never heard of myofacial and was really interested in what you had to say about it. I remember having a discussion with you on a thread about it and finding someone that is training myofacial release. But the reason I am saying this is one thing that you mention about is the rib pain. Is it like they are crushing in on you? Since the jury are still out whether or not I have ankolosying Spondylitis (A.S). are not, and since I am HLAB 27 positive and have nearly all symptoms. It can take years to develop and the bones to fuse into one another, and that is then when they say you have it. The reason I am saying that as a friend of my sister took 10 years to be told she had it but she is suffering big time with her ribs. Seemingly it is due to the A.S. the ribs are effected and she has to go into hospital and go on some pump machine and blow into it for the rib-cage to expand. I am just wondering would this be due to A.S? have you ever been tested for it? Its just strange about the rib pain.............. maybe you know this isnt the case, or maybe its worth looking into. There is some good research on it. Hope this helps take care
Round1

 
Old 08-19-2008, 11:31 AM   #4
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Re: Cmpgirl - Question about myofacial

Round1, Interesting that you brought this up, because I was doing some reading about AS recently and there are a lot of symptoms that are very similar to CMP's symptoms. I've noticed it with a few other conditions as well, like RSD (relflex sympathetic dystrophy) which is kind of a rare disorder and also Lupus and Rheumatoid Arthritis. It even shares many of the symptoms of Fibromyalgia and some docs see the two as interchangeable. (my doc doesn't)

I think that the rib compression/pain that you have mentioned can absolutely be a symptom of CMP or it could also be related to any of the other conditions that I listed above. Because the fascia (which is the web-like structure that covers our whole body and holds all of our internal body parts together - just think sausage casing) becomes really thick and inflexible, it puts a great deal of pressure on your organs, muscles, bones and nerves. When it is severe, it can cause muscles to go into constant spasm, cause your joints to become inflamed and impinge on your nerves and cause nerve pain. It really can affect the entire body. (In my case, it does)

I've discussed some of the other conditions with my PM but we've never really discussed AS. I will probably do that at one of my next appointments though, because he is always really open to exploring new possibilities. It's actually possible to have any of the other conditions and CMP too.

Thanks for bringing it up. I am always researching other possible causes and/or treatments for my pain. In my opinion, it can't hurt! How are you, my friend? I've read your most recent posts and it sounds like you are on a good path finally. Maybe no complete diagnosis yet, but somewhere to start, at least. And a doc who is willing to help with the pain, too. I'm so glad that you finally have some relief. I wasn't sure how much longer you could have gone on like you were before! Sending lots of hugs, CMP/MM

 
Old 08-19-2008, 02:54 PM   #5
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Re: Cmpgirl - Question about myofacial

Can you describe which kind of dr. handles the diagnosis of this?

 
Old 08-19-2008, 03:25 PM   #6
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Re: Cmpgirl - Question about myofacial

Hi there cMPgirl, you could just get a blood test done to check if you are HLAB 27 positive and that would be one way of getting the ball rolling. Thanks for helping explaining the myofacial, certainely has turned me of sausages . How are you doing? Please do let me know?


Yes thanks I am having some relief, definetely with the 6hour 20mg of oxycontin. No wonder I found no relief of 30mg every 12 hours. I was fine for about 4 hours and then wack full force pain. There is still alot of improvement to be done........... but at least I can see myself doing normal things during the day once I pace myself, and lye down at the right time etc.
I really would love to up my oxycontin to 30mg...... just to see does it make a big difference, I will see at the end of the month if I have some left over to try.

Tired O Tired. Dont know if it is Myofacial you are asking about or A.S. The A.S. can be checked by blood HLAB-27 positive, x-ray or mri shows bone fusing to one another but this is only after a good number of years like 10.
The thing is being HLAB-27 positive doesnt always mean you have it and then it is meant to be more common in men. So it is greatly overlooked in for women. Should you be positive it can be confirmed by a rhemy, but you could also be told its fibromalyia (sp !!) and then years later they might say ohhhhhhh it really looks now like A.S. which was the case with my sisters friend.
round1

 
Old 08-19-2008, 04:56 PM   #7
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Re: Cmpgirl - Question about myofacial

I meant myofacial, but will take an answer for either. Thanks.

 
Old 08-19-2008, 07:58 PM   #8
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Re: Cmpgirl - Question about myofacial

Tigg:

Any news from the appointment today? I hope everything went well. Let me know how it went, when you can, OK? I hope the answers about myofascial pain are helpful.

TiredOTired:

The doctor who diagnosed me is a physiatrist. These are docs who are specifically trained to diagnose and treat pain. You will commonly find them under Physical Medicine and Rehabilitation in the directories. Or you can just look for Physiatry. (This doc also happens to be my PM doc) Do the symptoms sound familiar to you?

Round1:

I can ask my doc for the labs. He is always good about things like that. I have an MRI about every 18 months, mainly because I also have several disc issues (degenerative disc disease) and he likes to keep an eye on that. So far, no mention of any fusion of my bones, but then again, it's only been about 8 years that I've had pain. I've had an appointment with a rheumy, but it was a disaster. The guy barely took five minutes with me and never gave me a chance to even tell him what my symptoms are. So, maybe I'll try a different one at some time........

I'm doing pretty well, for the most part. I have to make some changes at the pharmacy next month, because the BT meds I got this month (Norco) are by Mallinkrodt and I know they are inferior. I am getting little or no relief from them. I have to call the pharm and see if they have or can order a different generic. I'm not getting much help right now, for BT pain, and hubby was on vaca all last week, so we were out and about quite a bit. I am having some serious payback right now. Hopefully, with lots of doing nothing, I'll be better in a few more days. Thanks for asking.

Hang in there everyone, As always you are all in my prayers. Hugs, CMP/MM

 
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