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Old 06-23-2011, 10:56 AM   #1
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Newbie w Myofacial Pain


My MP was brought on by a mva (car accident). Before the 'accident' I was a housekeeper in a large hotel. I made several beds a day, cleaned tubs, vacuumed, and ran up & down halls and stairs all day. Now - 2 ys later - I am barely able to work pt as a sales associate in a dept store. I have been blessed in having an amazingly talented PT who knows from experience what I go through. I experience full back/neck pain & spasms. Its like my back is seperated into different sections: upper, mid, lower, and neck. Seldom do they all hurt at once except during a flare-up.
A few weeks ago I had the worst pain I have ever experienced. I thought I was having a heart attack, the pain in my upper back, upper chest, and neck was a 10++. I spent 3 days in the hospital having evey kind of heart test. Everything looked good. I left the hospital the same way I entered, not knowing what happened. So last night my husband and I began our evening walk. I began to feel pain/tightening in my mid-back but kept walking. Within minutes I had that same pain in my upper back I had weeks before. It lasted 3 hours! I took my meds (esp muscle relaxant) and sat w a heating pad. The pain gradually went away but not completely. This a.m. I woke with cramping and mild tightness.
I am beginning to think this is all a part of the Myofascial Pain Disorder. Any ideas out there? Really could use some help. Ive never felt anything this intense before. Im worried I wont be able to exercise (walk) as much. (It really helps!) Thanks in advance!!

 
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Old 07-05-2011, 09:27 AM   #2
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Re: Newbie w Myofacial Pain

i am just wondering, after your MVA just what specific types of actual testing/scanning was done on you and where exactly on your spinal? anything AT ALL found there? there just usually IS, in almost every case of myo pain a very much 'there" type of an underlying condition such as herniations, or strong history of injury(like whiplash or MVA for just examples) or anything that would or could impact that spinal and hence lead to muscle to even have actual myofasical problems at YOUR particular level of intensisty. this basically stems from repeated inflammatory types of signals that would run from an 'injured/inflammed" or damaged area(s) within the spinal that natually just shows itself by "fireing out" directly TO the surrounding fascia that actually totally covers every single muscle, organ and blood vessel within our bodies in one very long interconnected spider web like sheet/covering. once those signals hit that fasica, it will thin out then totally clamp down around that particular muscle which is what generates things like pain, and the dreaded trigger point globs that are mostly muscle and tissue held hostage up there.

and if not interveined upon, meaning getting the right therepys/meds(do not always work real well as getting rid of that trigger then working out the damage) or even better, removing that "trigger', it will tend to eventually migrate the muscle hell to different muscle groups as well, and YOU, that sufferer just ends up with more and more muscle involvement and higher levels of signals still firing out to now a much wider group of muscles too which also then can imact tendons, ligaments and soft tissue around that specific area as well.

the very first thing you really NEED to do here is find that generator/trigger that could very easily be within your spinal considering everything, probably in the more rarer area of the T spine, with the standard herniations(or other nasties we just can get from wear and tear over the years to spinal sections)? they usually tend to hit more vulnerable to injury areas like the c spine(tho you could have a lower c spine issue or upper T too) and the lumbar areas. but just considering the type of work you did, and i used to do the very same thing for a very very large complex myself so i DO know what really gets trashed the most in a persons body simply 'housekeeping". my rotator cuff and spinal took hits from that and being a emt/ff for too many impactful on my body years. now it IS a flippin mess and has major myofascial damage too.

if there just is any possible way you can at least obtain a very much needed to rule in or out contrasted MRI done, better done on your whole spine considering the MVA and how it simply disperses the impact energy, or at LEAST that c and t spine would really help and try and either Dx the issues in there that are creating that level of pain intensity, or rule them, out so you and your doc can move onto other potential areas

but knowing what WAS actually even scanned post MVA and if there just were ANY levels of real solid findings really would help uus to try and help you. you just could have very easily, buy just doing that particular type of job, started to breakdown certain areas within joints and spinal too that when you had that MVA, just made those areas much more 'susceptable;' to becomming more deeply injured as well. but looking 'into' the areas of potential impact at this point(at LEAST the C thru T spine just considering symptoms), really does make alot of sense. you NEED to find out just what IS behind this in order to best try and treat it. do you have ANY of the scans that i most certainly 'hope' they did on you post MVA at the ER? how serious was this MVA as far as what they 'knew' was your true level of injury/impact? marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

 
Old 07-05-2011, 09:48 PM   #3
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Re: Newbie w Myofacial Pain

i have myofascial pain in the left shoulder, left side of neck, radiates down left arm. plus i have it in my legs at multiple areas... and i know first hand, the pain can become unbearable.... my neck and shoulder hurt frequently without even doing anything to "trigger" the pain, it just comes on... when the pain gets the worst, i can barely touch my neck and it feels like the one muscle is basically a knot and it hurts to touch. when i have the flares in my legs, usually in the calf or lower thigh, the muscles feel very tight. i also have really bad cramps in my legs, and sometimes even moving my leg a certain way will cause them..
i have multiple cervical spine issues including stenosis and a herniated disc, and then i have neuropathy in my legs (dr says possibly due to lumbar spine issues that have been diagnosed)..i have also been diagnosed with TMJ and fibromyalgia..
i sometimes have a burning & pain sensation in the thoracic area of the spine on the left side.. i have not had an mri of the t spine done, but am going to discuss with my neuro on the next visit..

so first i recommend mri's are done of your entire spine.. you could also ask about a TENS unit (works good for me most of the time). also ask about Lidoderm pain patches (lidocaine- numbing agent).. the patch is my lifeline during sleep time & you can wear one for 12 hours straight, then off for 12 hours.. dr can even give you some samples to try, before you pay for a script, as they can be expensive. if you cant afford the cost of them, you could inquire with the manufacturer about getting them for free.. my copay for a box of 30 patches is $30- but to me they are worth every penny...

 
Old 07-06-2011, 08:35 AM   #4
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Re: Newbie w Myofacial Pain

ms, i would have to agree that the lido patches esp and the TENS really are great for this type of crap too. i LOVE my lido, and have used it in many many other ways than just my TPs that radiate out in every freakin direction too. i also have pain syndromes from sp cord injury that generated themselves after that have that sick 'burn' component to them or feel LIKE i have a second degree burn that just will not heal, just for even MORE fun and excitement added to every miniute of every day(that last one is called central pain syndrome). the lido IS wonderful for knocking down some pretty ugly flares in alot of ways.

what i am wondering about YOUR situation is the mere fact that your lower torso levels are also involved, combined with already having some levels of confirmed issues up in that c spine too? when was the last time your c spine problems were MRIed? what was found, anything actually impacting your spinal cord in ANY way shape or form? i am also wondering if you don't have more of a combination of both myofascial and radiculopathic types of pain esp running down that arm? while myo pain/muscle involvement can and does generate and radiate 'out' from the inflammed area, it 'usually' does not hit the actual extremitity(muscle, becasue of how THAT simply runs differently from like the back and neck in more solid 'groupings" more to hit and inflame?) to THAT degree, but radiculopathic will, and all the way into the hand and fingers too(esp if your 'fine motor" muscles are impacted from herniations or that stenosis in a bigger way which stems from a very specific nerve), and esp if you already have confirmed c spine crappy stuff going on. it just all really depends upon how really 'impactful" the c spine issue is to any given nerve that will dictate sensory loss/strange sensation and of course pain, and also how your fingers would move(fine motor muscles down the arm into the wrist then hand/fingers). muscles that have actual myo pain will 'generally" get fired out from inflammed spinal nerves to the 'closest" muscles to it "directly from" the spinal moreso than further down the overall downward muscle groups(the more down the arm is usually a fine motor affectation). that would usually be more radicu pain casued by that spinal area that is being impacted firing or misfiring pain and sensory issues down an extremity, ya know what i am trying to say? unless you are actually really 'feeling' real solid TPs down the arm or in the legs?

the c spine, unlike the reast of the spinal segments/levels actually have ONLY one nerve running out on each side(of spinal cord) at each level til you hit the T spine. where as the rest of our spinal segments all carry TWO nerves on each side at every level, one motor(muscle) and one sensory nerve(feeling/sensation/pain). the c spines nerves actually carry BOTH the fine motor AND a sensory component in one nerve,each side. the thing here is, those nerves do NOT correlate with dermatomes(sensory innervation) and fine motor as being on that very same nerve. we have dermatomes(sensory0 and myotomes(muscle) that when up in the c spine,while in my particular case and as an example of how insane this is, i lost my ulnar nerves sensory innervation right after my spinal cord surgery. that damage was severe enough to also impact the fine motor functions that also stemed from the ulnar too(the ulnar innervates the total pinkie and half of the ring finger with sensory) but the fine motor damage actually shopws up on the totally opposite side in my thumb mostly. i cannot rotate that right anymore and lost alot of that 'cushy thumb pad base too. but THAT was from the ulnar nerve damage that showed its sensory and fine motor damage. if you simply look up the 'peripheral nervous system' you can get a much better idea of what this all means.

soo, depending on what specific nerves are being impacted up in your c spine, wouldand could easily show itself in those arm to hand muscles. while this 'could' in some strange way still be connected to your myo pain, you seriously DO run a much higher chance of what youare feeling down that arm as fine motor musle affectation FROM a c spine nerve too. an EMG would show the muscle issues pretty well if they are there, but unless you have even an intermittant to solid level of numbess going on at the TIME OF that test, it would not always pick up on anything sensory, and that would not be at all abnormal, just means your nerve has not suffered any real sensory impact,or it was not being impinged upon during the actual testing of it.

one other problem that DOES generate leg issues with cramping or holding 'cramp/spasm like you described is actually a lower than normal potassium ansd also at times magnesium too. has this been checked out(the levels with labs)at all since the lower stuff atarted just to get that ruled in or out as the possible culprit? sometimes it just really CAN be that simply explained, and once you get your esp potassium levels up to par over even a few days, the cramping would just also go away. this would just be the MOST "common' reason for anyone to start getting cramping in the muscles of the legs esp.

as far as that neuopathy dx goes? usually with neuropathy, the person is either losing or has lost at least some level of nerve so things 'usually' tend to be more 'calm' as far as what your opposite type symptoms are showing with what appears to be a very strong 'increase' in overall nerve activity? ya know what i mean? the more 'common reason, other than what i described above actually could be stemming from just about any level of that spinal depending upon possible impact to your actual spinal cord and what are called the upper motor neurons(they just usually get disrupted first with most 'impact' type of findings to the cord itself. so they 'show it first). when they get impinged upon, they get somewhat 'overly excited' so the initial symptoms of impact to the cord can usually be a very real 'increase' in overall tone in the legs(even with 'just' c spine impact too), meaning more "hyper reflexes" or outright spasticity occuring, MORE nerve activity, not 'less' kinda thing?

just what happens when you have that lil hammer tap you right under your knee cap when they do that normal neuro exam on you? you CAN do this at home too just using the heavy end of like a butter knife and just tap lightly right under that kneecap area til that leg either subtley 'moves out lightly"(normal) or more 'briskly" kind of 'pops out'(hyper reflexic). that test alone would tell if the upper motor neurons are involved, thus your cord is being somewhat impacted/compressed upon somewhere up there?

but knowing when you had you last scan along with how severe the fibndings actually were would really help to know too. this just really does NOT 'sound like' actual myofascial stuff you are getting esp in the arm or "down" that arm, and the legs too. at least to me. while trust me, anything IS just indeed a possible when it comes to the human body esp, some of whatyou are describing really sounds like much deeper/further types of testing just IS really needed to fully know/define just what IS generating what in your body overall.

some of this i just really wanted to explain to the both of you here, so it was much easier to place it all into one post. marcia
__________________
3-22-01,herniated C-6-7
11-20-01,placement of hardware for failed fusion
9-22-03,removal of cavernous hemangioma that was inside spinal cord. Neuro damage to L hand L leg and R leg.

Last edited by feelbad; 07-06-2011 at 08:58 AM.

 
Old 07-06-2011, 10:05 AM   #5
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Re: Newbie w Myofacial Pain

Iamnotw, I have been in a car accident and had a whiplash. You really need to do an MRI. Perhaps you have bulging/herniated disks. The professor who checked me told me that if after 6 months the pain does not go away it is probably due to bulging disks but my case is more complicated cause I feel it is the tight muscles. This I will need to investigete even more.

The person who will invent a cure for neck pain will be a millionaire.

So do the MRI.

 
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