Well, my new specialist wants to try trigger points on me, and also a drug that is also an anti depressant. I don't remember the name right now. So of course this means that we can't keep trying to have kids yet. He said he would like to try these out for at least 6 months. That is a long time. He also wants me to go to a psych. to get my pain manage correctly.
Anyways my questions are; what exactly are trigger point injections? Do they hurt? how long do they usually last for? How many should one person have?
Yes, I am familiar with trigger point injections. This refers to injecting a mild solution (usually saline and marcaine) into a palpable band within a muscle. I've had lots of these over the years, trying to relieve a spine condition. If the practitioner does trigger point injections the official way (developed by the late Janet Travell), he/she should get a "jump" or "twitch" response during the injection. After injection, strecth is very important - to restore the muscle to proper resting length. As far as trigger point injections inside the mouth...maybe into the lateral pterygoid or masseteur muscles, I've never had these. My pysiatrist injects these from outside the face, but she is sending me to a tmj dentist who is very comfortable doing them intraorally.
If they work, they should cut the muscle trigger - and release tension - thus relieving pain - and referred pain. There is a lot to read on myofacial pain trigger point injections.. and Janet Travells work online if you do a search. She is famous for her 2 volume medical texts - The Trigger Point Mannual.
Hope that was a little helpful, Robyn
[This message has been edited by RobynRose (edited 05-21-2003).]
Hi again Cathleen!
I've had prolo, but not of the tmj. My prolo was all lumbar spine. It is intended to strengthen the weak ligaments. Unfortunately it did not help my back pain - or my instability. The concept with prolo is that a sclerosing agent (usually glucose) is injected right into the ligaments in an effort to cause inflammation and scarring. This targeted injury is actually supposed to leave the ligaments thicker and stronger. I have no clue why it failed me, so I'm hesitant to try it on the tm joint...but perhaps.
The trigger point injection if done properly(and many do it wrong) - is intended to deactivate the tight palpable band (trigger point) within the muscle... These trigger points cause great trouble and referred pain patterns. There is some good educational info on this whole field of myofacial pain and trigger points if you do a search. Just injecting procaine into muscles is not a triggerpoint injection. There is something called a "twitch" response that occurs if the injection is done properly - the muscle actually "jumps". It's sometimes painful during the injection...and should provide lasting relief after. Many times a series of triggerpoint injections need be done. The problem with me though, is that since I'm so "unstable" - the triggerpoints continue to survive - even after this treatment. I think the stress and strain on my muscles trying to support the joins (where the ligaments won't) is like major trauma on a daily basis. I can't even believe I'm dealing with this in the jaw now too. For many these injections do help a lot. For me it's never been magic, but I continue to try.
How were your headaches today?? We are having real rainy weather here...
Hiyas Heather! Sooooo sorry to hear about potentially putting off motherhood for a bit. I know how much you have been looking forward to it. It'll come in time.. I'm sure of that! We've just got to get you well so that you can have lots of kiddos at your feet!
I've only read a little about trigger point injections. Seems as though it helps some but others it does nothing. There was a thread here about them a while back. I'd dig it up but I'm soo sleepy right now heh.
How far is your jaw opening up now? Some anti-depressants might help lift your spirits a bit. It's so hard to live with pain everyday and eventually it just wears you down mentally. Hang in there girl!
Did you finish painting the butterflies? Any new projects on the horizon?
Long time no hear!!!!
Micaiah and I have really talked and prayed about the whole situation, and we both decided to continue trying to have children. I am still going to be doing everything but the daily medicine (the one that acts like Prozac). The trigger points is a local medicine so I still will be able to do that. The specialist also gave me exercise to do throughout the day. I will still be going to pt mainly for my neck and shoulders. I also have heard that when you are pregnant your muscles have a chance to relax. I really don't want any medicine in my system even if I wasn't trying. This has been the first full month that I have not had any medicine in my system in years. I can feel every part of me and I am enjoying that. I am still in a lot of pain but I am coping.
Anyways, my butterflies are all up and our bathroom sink has been painted and now in dry mode. We have bene using our kitchen as our bathroom for the last week, but man is it worth it!!!! I also have been coloring and painting lighthouse pictures. (I did not sketch them I am only coloring them.)
I'm so sorry the headache is not making a rapid exit!! Gosh, when you invest so much hope and $ and diligently follow the treatment plan - it would be great if symptomatic relief showed up too!! I guess it may take time. It's a trick for us all to figure out what exactly makes the "headache" "neckpain" "ear pain" or whatever. For me - I feel disticnt movement and know a lot of my issues have to do with instability (clunk clunk). The upperbody symptoms came on right after this myelogram test where they inject through the dural sheath - and spinal fluid leaked out. Guess it was enough of an irritant to set me up for the head/jaw nightmare that followed.
If only I could get in proper alignment and STAY THERE. I was reading one site where a doctor from Michigan was giving a talk to the FDA (about the device that measures where your most relaxed jaw positon is)... Anyway... he was a surgeon who realized that this targeted splint therapy (it sounded a lot like yours..and he even references Cooper) - did a much better job at helping people with tmj problems than the surgery did. Unfortunately, he quoted figures - and the small % that did not do well were the "hypermobile" patients with recurrent subluxations and dislocations. I was bummed to read this. Have you seen the site I'm referring to??? It's an entire transcript from this Food and Drug Administration conference about whether or not to approve this particular measuring device. It was pretty interesting. Anyway - Enjoy the cooler weather. Hope your weekend is fun too!
It's probably because our ligaments are too lax to allow the disc to stay in place. Figures!! I am hoping I can get the muscles stronger to keep the joint more stable. If not I may have to consider Prolotherapy. Cathyk said it helped her. Thanks for the info.
[This message has been edited by totallyconfused (edited 10-28-2003).]