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myofascial pain syndrome or fibromyalgia??

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Old 04-16-2011, 08:38 AM   #1
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myofascial pain syndrome or fibromyalgia??

i have had 4 cervical spine fusions with hardware, the last 1 in 2005, i was said to have developed RSD/CRPS. the last 5 or so months, i am having severe elbow main in both arms but worse in my left. my doc is now thinking fobro or mps...he referred me to a pain mgmt specialist. i would rather c a neurologist but i will give the pm a try. ps, i had the elbow pain after the surgury in 05 but just recently got like 90% worse....and advice?? i have tried every med out there for rsd/crps..i'm sick of all the pain meds as they had adverse effects on my body, weight gain, sleepyness, always feeling stoned...ect.. also, the last spine fusion was i think(so many cant remember) c7-8. my pain after that which i never had prior is in my hands, burning pain and runs up my ulnar nerve and ended around my elboe, this pain now extends to my upper arm and if i push certain areas by my elbow, it hurts like heck. i was hoping it would be tennis elbow so it would be "fixed" but dont seem to be that lucky. i am a 45 yr old woman. i was hurt at work in 2000 and have never been the same. i use to be very active now, too much pain although i try to fight thru it. i am only on a few meds right now as they didnt seem to help anyway...and help out htere??? what doctor shoul i see???/HELP!!!!!!!!!!

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Old 05-01-2011, 03:07 AM   #2
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Re: myofascial pain syndrome or fibromyalgia??

Originally Posted by gohabs View Post
i have had 4 cervical spine fusions with hardware, the last 1 in 2005, i was said to have developed RSD/CRPS. and have never been the same. i use to be very active now, too much pain although i try to fight thru it./HELP!!!!!!!!!!
Sounds like Fibro. You can ask your primary care physician to check you, they check trigger points etc. They also need to rule out other things like lupus or RSD. But to me it sounds like Fibro.

I feel for you, I also suffer from immense pain in my neck, it is every day. No life. How is your neck now? do you feel any pain? 4 cervical spine fusions it is alot, I would think. howcome you had to do so many spinal fusions, sometimes it is like a domino effect be really careful.

What meds are you on? I think and suggest you go to your doctor(pcp) - no contract, thanks god, and try oxycontin and then when that does not help go to fentanyl patch. The pain in the neck is horrible to treat and now you have pain all over your body and you will not be ablet to function. That is what I think.

You can also try gabapentin, it is a mild pain killer. It helps some. I did not like lyrica.

Please tell me what meds are you on right now. and again, I feel for you and know what your life feels like.

Old 05-01-2011, 08:00 AM   #3
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Re: myofascial pain syndrome or fibromyalgia??

my doc is sending me to a pm specialist in burlington vermont. i have tried tons of meds including lyrica. i dont like any of them, all make my stomach upset and make me gain weight. currently i am on hydrocone, clonapin and my doc just addes nortriptolyne(probably spelled wrong). u r right about the domino effect. had the 1st surgury in 2001 and had to have it redone cause it did not fuse. after that ,i was ok for a few years then i think it was c7-8. that was real bad, pushing into my spinal cord, i was told by my surgeon if i did not have that surgury, i would do permanent damage. i did anyway. was diagnosed with rsd a few months after that in 2005. recently, i am getting pain in both my arms/elbows. i had this pain after my last surgury but recently it has gotten much worse, can barly use my left arm and i am lefty.. the pain is horrible weather i do anything or not. i am so against the meds but we will c what the pm doc says, never tried trigger point injections so i guess i will give that a try. i'm too dam young for this...the pain in my neck is aweful and pain in my right shoulder blade area. since the 05 surgury, i have numbness from my elbow to my finger tips and constant burning pain, feels like my hands r always on a hot stove. this sucks. hard to explain to my hubby and kids but they handle it very well and help me when needed. thank you for ur response, i will let u know how i make out with the pm, apt is may 19th. would rather c a nerologist but we will c...

Old 05-21-2011, 11:46 AM   #4
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Re: myofascial pain syndrome or fibromyalgia??

while i do have some good info for you, i am unfortuently running out of time here.but wiull be back. but i wanted to know just how your doc came up with the actual RSD Dx? did he do the standard sympathetic block, or what you would have to have done when the suspected RSD is simply in the upper torso/arms/hands as a 'stellatate ganglion block"? this seriously IS one of the few more definitive ways of even telling if anyones pain is just being symp generated like RSD also is. i have RSD in my R knee on down thru my foot. its the MOST hellish and insane level of deep burn i have ever felt in my life, but unfortunetly only one part of what is RSD.

what specific symptoms are you having right now and in what areas? and what IS brand new since this last surgery and what is still there from before it? so you did NOT actually have ANY ulnar nerve involvement PRE op only after?(the ulnar crease is that area in the elbow that you were describing? it would also involve the last two fingers on that hand too). just the many fusions you have had done esp down in that c 7-8 area, 'could have stimulated the symp chain since it does start up showing itself then down that spinal column right AT the c 8(ulnar) nerve level too. this is the exact area of my symp damage from cord surgery where they inadvertantly HIT my symp chain somehow.

what NC mentioned about that sick 'domino effect' upon all the other verts and discs post fusion IS unfortuently VERY real and true, and it sucks. i am dealing with MY current domino right now too.

just how severely was that c 7 and i am assuming here it would have also had to have been either c 6 or T 1 with it, only becasue that c 8 nerve does NOT actually even have its own vertebrae at all. its kind of a "free nerve" in there? so any disc that was pushing into your cord would have had to have been the 6 or that T 1 along with of course c 7. but that IS the junction area(c 8 T1), so ending up with either RSD OR, depending upon just exactly where and how much real impact was being done to your cord, it could be another really sick pain syndrome that you can get when only a specific spinal 'tract' becomes damaged or impacted called 'central pain syndrome' which i also ended up with from that sick spinal cord surgery too. BOTH are really horrid noxious suckers to live with. but RSD has a deeper level of what feels like both very hot burn and also a 'cold burn' too. with hypersensitivity to touch as well. but central also has that hyper to touch crap but THAT actual pain is like what you would feel after suffering a very severe second degree burn times like ten, that is ALWAYS there, non stop 24/7 that stings and stings like all get out constantly. but VERY much more feels like it just is 'your skin'? not in it, or under it, but more "into it"(surfacey?), its just 'your skin'. its a really insane one to try and describe.

if there is any way you could type out that esp critical finding on the MRI(the whole MRI would be even better just based upon the "wording' and specific phrasing the radiologists tend to use while doing interpretations of films) that describes your actual cord level impact/severity, that would REALLY help alot. depending upon just how far THAT went in there and for how long, and esp if that report mentions the word 'myelomalacia" ANYWHERE within that area or any other area of your cord would really show very hard direct impact on it to the degree of actual cord damage.

what you are describing here seriously sounds to me anyways WAYYY above any level of what just IS myofascial pain OR fibro alone for that matter(this simply DOES sound like alot of spinal impact, esp being bilateral and burning and impacting your c 8/ulnar to the degree it is?). since you do have hardware up there, getting even a good contrasted CT right now would be what i would do. you NEED to be able to actually 'see' into the area that blurrs the most upon doing ANY type of MRI. this is how MY insanity with a completle vertical turn(no actual screw bending, the full screws turned up)from horizontal change/shift in my 2 c 6 screws going up into my c 5 disc from below was just discovered about a month ago, totally did NOT see THAT one a comin. none of that showed up on my recent MRI at all. it just cannot even see in there at all really. and the more hardware you even have at all, the worse the overall pics just are too. a CT could reveal exactly what is possibly even impinging your c 8 too(have they even done an EMG on at least the worst side just to actually find the true area where this is being impinged?). hardware CAN shift(and also 'onto' things like nerve), trust me. my plate and screws were added back in 02 after it was found post op nine months that i had only fused one endplate after the original ACDF on c 6-7. this just 'could' be a possible part of YOUR problem, hardware shifting too. CT simply shows hardware and bone and where your spinal cord is in relation with the slice pics soo very clerar that you can even see the swirls on the flippin screws. i was just dumbfounded when i read my own report. and that CD? wow, that was a trip to see.

right now i would push for a contrasted CT and if you have not yet even had that stellate ganglion injection, mention THAT to your doc too(he can refer you to a good anesthesiologist. you just really DO need this much more that the TP inj right now). that inj IS just a very good way to help narrow down DX of RSD AND also, if this IS RSD and sympathetically generated pain, it also can bring your overall burn hell down too. i use these regularly just for help with pain control now too, among other things. i really hope someone can figure out what just IS torturing you like this, and soon hon. 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 05-21-2011, 01:45 PM   #5
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Re: myofascial pain syndrome or fibromyalgia??

What areas were your other cervical fusions? Did they use donor or your own bone? Were they all Anterior? Just curious as to why you needed 4 surgeries and what they did in each of them..

I would first go back to a Neurosurgeon which I assume did your surgeries...and if you liked the one that did your last it sounds like if you are having specific problems in the hand and elbow...then it is a cervical issue...I have had 3 fusions myself...

A Pain Management DR. will provide injections, medicine, and/or acupuncture, PT, etc...It sounds like you do not want to try any other medicine?

A PM will not be able to diagnose you for your issues...

It doesn't sound like Fibromyalgia as that is through the entire body at specific points...this seems likely to be cervical related as Feelbad much can happen with that many fusions..

And yes...RSD/CRPS can certainly happen as well with that much trauma done from the surgeries...

What type of Dr. is prescribing the medicine you are on now?

Just also know that a new PM will want to try different things as you will be a 'new' patient to hopefully you have your medical records in hand..or being sent from your Dr. to show what has worked and hasn't worked...

When was your last MRI?

Unfortunately our life with CP has many ups/downs and especially with that many fusions...there can be life long problems that come from it...I wish you luck and keep us posted..

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