Paraspinal trigger point injections

[JKD]

I have been combating back pain since I was 17. I injured my black playing hockey when I was 17, I fractured a vertebrae in my lower back and and herniated disk l4 and l5. I went about 9 years without any major pain but over the summer I f**ed it up lifting an air condtioner out of a car. I kept lifting through the pain and continued my martial arts. I have been seeing a chiropractor for the last 2 months to help cope with the pain. I am getting to the point where if I work out hard I can barely walk for about 2 weeks - i am in a shitty posistion.

So, my chiropractor gave me a referal to see a neorosurgion to get paraspinal trigger point injections. They inject cortizone and some other type of pain masking agents. I would love to be free from the pain but i am worried about getting a false sense of security and injuring my even worse. Has anyone had this type of procedure done? Anyone have surgeory? How old where you and what was the result. Your insight is appreciated. I am in so much f**ing pain right now I feel like eating a whole bottle of vicoden.

 

[Zyglamail]

If it were me I would run as fast as I can from a cortisone injection until you have tried all other methods. Cortisone has proven to cause long term damage and it actually prevents the body from healing itself, however it does releive the pain. The choice is yours, you can put up with a little discomfort and get the problem fixed, or you can get cortisone and deal with the symptoms but never get the problem fixed. Do yourself a favor and check into prolotherapy (get more info at prolonews.com) you will be glad you did.

The reason yo

 

[JKD]

Zyglamail - I have heard that codizone can actually heal injuries - but I haven't actually done the research - its just what my doc told me. Its not just a little discomfort - I am 26 and some days I can barely walk upstairs and get out of bed. I have always been an athlete and I cant not be competitive - It would kill me. I really don't have many options - surgeroy is really the only alternative - which has a lot of drawbacks. I do think that masking the pain is not a good Idea. By masking the pain i could end up worse off. I am to young for this shit.

Anyone have surgeroy on there back here? What were the results are you still able to do athletics?

 

[Zyglamail]

The pain is largely caused by inflamation which is due to strained tendons/ligiments supporting the spine. This inflamation is what triggers a healing response by our bodies. Cortisone, nsaids etc will all reduce inflamation and prevent healing. No healing means you are more susceptable to future inuries/ Prolotherapy WILL thicken and strengthen the tendons and ligiments that are damaged so that you can resume doing all the things you enjoy doing. At this point I simply do not beleive surgery is your only option, because surgery will NOT fix the injured tendons/ligiments and therefor joint laxity will still be a problem. You need to get the laxity fixed if you want to resume a normal life style. If you are in the fence and surgery is what you feel the only hope, do yourself a favor and see a prolo doc as soon as you can for a consultation. He may say sugery is the way to go(not likely) but if thats not the case you can start getting better NOW. At this point, what do you have to lose by seeing one more doc?

 

[Zyglamail]

By the way, if your Doc is so convinced cortizone actually heals, then tell him to show you some abstracts on the issue.

 

[JKD]

zyg - did you ever have a similiar injury? Whats a prolo doctor? I am willing to try anything. On of the issues with my back is that when my disk ruptured - there was a lot of fluid that leeked out of the disk and now my vertebrea are vary close together in that area. Because of the degeneration my ciatic nerve is being pinched. I have been in traction the last 2 months with little success. The only solution might be to just do nothing - no athletics of any kind and let it heal. That would be hard for me to do.

 

[Zyglamail]

zyg - did you ever have a similiar injury? Whats a prolo doctor? I am willing to try anything. On of the issues with my back is that when my disk ruptured - there was a lot of fluid that leeked out of the disk and now my vertebrea are vary close together in that area. Because of the degeneration my ciatic nerve is being pinched. I have been in traction the last 2 months with little success. The only solution might be to just do nothing - no athletics of any kind and let it heal. That would be hard for me to do.

Ive had prolo done successfully on one elbow and one shoulder. How I am getting nagging injuries to my middle back, foot and other elbow treated.

As for your unjury the initial compaction not only compressed vertibrea, but also strentched tendons/ligiments. If it didnt your disk would not be bulging(and in turn rupturing). Bulging disks should heal on their own if the spine is in proper alignment. If your isnt the problem will be ongoing until the tendon/ligiment laxity(which allows the spine to arch and bones to not sit properly) is fixed, at which time the body will take care of the disk.

Take some time and goto the link I posted above there are a lot of articles that will apply to you. There is also a link on the page that lists docs by state, see if you can find one in your area and if nothing else just give them a call. Most are more than happy to talk to you.

 

[JKD]

bump for so more insight.

zyg - I checked out the sight - sounds like I may have some hope other than downing a bottle of pain killers

 

[Zyglamail]

bump for so more insight.

zyg - I checked out the sight - sounds like I may have some hope other than downing a bottle of pain killers

Good to hear you checked it out, its a solid tratment, one that is so often overlooked because simply put, its too simple. The big HMO's and stuff cant make a lot of money on it etc. The procedure is very fast and you will know right then and there if the extent of your laxities. Regardless of what many think, cartiledge can regrow if everything is stabalized and the forces that destroyed it are no longer in place. The effects of surgery are irriversable. Anything is possible so prolo may not work for you but if it doesnt your no worse for wear than before you started. If surgery doesnt work, which often times it doesnt(ie because it doesnt fix the joint laxity, simply cuts out the bulge etc which is a symptom of the real problem and not the underlying problem) you have often times done more damage than good.

Like I said even if you dont see a doc, at least call one and explaine your situation. After having prolo myself Im sure it will aleviate at least a significant amount of your pain.

 

[deanosig]

triggers and prolo

I have had both trigger point injections and prolotherapy.
Usually a physiatrists (physical rehab doctor) does the injections.
If it is muscle you do trigger points, which lidocaine is used to numb the tissues. It is the needling of the tight sacomeres that
releases the muscle with muscle twitchs when the needle hits the trigger point. Prolo is when a solution of lidocaine and glucose is
injected around the ligaments and tendons. It is faking an injury
and your body will lay down mast cells which convert to what ever tissue your bodys wants. It has no cortisone it at all. I would
really question a physicians training if he did use cortisone. Some
general practitioners and some rhumetoligists have some training
in trigger point injections. There are web sites that have doctors who do trigger point therapy. Also see chronic myofascial pain
syndrome. Also there are some web sites that list physicians in which state or province you live. Some chinese medical doctors
are trained on how to break up trigger points with accupuncture
needles. Not the same as just putting accupuncture in the tissue and just leaving then. You have to inject around the area by fanning the needle in all directions. If you have a good book store
lokk under fibromyalgia, a close cousin to chronic myofascial pain.

Good luck

 

[DocTodd]

I do trigger point injections and prolo. Cortisone isnt always used for tpi's. And we use bupivacaine instead of lido cuz it is a longer acting local anesthetic.

First off, your primary pain generator is probably the disc. Its leakage causes a chemical inflammation which irritates the nerves. I dont think this is your main problem right now. Second, in your case, this is an acute injury that you keep aggravating cuz of your lifting. The disc can cause muscle spasm also, but it really doesnt matter what came first, the disc or the muscle. Soft tissue can take 3-12 months to heal, but it wont heal right if you keep straining/tearing it, and eventually your muscle will be replaced with scar tissue, which will never heal. We only use cortisone injections in people who have had pain for a long time, not acutely.

This is a complicated subject, but the short version is that the body's inflammatory reaction isnt always a good thing, such as in rheumatoid arthritis, lupus, and other autoimmune diseases. Prolo will work for certain things, but i find that it works best where the body doesnt have adequate circulation in the first place and stimulating it accelerates healing. The SI joint is a good example. Muscles arent a good place for prolo IMHO, but every patient is different. If other proven things dont work then we try something else.

Hey Zyg, how about showing me your favorite abstracts on prolotherapy?

T

 

[deanosig]

Dr. Todd you said you may inject into someone who has pain for a long time (cortisone). Is that into the disc or into the muscle. All the books which talk about trigger points say not to inject cortisone (Travell and Simons trigger point manuals). Are you physiatrist or a general practioner who has trained in prolo and trigger point injections?

 

[Zyglamail]

DocTodd, good to see some other people who have actually heard of prolo. It surely isnt a cure all, but it never hurts to get a prolo's perspective. Far too often today I hear about people, young people, going under the knife and then continue to have pain and never quite be the same. I just wish more people would seek out some of these alternatives more often than they do and maybe someday we can get back to the basics and things that work at treating the underlying problem instead of the symptoms. You seem to be a practitioner who is willing to explore some options instead of being adamant that the one narrow field of knowledge is the only way. I will have to see what I can come up with for abstracts etc, prolo as well as the other simpler solutions, in my opinion, dont get near enough publicity.

 

[DocTodd]

Im a physiatrist doing a fellowship in interventional pain management.

Ill be looking up something on monday concerning prolo too. Long story short, i always send young people to physical therapy. If and when i do use triamcinolone, i use a 1% solution mixed with bupivacaine, which is longer acting than lidocaine. So it is a very small concentration.

Careful how you define trigger points and tender points and muscle spasm in people. They are 3 different things and they arent always treated the same. But suffice it to say that trigger points can be treated with dry needling and no medicine, but i usually use a little bit of 1% solution.

You can inject into a disc or a muscle or a ligament. The diagnosis is made in person with or without an MRI and each one has different clues. Disc injections are techincally more difficult and have more risk since the spinal cord is right there. I do all of those.

T

 

[browndog1]

Why not try alternative methods first? (ie - manual chiropractic adjustments, interferential therapy, etc).

...bd

 

[visions]

Im a physiatrist doing a fellowship in interventional pain management.

i always send young people to physical therapy.
T

This method has been kind of frustrating to me cause I have no seen a few Dr's and I feel like they're all tryin to get rid of me as soon as possible because my nagging injuries are not specific but I have some major concerns that I feel really need to be addressed instead of going to physical therapy where the assesments are almost like a crapshoot, I have severe pain in my shoulder, my thumb and moderate pain in my knees, oh and a diagnosis as an enflamed it band, and then at physical therapy they give me a generic stretching program of which half the stretches I can't even get into.

Don't mean to sound like a whiner even though I am doing just that, just wondering if you had any suggestions as to how I should go about seeking out the help that I need for the numerous concerns that I have, played college football I'm not a 25 year old personal trainer that stays very active.

Thanks!

 

[triggerfinger]

I have nerve inflamation c4,c5,c6

I went to an ortho and they gave me an epidural injection. I assume it was some kind of steroidal anti-inflammatory. I am going back to see the doc in a few weeks and will ask more questions.

I am not 100% but much of the pain is gone.
ZYG,Doc Todd
What do you think about my injection?

I had the same thing done about a year ago. I was living on vic for 6 months prior to the inj and seeing chiros and PT's. I was fine until about 1 month ago.

I am looking for a more permenat solution. I am right handed and the right side of my body is visibly smaller than the left and is also weaker. I would live to get this fixed and get back to my life.

Last question - Can being on cycle efffect the reults of the injection

 

[satchboogie]

wish you the best bro.

bump!!!