You are in the early stages, so yes, you can get this under control. Even if you have had it much longer, like I have, you can get the pain and trigger points under control, but it takes a lot of work to find your path out. Believe me, I have been where you are as far as pain level and depression, and my diligence in finding a solution is finally paying off. Please don!'t give up. I can only tell you what has worked for me, but hopefully it will give you some ideas. First, you have to educate yourself to understand the reasons why you have TrPs in areas that you didn't think you had them. Devin Starlanyl's book is a good one and the one Pumpkin recommends. Also, The Trigger Point Therapy Workbook can be very informative and show you how to start working on yourself. I have TrPs in the areas that you mentioned in addition to my gluts, hamstrings, quads, etc..., but I have decreased my pain level from a 6 or 7 to a 2and sometimes 3. I only take medication occasionally. For me, it has taken a combination of the following modalities: osteopathic and later an Atlas Orthogonal Chiropractor to keep my bones in place ( I have a mild case of hypermobility), trigger point injections, trigger point manual therapy, myofascial release, and Restorative Yoga. I can not stress enough that you have to try different therapies, because what works for me may not work for you. Read Paulina's post. I have been going twice a week to a PT/ myofascial release therapist for over 2 years, and I was feeling a lot of improvement, but it wasn't until I added Restorative Yoga that my pain decreased significantly. I started it 7 weeks ago and noticed that I was improving after 5 weeks, so now I have private sessions 3 times a week instead of 2 and on the other days I do the stretches and poses on my own. I had to buy the items that my instructor uses but it has been worth every cent. I feel so relaxed and flexible after each session. Relaxation techniques were helpful to me, but yoga is the best I have found to reduce my anxiety and depression. I think it is because I am using my mind and my body at the same time. I still see my myofascial therapist twice a week and occasionally go in for TrP injections on some muscles that are stubborn and won 't release with therapy and yoga. You can find your way, but it takes a lot of patience and effort.

My best advice is to throw away your previous treatment plan and start from scratch again, now you're beginning to discover where your tigger points are.

It's very common in a case like yours involving at least poor ergonomics and overuse to have trigger points in pretty much all of your musculature. Not all will be as entrenched as the ones around your shoulder and where the more 'acute' pain is, but all your muscles will be involved in compensating for the original injury and the tight, contracted muscles around it. (there are cases where it's been so bad it's pulled joints out of their sockets!)

You may find it easier to expect to feel the trigger points everywhere you palpate. It's kind of like getting to know yourself all over again, feeling what the trigger points and contractions feel like, feeling where they are and what feels 'ok', normal, what pains and sensations occur when you press hard on the various trigger points. It's kinda scary when you first start to map your own trigger points and you realise quite how endemic they are. I've had areas where the overall spasms were so bad I couldn't feel the underlying trigger points and had to massage out the spasms before getting to the trigger points.

Always remember your mps took time to develop, and it will take time to release too. But you can get a significant improvement, you can get to a place where your pain is low and your movement near normal.

You mentioned poor ergonomics - it's essential that's resolved quickly somehow or else you will continue to injure yourself everytime you use the machines.

You also mentioned overuse. This is a tricky one, because mps-affected muscles, fascia, nerves, etc need rest, and lots and lots and lots and lots of it. Cold hard truth?? If you continue at the 'overuse' intensity you will continue to injure yourself. Paul Ingraham and saveyourself.ca talks about the 'art of rest' and how much rest is enough? And there's no answer, you just have to rest as long as it feels as acutely painful. I'm not suggesting not working but seriously consider reducing your hours for at least 3 months to relieve some of the pressure on your muscles.

A word about medication - it's important to get good pain relief, to get it under control, so that you can tolerate the treatment to reduce the trigger points. Sometimes you have to up the pills to get through something intense either at work or home and then it's got to be important to risk further injury by irritating your trigger points even more. Pain relief, including the injections, is rarely a good idea as a way to continue overworking.

The first priority is to ensure adequate pain relief and you really don't sound like you've got it yet. It's always a bit of trial and error working it out but you shouldn't be so bad you're almost crying in pain all the time, which is what's causing the misery and depression. I defy anyone to feel chirpy and positive when they have pain off the chart that's just unrelenting. It's impossible, and then of course some bright spark says 'you don't seem very happy at the moment'! It's hard to be nice and polite when answering.

For starters you may find it easier to pause the needling, injections and exercising until you get your pain under control. Your medication regime doesn't sound right. Ibuprofen and paracetamol - probably not helpful. Tramadol is a good choice as it helps relax the muscles too. I don't know what dose you're on but if you're in pain it needs to be increased, and at pain levels like yours we're talking at lease a 50% increase. There's a really good chart about what analgesics to take at what pain levels here: http://www.painclinic.org/aboutpain-analgesicflowchart.htm

In my case rather than tramadol I take dihydrocodeine at max dose, but I also take nortryptaline (antidepressant also used for nerve pain) as an extra pain pill plus baclofen as the muscle relaxant. My pills are split 4 times across the day. I also have valium for breakthrough pain but I try not to take too much. In my experience I would say it's more important to get the pain pill(s) right first rather than the muscle relaxant.

Again, cold hard truth....stop beating yourself up about extra psychological stressors and any impact on your career. You can't do anything about the 'mind' stuff whilst you're in the grip of such acute pain. Getting through the day is the important task and it's incredibly difficult when the pain is biting hard. Try if possible to 'park' that pain-depression on one side for a few days whilst you concentrate on pain relief.

Once you get a good pain coverage you'll be able to think about treatments and what to do next. Concentrate on the success stories, because many people find relief. In fact, I'm going to be as bold as to say the majority of people in this group find relief in some way which is why they don't come back. Most people have a relatively straight foreward case of mps that responds well to rest, treatment and making some changes to their lives. Sadly, there's a group of people who find their progress slower, much more complicated as other factors reveal themselves. Some people are biologically predisposed to get trigger points, and some people have very complicated reasons for the trigger points and mps - whatever the reason there's a small group of people who hit 'worse case scenario' (again quoting Paul Ingraham) and need a highly 'creative' and persistent approach to management!

You're not pathetic. You're in pain. It's very very different. It's ok to feel a little pathetic now and then, but not to beat yourself up and label yourself as pathetic. Pain really messes with the mind, especially when it's on a high day, and you get these little negative voices that come out and whisper horrible things about yourself. We all struggle with them at sometime or other.

You're not alone getting to grips with your mps. You can pop in here with questions, or just to vent your frustration and anger, a helping hand and lots of support.

Thank u katty2 & pumpkin31 for your valuable inputs..
I have started to begin the healing process afresh give it a re look and overhaul ..

I am undergoing am MRI of the cervical spine to look out for any worsening of IVDP , coz i have significant neurological deficits in addition to MPS..

as you have suggested , let me "park" my other issues and concentrate on pain relief first..

The links and inputs that you have given and shared are very informative indeed..
May be i will start working out with a new pain physician and tailor the regimen and take break from work.. and try healing up first .
My prob is cervical disc + MPS , thats adding more to the symptoms.
please keep me motivated and informed as you have always been

I don't think MPS is ever cured. I was diagnosed with this condition about 2 years ago now but had the symptoms for maybe 5/6 years now.

I've corrected a hormone deficiency, improved my diet, exercise regularly, tried numerous antidepressants for pain relief and recently started treatment for vitamin D deficiency .

MPS is a functional diagnosis and I think it is really it is a case of learning to live with it.

There are good and bad periods but nothing gives total relief. Psychological stressors make things a lot worse but they are not the underlying cause IMO.

I'm currently making an effort to eat more fruit and vegetables and lose weight to see if that helps some more. But the thing many people with MPS were fitter, stronger and healthier BEFORE the MPS kicked in an limited their activities.

The thing that does help me is taking my pain killers regularly (co-codamol aka tylenol 4 in the US?), getting rest when my body tells me to and pacing myself.

Hi estranged78,

I am so sorry for what you've had to go through! It's so tough having chronic pain! It can take you to dark places.

I have been fortunate to swing back from MPS. I think your ability to turn MPS around depends on how far advanced you are and whether or not you find the treatment that works for you. I had MPS for about 7 yrs and was able to reverse it with trigger point therapy and foam rolling.

I sure hope you can find something that works for you ASAP! Have you tried trigger point therapy?

Best of luck.

Good luck, keep at it.

Seriously, I was diagnosed with FMS and MPS in 2001.... trying to get them both under control has been a nightmare. Anything slightly antidepressant related (even flexeril and beta blockers) seems to make me worse, and a lot of them are common for the FMS. (Beta blocker was for blood pressure...)

Anyways, 3 months isn't long to be working on it. Once money ran out for massages I had to rely on the tennis ball techniques in that book mentioned above. I also have a shisatsu(?) Massage chair my father in law didn't like so he gave it to me.

So just keep at it and even once you think you're good it will probably act up again... so remember what worked. Best wishes...

HI guys , i could not post coz i was wasy in a naturopathy Hosp for 3 weeks , I learnt a lot there.
Basic Yoga , Relaxing techniques ,Physio & accupunture.
all was well till i was there , Now gradually the pain is creeping up..
i am on Prudent amounts of Tramadol and Synaptol a muscle relaxant .
stopped dry needling as of now
HOW are you guys doing , do share

regards

I just read about spray and stretch yesterday. I did not see anyone post on this, but Janet Travell used it and found it helpful. I went to a PT office 2 yrs ago and they had a cabinet full of the spray. I asked why they were not using it & was told that the spray was harmful to the environment. Since then someone did come up w/ a spray that was safer for the environment. I can't get a hold of the spray so I thought hard as to what could give the same reaction to the body. Once website mentioned the use of ice in a thin plastic bag. I didn't do that but maybe I will try it later. Instead we used Dust Off Electroniccs compressed-gas Duster. it's basically very cold hair and immediately after following the trigger point and it's pain referral with it one has to warm to area. I had my heating pad heated and ready for immediate use. I have to say that yesterday after doing this I had more range of movement on the parts treated. I feel tight mostly only on my left side. But after loosening up my left w/ the spray & stretch technique I noticed my right wanted attention. Funny. This is still experimental for me and I heard it works best on those who have not had trigger points that long, but it does sometimes work on those who have had it long. I think I'm going into 3 years. Could of had them longer, but wasn't symptomatic & aware of why I had aches & pains. I have a high tolerance for pain - so I have been told. Anyways, I had my husband spray me and we had to work out some kinks and I do have some mild skin irritation in some areas where we maybe were to close w/ the spray. You don't want to over stretch - it must be GENTLE to not activate the stretch reflex. This too I am learning. Another thing I find helpful is PNF stretching which is helpful for gaining ROM. I am new to posting here. I am afraid of groups like this cuz I believe those who do find relief abandon groups like this and those who are suffering may be here to complain & I can't be around negativity. I am a fighter and I am fighting this! I want to feel good again. I believe I can. It's just hard when the medical community is not set up to effectively treat this and insurance makes things hard. I am hopeful everyday that I will find relief. I will my best to share & be positive. :)

Welcome to the group, Rachy3. I don 't remember anyone posting about Spray and Stretch, so I am glad you mentioned it. About 10 years ago, I read about this technique in one of my books on myofascial pain and asked the osteopath who diagnosed me about it. He told me that he an other doctors had observed Janet Travell use it on a patient. After they left the treatment room, the doctors agreed that they would not choose this treatment if they had trigger points, because they could see that it caused the patient a lot of pain. This was before the spray cans were banned. I know one patient in Canada whose therapist used it on her chest pain and she said that it was like "being on a rack". Another therapist told me that she was trained to use it, but that she felt that myofascial release was a lot less painful and just as effective. With this information, I never pursued it further. I hope you will keep us posted as to your success with it.

I hope you will stay in our group and will find the posts mostly positive and informative. On the other hand, we are here to support anyone who is having a bad day and needs to vent. Sometimes a person feels so alone with this condition that it is helpful to know that others understand.

I believe that you will beat this too as it does take dedication and commitment to finding the modalities that work to relieve the pain. Please continue to share what works for you.

I forgot to mention that the person who had Spray and Stretch on her chest said that it did work for her and that she eventually became pain free.

Thanks Rachy & Katty .. for ur inputs
I am gonna try This Spary and stretch technique,looks promising.
also planning for a deep tissue massage regimen , may be once a week.
what i have endured and learnt so far is Dry needling , followed by stretching + moist heat or sauna + Right medication + good sleep +posture + relaxation are the key things to keep MPS under control

I have to say that I have never heard of spray and stretch and I have used s lot of different healing modalities over the 20 years I have had mps. I do not know if it can ever be cured or healed because it has not gone away for me however I have good days and bad days. I choose to believe that it can get better by how we treat ourselves and our attitude as well as negative self talk. Also taking the best care of yourself that you can make it better. Good luck everyone.

Does MPS ever go away??

I think about this sometimes, usually in the depths of misery with a flare up of some kind and are feeling pathetic, pitiful, and totally wallowing in my own misery feeling like it never ends and howling at the moon :)

All you can do is keep trying, that's for sure. If you don't those pesky little trigger points just have a happy old time multiplying and creating chaos and misery.

That's a bit of a rubbish point isn't it? Sorry about that...brain like mush...

But spray and stretch is a classic treatment from the original ''big red books'' by Travell and Simon's 'Myofascial pain and dysfunction' volumes 1 and 2 that underpins everything on myofascial pain and trigger points.

Do a simple search on 'spray and stretch' and you'll find lots of interesting information about it, including youtube videos.

It's not a widely advertised treatment, that would be myofascial release, and I'm not sure why...maybe it's because you have to have a really good knowledge of the individual muscles? Maybe that's too harsh, but it's certainly worth a go if you have a limited number of trigger points (if you've got lots all over the place I wonder where the therapist would start!!)