Wow, so sad nobody's active here - all providing Facecrook with more private data!

I am so sorry to hear of your situation e. Not familiar with refractory. My understanding is that posture does not cause herniated disks though. As a scientist myself, I find this guy's site refreshing since it is loaded with references to original research. If you haven't seen his site, well then as a trigger point sufferer it's time you did.

https://www.painscience.com/biblio/at-least-half-of-herniated-discs-spontaneously-de-herniate.html

https://www.painscience.com/articles/mri-and-x-ray-almost-useless-for-back-pain.php

You will note that the research provides little if any support for dry needling. Been there, done that.

I have been suffering from trigger point pain for 12 years. My problems are spelled out in Chapter 48 of Travell and Simmons - I have one of the most debilitating TPs there is in the upper back, right behind my heart, as well as other disabilities. My TPs trigger palpitations when they get really bad.

The only meds that work for me (the ones that have kept me from wanting to kill myself) are the opioids. I take oxycodone. Since my pain varies (it's always there but gets worse when I get up and am "vertical") I use the meds mostly during the afternoon and evening. I also cut them up into quarters and titrate the amount throughout the day. I take 1/4 to 1/2 pill every 2 hours during the night and this has helped me sleep for the first time in many years! In this way, they continue to work to help with the worst pain, even though I've developed a tolerance. I don't have a problem with constipation because the pain was causing really bad dirrahea, so now my constitution is normal also!

Is all or your worst pain in the neck area? There must be some way to disconnect the nerves in that area. Or have you tried a morphine pump there?

DO NOT allow yourself to suffer. You are a human being, a talented, educated one with a lot to offer, especially to your family. Don't give up. Find a primary doc who cares and gets it.

Best to you my friend.

Thanks a ton @Gonga for sharing resourceful scientific info & your encouragement.
I fell sorry for the ordeal you are facing.

Well my pain saga started with disc issues with years back with neck and Rt upper limb pain.
But now I have full blown MPS.
Have widespread pain with trigger points all over neck, shoulder, upper lower back Rt pectoral region deep ache in my thigh and calf muscles as well.
In addition taut bands mainly in side of my chest.
Its very crippling. Have major sleep issues anxiety & depression. Pain physicians have made a diagnosis of MPS.
I am on Tapentadol, an opioid class. I take it every 4 hours. This one helps to an extent, in addition antidepressants and sleep aids.. All said and done at times its just unbearable.
Have not tried morphine pump , it's very difficult to get one in our country.
Of late I get thought of pulling the plug!
Do we have to be on these high grade opiods for rest of our lives??
Every aspect of life is affected.
Its just been pain and suffering from 4+yrs.
Please suggest any other combating modalities to deal with this.

I haven't given up totally , I take your advice to be STRONG and face it.
Being a doc myself it's hard to drive into the messed up brain.

Please be in touch-let's share and be of support.

Best to you as well.
Awaiting for your response.
Do. Take care my friend.

So your pain is very widespread like mine. My TPs are all over my entire back, with some in my hips which interrupt sleep often. I am fortunate though in that though my pain never goes away, it is not constant in magnitude. It is worse after I get up and continues to worsen until I lie down again. But because of this I can take less meds during the night and none throughout the morning. Then when the pain becomes severe I take the meds in the afternoon and evening, and they continue to be effective that way, because I am not taking a constant amount around the clock.

I find that McKenzie extensions actually help. The only way I can get at the worst ones in the thoracic multifidi is to lay on my back with my head and shoulders hanging off the bed, then slowly allow more and more of me to hang off, which stretches that area. Then I use a Thumper Mini Pro massager - it is not a vibrator it is a heavy percussion massager. This helps so much I don't know what I would do without it, because I cannot afford massage therapy (there is a local therapist who is very good with TPs). I do this while waiting for the Oxy to kick in in the early afternoon.

I also exercise, which is quite painful, but I find that it is worse over the long term if I don't. When I become very weak, the taught muscles really wreak havoc with my weak joints and my pain increases dramatically. I have gone to many physical therapists for various joint problems, so over the years I developed my own exercise program based on PT and the idea of PFROM (Pain Free Range of Motion), which basically says that when exercising, to do as much as you can without pain, gradually increasing the range of motion or even resistance to a small degree, until you can do the exercise. I use only very light hand weights, resistance bands and a ball. And I do lots of stuff like walking up and down stairs, and exercises that don't require any equipment.

I also find that moist heat is very good. I use large bags of microwavable beads. I wish people like us could have Jacuzzi tubs and massage every day.

I am lucky that I have things to occupy my mind. I do photography and play a bit of keyboards, though my playing is getting very painful due to Depuytrens Contracture in both hands. I think the playing actually makes the condition worse.

I hope anything I have said might help you.