It sounds like you're doing most of the right things but haven't quite got the balance right, and the good news is you can rebalance and get back on track again. Although it may not surprise you that you may need to rethink that 'pain cave' idea.

The best advice I can give you in relation to work outs and trigger points is to purchase www.painscience.com and read about the science of trigger points, why you've been experiencing that sense that the trigger points are winning over your trigger point work, and what you can do about it all and still go to the gym.

Muscles with trigger points are weak and completely overstretched. Very weak, and don't cope well with strength work. That's the simple explanation. The good news is they do respond well to trigger point work although they never go away completely and will 'fire up' very quickly depending on what's happening.

The 'what's happening' are called 'perpetuating factors'; what makes them pop up in the first place and keeps them loud and painful. Reading through all about perpetuating factors should give you insight into your own case, as well as what else to do.

Section 5 in the ebook has a section (just for you) called 'How to take your trigger points to the gym (if you must)'!

You ask what you can do to help at home...stop the strength training until you've read up on strength training and trigger points and how and why they don't go together before reading how to keep strength training. Keep doing your trigger point work, use hot packs, hot baths and generally rest your muscles, because they should help bring relief too and that's about it in the short term.

Be wary of taking pain pills; there's nothing worse than having a growing problem with trigger points and using pain pills to 'mask' the pain so you can keep doing the activity(ies) that's been making the trigger points worse. However, if you are clear it's just to help during this first phase of treatment, then a mild analgesic such as ibuprofen can help 'dial down' the pain.

Muscles with trigger points seem to respond very well to different types of muscle work, tai chi / yoga / pilates to name a few. We've seen repeated cases of excellent results with all of these, plus there's the added benefit that each helps hugely with even severe anxiety. Most people start with 'remedial' work, one on one with the practitioner rather than taking part in general classes. (I always remember how big burly rugby players do these sorts of training as well as all the gym work - some even do ballet because it helps them get stronger!)

There's lots of views on supplements and other therapies to try and it's certainly worth it if it appeals. There's an excellent section in www.painscience.com about medical factors, including supplements, and trigger points. Just remember it's very very (too) easy to spend a lot of money on treatments and therapies that don't do a whole lot for you or whilst you try and find the right treatment or therapist. With a lot of the knowledge that painscience gives you you can make excellent progress without having to spend too much. That said I do recommend using comfrey oil to massage on your trigger points - it works wonders on my trigger points, helps 'treat' but don't 'cure' them (sadly!).

In other words, you already have most of the tools you'll need! Now that's a radical thought, isn't it?! We always seem to reach for 'something' or 'someone' to treat us but perhaps we reach out a little early, there's lots we can do before that stage.

Good luck and please come back with updates, questions or just for an expressive venting in frustration. We're a gentle welcoming group with a wealth of knowledge and support for you.

Sorry, I forgot to answer your question..."Does this sound like normal muscle tightness and pain from exercise, or do I get it worse?"

Simply put...no, it really doesn't sound like normal muscle tightness and pain from exercise. It sounds like you've got some nasty trigger points that are firing off each time you do the gym work and flare outwards developing satellite trigger points. I suspect you're someone who has strength and determination to succeed, and you're putting the work in but getting none of the rewards.

That tight feeling is the 'over tight' feeling from trigger points that are causing the muscles to contract more and more and don't relax in the normal way they would after a good workout.

It makes sense the lack of flexibility causes you anxiety. Again, you're doing the work and seeing the opposite result. It's not 'you', it's because of the trigger points and how they react to strength training. www.painscience.com has all the details about how and why it happens etc.

The good news is you can achieve that flexibility in other ways, especially those I mentioned - tai chi (and chi gung, not for the faint hearted!), yoga and pilates. Each will help build strength and flexibility and can help reduce the overall power of the trigger points.

There's a post a few few back about the success someone had with a physical therapy (welcomed relief) that may be worth reading.

It doesn't sound like normal muscle tightness, but that the trigger points are developing faster than you are deactivating them. I hope you will take Pumpkin's advice. Also, you might want to buy The Trigger Point Workbook by Claire Davies. If your TrPs continue to bother you, you could try seeing a manual trigger point therapist. Check out this website www.cbmtpt.org or www.bonnieprudden.com. I have found that therapists differ in ability, so if one isn't helpful, try another one. Look for one with a lot of experience and training. I also would suggest rethinking your exercise routine.

I've had very severe myofascial pain since I was in high school. For several years I was in pain 24/7 but was able to control it with trigger point massage. I use The Trigger Point Therapy Workbook Pumpkin mentioned.

A couple of other things that have really helped me are magnesium and vitamin D3. The meds you're on block magnesium from my research so you might google that to be sure. Magnesium is needed to relax the muscles. Now that I take high doses of magnesium, my day-to-day pain is very low. I still have the trigger points, but I'm not in any noticeable pain about 90% of the time. Low vitamin D is also associated with pain so have your levels checked.