I definitely think that being up and about or sitting for too long causes my worst pain. If I am sitting for awhile (even just for 10-15 minutes) I can literally feel my muscles tightening up and of course the pains that come with that.
Since the trigger points all over hurt and not just where your doctor worked, I would think that your flare ups are more from your big day Saturday than from the treatment.
For me, when I feel the trigger points all over start to hurt, I get the most relief from taking a hot bath and laying flat.
I feel like what you are feeling now is like what I was feeling in early January. I had gotten to the point where the trigger points literally took over my entire body, even up my whole neck and jaw. Up until then I was working full time and was absolutely miserable and depressed, The last 2 months of work before that was absolute torture and I just continued to get worse and worse. Since early January, I have been getting dry needling treatment 3x a week. I am currently on sick leave from work and am very fortunate to have someone that is taking care of me and driving me to and from all my appointments. It has been a very painful, tearful 2 months of ups and downs but I am finally starting to get a lot better. About a week and a half ago I really started to turn a corner. Pretty much all trigger points have stated to decrease in size and the pain has gotten a lot better. I really think that I am getting close to a recovery. I need to continue to work on the remaining trigger points and get my strength back. Dry needling 3x a week is a HUGE commitment - mentally, physically, money wise, and on your family, but I truly believe that it works. I think the combination of being fortunate enough to not have to work, get intensive treatment, and a supportive family, have helped me along the way to a full recovery. I would really recommend this treatment to someone with widespread myofascial pain.
Sorry for the little rant.. From my experience with flare ups, my best advise is to do whatever you can to lay down and rest when you start to feel your trigger points flare. I also have been drinking Whey protein shakes to help with muscle repair, taking Cymbalta, multivitamins, getting a weekly deep tissue massage, and really taking it easy - resting whenever my body tells me to.
I hope this helps and that you are feeling better than when you wrote this earlier!

Here are the things that have opened me up to flare ups. The first and the most painful is stretching or over using a muscle that has an active (active = referring pain to another place) TrP. This "sin" has sometimes caused what I call a cascade effect; it spawns or reactivates multiple TrPs. I've learned that if the TrP is referring pain, then the muscle it is in should be "babied."

The second gotcha for me is stress or anxiety. I react to these things by unconsciously tensing a whole bunch of muscles. If it goes on for very long TrPs in those muscles will flair up or in some cases reappear. My last incident with this came when taking a 3 day drive through 4 states in Mexico that have bad cartel problems. That woke up several of the little buggers.

The third and final cause in my case is one of getting lazy. Though I am back to living a pretty normal life, I still have several muscles that have to be massaged 2 or 3 times a day. If I fail to do this simple duty, I pay.

I think you are wise in soliciting input from the group. It will be interesting to see what the full inventory of causes will be.

one of my practitioners i respect used to say to me, "Think about what you did yesterday to figure out the pain you're having today." that has proven to be very true over time.

Well the pain level is almost down to what I, unfortunately, have come to call normal. It might have been the activity that caused it. (Maybe the first flare up of myofascial pain caused by lasagna!)

I can't help but think it might be the structural work that was done on me to straighten out my alignment that caused it too. I say that because the muscles between my hip and ribs on my left side (the crunched side) is really sore, but it isn't at all on the right. I put another Flector patch on the left side because I got more bruises there digging in to the quadratus lumborum muscle.

I have taken up my lying down stretching routine again. Even though it might not make much difference I find it comforting. I do worry about the exercise I do circling my arm about in each direction on each side. I'm afraid it might make trigger points in my shoulders worse.

"Myofascial Pain": it is great that you are getting so much better. I can only see the doctor who does injections once a month because he is so popular. And then we never get around to doing the injections. --and when you talk about resting for a flare up, do you mean like not leaving the house resting, or resting up between activities? Oh, and I might look into the whey protein shakes.

Glad that the pain is getting better.

By resting, I mean pretty much laying around the house resting. Up until the past couple days, since early January I have been getting treatments and resting. One, because I was extremely sore and in too much pain to do anything, and two, because I wanted to give my muscles a chance to heal and recover between treatments. I feel fortunate that I have been able to really take it easy because I think that this is one of the keys to why I am getting better. Recently, my neck has finally gotten a lot better which has allowed me to start walking for short periods of time (15 min) and start trying to sit for short periods of time. As soon as I feel my neck, back, ect. start to tighten up, I rest right away to make sure I don't aggravate it and revert back to how it was. I have also been doing light PT type exercises throughout.

Unfortunately, I learned yesterday that if I don't return to work asap, I will likely lose my job... It is so tough to deal with because I truly think I am on my way to a full recovery and that I just need some more time. I know that my body can not handle going back to work now and that if I go back, I will end up as bad as i was before. But on the other hand, losing my job means losing insurance, income, added stress of looking for a new job... really sucks!

MP, I am so sorry to hear that you might lose your job if you don't return to work right away. But I've learned that if you don't have your health, you don't have anything. Not only is it your number one asset, but it is number one by far. If you've made great strides in your recovery and you think that more time off work will help you recover even more, it might be worth it to choose your recovery plan. I definitely know how hard it is financially to not be working and missing the income and insurance--I quit work 10 months ago to try to figure out my health problems and try to treat them. I think that many people in my financial position would choose to take morphine round-the-clock and attempt to continue to work, and that is admirable to me, but I think the investment I'm making in dedicating more time to attempt to unwind all of my health problems, being able to lay down when I know I need to, and taking fewer, less-potent painkillers works for me, even though by time I've corrected most of my problems I'll probably be completely wiped out, financially. Tough decision, I know. I just feel that if I ever want to be back to near where I was healthwise, I have to be fully committed. And actually, I'm not quite sure I could work even on morphine (the sitting kills me, too).

Myofascia...
I had to make the decision about work many years ago with the other problem I have of ptsd. Occasionally I've tried to go back to work, but always it ended in disaster, including ending up with cmp. It's never been easy. This past few years is the first time I've had any financial comfort at all and that is through my husband and because I learned to live so meagerly. It's also the first time I've had medical insurance. But I still find myself using mostly alternative health care that is not covered by insurance.
I'm sorry you are being faced with this decision. It's really not fair. I hope you can find an answer to this dilemna that will provide for continued healing for you.

Chimerical,
I have been without trp's for over a month now. But still, I can overdo very easily. And that means anything...Get fatigued, too much stress, eating trashy, too much stimulation of any sort, and definitely too much physical activity.
When I was being treated for trigger points, I thought I just had them in my legs and hips. But after she started treating me, others began to show up and soon I had them all over my body. But it also wasn't long after that when they began to disappear from areas of my body and haven't come back. Eventually I was back down to the areas that were screaming the loudest in the beginning, and with correctional structural work, those disappeared.

Myofascia...,
I am sorry that you could lose your job if you don't return to work soon. Even though I never had to face this tough decision, because I had already stopped work when I developed cmp, my heart goes out to you. LisaLoo and Asunda had wise words. My little piece of advice is to listen to your body. You stated, "I know that my body can not handle going back to work now..." In my humble opinion, I think this is the answer that your body is giving you. I hope that you can figure out a way to live without going back to that job. My thoughts and prayers will be with you as you grapple with your decision.

Yes, pain sucks...truly sucks! I'm with me on that too :-)

Flare ups. Hmmm. No real wisdom but plenty of experience these days. Anything can cause a flare up, but some things more than others. Emotional stresses definately, so trying to control anxiety stress anger frustration and depression is a must. I'm still working on that one! The flip side is that positive emotions will help pain, so smiling, laughing, feeling chilled, relaxed and happy will always help. I'm still working on that one too. But giving yourself specific time everyday to relax is an essential part of managing pain.

Doing too much or doing the wrong thing is a big no-no. This doesn't mean doing nothing, because that makes things worse too! There's a fine line that can change day to day.

From what you describe any of those things could trigger a flare up on there own so all of them together was probably a bit of a triple whammy. The best bit of advice I can give you is to keep a chart of what's going on for a few weeks, listing your pain score against what you were doing that day and see if you can identify the triggers for you. It can be an interesting exercise and show you things you weren't expecting.

And, as someone who is a rubbish cook, well done for making a lasagna!

And, to Myofascial, so sorry about the work situation. I recently had to take 5 weeks off work because of the pain (and am now being penalised for taking too much time off sick, but that's another story) and it's amazing how quickly the pain begins to settle. I used to have a 3-day rule...when the pain and spasms were too bad I would stop everything for 3 days and it would settle down. Unfortunately I've had a major flare up and deterioration recently and I think I'm now on a 4-week rule, which is way depressing.

What you need is a plan. A plan for how you can work when you know deep down that it isn't what your body needs. Maybe start listing all the things at work that make it worse and then thinking about what you can do for each thing. Is there any way of phasing your return to work? Or change how you work? Try and hold on to the fact that it might not be as bad as you think, because the fear of it being bad might actually make it worse than it would have been.

I eventually made it back to work and have made alsorts of changes to how I work and it has helped a bit. And it's only a bit, but that little bit is keeping me at work when the alternative would be to be disciplined for having too much sick time and potentially being sacked.

Good luck and feel free to post any questions or queries as you head back to work. A problem shared can sometimes be a problem halved (or whatever the phrase is).

Thank you all so much for the encouragement and good advice. It is comforting to know that there are people who really understand what I am going through.
Before I made the decision to go on sick leave and start treatment, my life for the previous couple months consisted of work, physical therapy and laying on the couch with heating pads crying every night. My quality of life was not very good. I agree that if you don't have your health, it is hard to really enjoy and get the most out of life. If I tried to go back to work now, I would end up in the same situation. I want to get completely better (or close to it) before I go back to work so I can hang out with my husband/friends, cook dinner, go to the gym, ect. after work and not lay on the couch crying. I think I have my answer right there... I owe it to myself to do everything I can to get better, even if that means I may lose my job.
Pumpkin, thanks for the advice about making a list of things at work that make it worse. I am sorry about your work situation also. I hope that they become more understanding. Something that I did when I first took off, was I sent my boss an email explaining in detail what myofascial pain is and included links to credited websites. I wanted her to know that it is a true medical condition.

Wow, MP, I am sorry. The first thing I thought of too was changing your work situation, maybe working from home some days a week. But maybe that is not possible.

I assume that you are a relatively young person. After thinking about it awhile I would think that would be the deciding factor. If you can overcome this health problem it would make the next decades of your life so much better. It would be a shame to go through your prime years crippled by pain. From what you say I guess the job does not mean that much to you. Maybe there are things you can do from home.

This woman Laura Hillenbrand should be an inspiration to us all. Even though she suffers terribly from Chronic Fatigue syndrome she has produced two fabulous books.

Hi chimerical,
Thank you for your input. I am keeping my fingers crossed that I will have a miraculous recovery and be able to return soon! But regardless of that happening or not, it would not be worth it and it wouldn't be fair to myself to put myself through going back too soon.
I wouldn't wish this pain upon my worst enemy... When its bad, it truly keeps me from being able to function and totally sucks the fun out of everything... hence being home online on a Saturday night!

Everything I did hurt and not a day later, but right then! Hanging up something in my closet could set off a whole body full of pain and trigger points. I couldn't get a wedge between any activity and relief so I sorta gave up for a while looking for ways to help myself because nothing was helping. In the process of this I found a doc who does trigger point injections and accupuncture. I noticed the time between and activity and added pain wasn't as pronounced and healed faster. But still way too much pain! Fatiqued all the time. No life it seemed.
It has been a few months and I am doing better it seems.
I also started hot pool therapy and Klonopin which really sets the body to a less startled state.
So I never could relate what brougt on a flare because I was always in a flare. Now I think I could see what brought one on.