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Unread 09-25-2004, 09:41 PM
trigger point injections

Hi there. Well, it's hard to believe, but I'm visiting this site again ... three years post op!

Like just about most visiting this site, I've got a LONG story, but won't share it tonight. I'm wondering if there's anyone out there who's had trigger point injections (abdominally or vaginally) with any success??

Also, anyone out there who has been diagnosed with a muscular/skeletal problems as the cause of their pain?

Turns out my sacroiliac joint has been out for quite some time. The "SI" joint is located in the pelvis. Essentially, my left hip is out of alignment. I have chronic pain that comes on with almost any activity ... standing, walking, even sitting at my desk for along periods.

Anyway, I'm hoping to find someone else out there who's maybe traveled this road?
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Unread 09-26-2004, 01:28 PM
trigger point injections

Oh ((((Kari))))) I'm so sorry you're dealing with all this pain I don't have any experience with trigger point injections, but just wanted to wish you the best of luck with this new therapy. I do hope that it brings the relief you so badly need

Please, do keep us posted.
Unread 09-27-2004, 08:37 AM
trigger point injections


I am very interested to see the replies you get to this post. I, too, am having back/hip/leg pain that seems to be originating in my SI joints. I am seeing a physiatrist for this and trigger point injections is something she has suggested might be a treatment option. At this point, I'd try just about anything as the pain is really getting the best of me. I had an MRI a week ago and will have a NCV/EMG done this Wed. We'll discuss treatment options further after that.

Good luck to you and do let us know how things work out.
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Unread 09-27-2004, 08:54 AM
trigger point injections

I also have SI issues. Manipulation will put literally "pop" the pelvis back in place for me, but it tends to not stay put. My doc suggested injections in the area of the joint, but I'm not sure this is the trigger point injections you were referring to. What was suggested to me involved injections into the hip which would cause some localized inflammation which would supposedly help the joint stay on place better. At this time I have opted to not pursue this option. I have gotten pretty good at either being able to pop the joint back in place myself (involves lieing on my back and hanging the opposite leg off of the bed - technique taught to me by a PT) and if that doesn't work then having my DH rotate my leg (bent knee) up and out a few times and the joint pops back into place. (DH took a manipulation class with the med students last fall, and my dr says to definitely put the man to work when I'm hurting)

Do you experience any muscle spasms due to your SI issues? When I'm really out of place I have pelvic floor dysfunction...
Unread 09-27-2004, 02:55 PM
trigger point injections

How did you find out that your SI joint was "out"? Was this dx by X-ray? MRI?

I only know that is where my pain is and that I can "pop" what seems to be my hip and the socket where my leg attaches. (Doesn't seem quite normal to me! ) I do get muscle spasms with the pain. In fact, the doc said I had 2 big fist sized knots right on my SI joints when she examined me. I am on Soma and Darvocet for now. The only preliminary report on my MRI was that I do have arthritis in my back. Keeping my fingers crossed that I get more info on Wed.
Unread 09-28-2004, 05:14 AM
trigger point injections

When my SI first shifted out it was from an injury of sorts and I was xrayed. But in truth a lot of doctors can tell its shifted just by feel, the pelvis rotates out of position a little. And since it is a joint, it should be able to move but when mine is shifted it "sticks" and won't allow movement. That causes me pain right at the joint and the more time that passes with the joint shifted the more intense the pain becomes, although I guess some folks may not have that problem. I also develop significant muscle spasms when the joint is shifted out of place, so its pretty easy for me to know when the joint is not quite in the right place.
Unread 09-28-2004, 09:20 AM
trigger point injections really have me thinking here! When I try to move my legs apart (abduct) it is like I have cement in my SI joints. There is very little mobility there and severe pain. Sometimes I have the same pain when walking, sitting, standing...whatever.... It often feels like continous counter-pressure (someone pushing just as hard as possible on that spot on my back) would help more than the pain killers or muscle relaxers. The Darvocet and Soma help most of the time, but I still have my days when NOTHING touches the pain. Besides, I don't want to be on these forever.

(((Kari))) I did not mean to take over on your post, I am just interested in this information too. It was my understanding that trigger point injections for this were given directly in the joint via the back. Were you told they would be given abdominally or vaginally????? What type of are you seeing for this problem?
Unread 09-28-2004, 07:13 PM
trigger point injections


I have alot of these problems you are describing in my pelvic, hips, and back. I found out I have a herniated disc and bulging disc. I tried the trigger point injections in my back with novicaine. It didnt work for me but I have heard it can work really well for some. I just went today and received 2 injections one in each hip for birsitis this had some steroids and novicaine in it. I am alittle sore but praying it helps. just to touch my pelvic bone and right below my hips in the meaty area hurts severe. I am on Lortab, muscle relaxers, and NSAIDS. I am to tired of taking pills. I have been thinking lately wonder if all of my previous problems have contributed to this. It seems like I get one thing fixed and then I have something else happen. I feel your frustration. My Physiatry doc said to start Yoga. Also I was in PT for a few months and if I do not stretch every day I pay for it. I am more uncomfortable sitting down. My disc problems are in an area to high and to risky for surgery. I am 32 and feel like I am 100 at times. Please keep in touch maybe we can all get through this together.
Unread 09-29-2004, 07:21 PM
Trigger point injections/SI joint

Wow, I'm thrilled that I've gotten to many responses to my post. First, thank you all for your kind wishes. I sincerly hope my experience can help in some way!!!!

And, I hope I can answer all of your questions here, but if I miss one, please let me know.

First, some brief background. I started having chronic pelvic pain about six years ago. Doc found ovarian cyst that later resolved itself but I still had pain, so I had a lap and they found endo. I didn't have it too extensivly, but was told it could certainly cause the pain I was having. I had several laps and then finally a hysterectomy (still have both ovaries). With every surgery, my pain got worse. AFter the hyst. the docs thought maybe I had lots of adhesions, so I had ANOTHER lap! The pain got even worse. When my pain first began in the very beginning it was more cyclical in nature but as time, and surgeries, went on, my pain became a daily struggle and it got worse the more active I was. Eventually, even walking up the stairs would cause severe pain. After A LOT of research and A LOT of doctors who couldn't help, I began to think the Endo diagnosis didn't make sense.
Finally, I began seeing a pelvic pain specialist at the University of Utah who specializes in trigger point injections and also works closely with a physical therapist to determine if women with pelvic pain might have a structural problem vs. something reproductive in nature. Aha! The doc had me lay down and lift my pelvis up and then lay flat with my legs extended. Low and behold, my right leg was about two inches longer than my left indicating a hip/pelvis problem. I saw the physical therapist who diagnosed me within minutes. My SI joint is out of place and my feet tilt in which causes a further alignment issues. I've been given some gentle exercises that I do to put my hip back in and have been doing them for about 4 weeks. I am REALLY starting to see the difference and am told my hip is almost stablized. However, I have all these nasty trigger point areas allover my abdoment and along my periformis muscles (butt). I also have some very tender spots internally on my vaginal cuff where there's an extensive scar from my hyst. Anyway, I just got back from my pelvis pain specialist who injected my abdomen in five places, my butt in three places and got one shot vaginally (it wasn't as bad as I was expecting ... not fun, but bearable). I am numb right now. The idea with trigger point injections is to retrain the nerves in those hypersensitive areas. In theory, when the injections (lidocaine and bovacaine) got into the muscle, they turn the nerves off termporarily. I have been in pain so long, the nerve pathways are worn down and according to my doc, pain travels the path of least resistence. It is also believed the injections help break up the tender, knotted area by flushing it out. It was also suggested by my phys. therapist that if my hip isn't fully stablized within the next month, I should have prolotherapy. I have done extensive research on this topic and I have read that many, many people receive a lot of relief through these injections. In fact, my phys. therapist gets them in her back for a herniated disk with great improvement. The prolotherapy injections cause an inflammatory response in the ligaments and causes them to tighten and regain their ability to provide support to the skeletal muscles. Whew! I know that's a lot of information. As I understand it, from my doc, he is one of very few who work alongside a phys. therapist and also one of very few who has studied the use of trigger point injections so extensivly. He was just telling me today that several years ago there was nothing on injecting the vaginal cuff so he did the research and got published etc... So, I feel blessed to have this doc.

Well, I suspect I've talked long enough. Please, please let me know if you have more questions and I'll keep you all posted on my progress. My phys. therapist thinks I will only need a couple more weeks before I'm stablized and I'm hopeful that tp injections will start to work soon.
Unread 09-30-2004, 05:19 AM
trigger point injections

Prolotherapy! That's the name that I couldn't remember for what they were suggesting for me! We had worked on trigger points with pressure to stop spasms, but it was prolotherapy that I saw the spine rehab dr about. I don't think its the right thing for me at this point, but the doc who has been treating me locally swears by it. The spinal rehab guy said that I would need to bring another driver with me for the injections because it could deaden my leg for a few hours. There would be a series of injections, every six weeks, for several months.

Like you, I had one short leg, and definite rotation of the one leg and the pelvis. I still certainly have days that are fairly painful, but as long as between DH and I we can manipulate the joint back in place I probably won't have the injections.

You mention piriformis muscle problems - are you also having sciatica? Has your pt tried u/s for the piriformis?

A rather personal question, have you found any particular activities that ALWAYS cause SI pain? For instance - I can't tolerate sitting on solid surfaces, lifting anything with any weight with just my right arm, certain positions with DH are definite no-no's. If I'm trying to get dressed in a hurry and I'm standing on one foot trying to slip the other into a pair of jeans that SI will shift dramatically, nice deep "crunch" sound and instant pain.

And to each of you - were you having SI issues before your surgery? Did you have any prolapse repairs? Some research leans toward relaxed vaginal fascia being related to relaxed tendons and ligaments in general. Just curious...

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