One of my patients kept a pain diary for seven years to document his ordeal. Doctor after doctor failed to diagnose or explain his pain to him, much less find him an effective treatment. His persistence paid off in the end, finding therapies that helped lower his pain and keep him sane until he ultimately stumbled upon The Trigger Point Therapy Workbook by Claire and Amber Davies, which led him to understand what his pain really was and then to search me out.
Myofascial Pain and Treatment: My Story
I am approaching the
eighth anniversary of My Ordeal as I call this experience, which
began as a feeling of slight numbness and tingling, and became
progressively worse, and developed increasing, constant pain.
In the beginning, the
many doctors I went to could not diagnose the pain, which I now know
is myofascial, caused by a muscle knot. I had never had
anything like this before in my life. I sought out both physical and
non-physical alternative treatments. It is my desire that what you
read is both informative and inspiring.
I experienced vertigo at
work in February of 2009 that sent me to the George Washington
Hospital Emergency Room. The diagnosis was benign positional vertigo,
and there was no recurrence.
However, I soon after
developed a burning sensation in my entire left leg, left hip area,
and left rib cage area just under my arm pit. I was referred to a
neurologist and had an MRI of my brain and neck with contrast. She
was not able to find a cause for the burning or vertigo, and
prescribed the drug Neurontin (used for seizures) which I did not
fill right away. There was a breakdown of communication as I was not
assertive enough to press about the cause of my condition when the
Neurologist did not seem to have an explanation. My neurologist then
ordered a pelvic and lumbar MRI and a motor nerve conduction test,
which indicated that I had about 50 percent of sensation in my left
leg versus my normal right leg. Additional blood tests were normal
except for a lower level of B12. I stopped seeing the neurologist
With the burning
sensation being constant 24 hours per day, with the only relief being
during sleep, I decided to try acupuncture. I has 11 visits from May
2 to August 22 that did not solve the issue either.
My discomfort level
during between March and October 2009 varied from 5 to 8.
I couldn't do anything
to decrease the burning sensation other than to avoid strenuous
physical exercise - my jogging workout - which I continued to perform
during the first 6 to 7 months of this ordeal. The discomfort level
stayed near constant during the first seven months. It became a
nearly unbearable 7 to 8 by that August. I called my neurologist to
see if she had any diagnosis yet. The only thing she mentioned was
that there was a slight disk hernia in the L5 area of my spine. I
then tried taking the Neurontin for about a week, but I did not see
any results or lessening of the discomfort so I discontinued use.
is an unpleasant sensory and emotional experience associated with
actual or potential tissue damage, or described in terms of such
damage. It is the feeling common to such experiences as stubbing a
toe, burning a finger, putting iodine on a cut, or bumping the funny
bone. I do not like to classify my sensation as pain, but more as
discomfort. I guess that they are one and the same, but I prefer to
think of it as discomfort.
The main area the
discomfort was in was my entire left leg from toes to hip, with the
main concentration in the left hamstring and thigh area. I describe
it as a burning sensation since it was constant: 24 hours a day, and
very steady. I kept a daily pain diary about this during my visits
to various doctors during that calendar year. The sensations
included burning, hitting the nerve in your funny bone, and that
feeling you get when you sleep on a body part for a while and lose
sensation, and then get tingling while the sensation returns. They
could also be described as as having a muscle rub such as Ben Gay all
over the leg and then having a heating pad on top of that, or a small
ball of fire inside my left thigh/hamstring area.
I observed that the
intensity seemed to spike when I performed vigorous physical exercise
such as jogging or swimming. It was like having an electronic ankle
bracelet that increased the pain, as though punishing me for
exercising. It wasn't life-threatening, but it was
By September I was
feeling desperate. The possible disk herniation sent me in search of
a rehabilitation clinic, hoping that physical therapy and traction
The physical therapist
evaluated me with range of motion and reflex tests. Everything was
fine. She looked at MRI films suggested traction for the slight
bulge of the L5 disk. I had some relief but after two more weeks
nothing much changed and the PT decided the pain was caused by a
pinched nerve and not a herniated disk.
I then began my visits
to the Virginia Spine Institute where I was also prescribed Naproxen
and Neurontin and had further MRIs ordered. After staying on the two
drugs for a month and then returning to the Rehabilitation Clinic for
six more weeks of physical therapy the burning sensation did not go
away, but was more tolerable at a 2.5 to 3, the best since the
previous March. During that six weeks at the PT Clinic, I did lumbar
stabilization exercises, received ice, heat, TENS, ultrasound and
massage. Although this seemed like a good approach, it did not solve
The doctor at VSI
performed a spinal injection in October 2009, thinking perhaps the
nerve bundle around the tailbone was inflamed and that a steroid
injection might work. Unfortunately this did not provide any relief
and finally the doctor at VSI told me after several visits somewhere
in mid-November 2009 that he did not know the cause and had no
The final doctor I saw
in 2009 was a neurologist recommended by the VSI. I told gave him
the entire story including all paperwork MRI films. He prescribed
the drug Lyrica and ordered another extensive blood test (five or six
more vials of blood and I will state here that I do not like
needles). Again they were normal except for a slightly lower
level of B12; I pressed him for a diagnosis and some answers as to
what I had. He said that he did not know and was doing all he could,
and tried prescribing the drug Nortriptyline. I took this for about
a month until mid-January 2010 and then stopped. I was very
disappointed canceled further appointments.
I was out of leave and
did not want to take off more work in attempts to figure this out.
Over the next several
months, my doctors tried me on Cyclobenzaprine, Tramadol, and
Tylenol w/Codeine,, with very limited results, nothing lasting.
In July of 2010, my
mother found a Reiki healer, a spiritual approach I was willing to
try since Western medicine had been unable to find a source for the
problem or provide any measure of relief. After receiving a Reiki
treatment that did a lot of good, I decided to become a student and
learn more about Reiki as a self-healing practice.
Over the subsequent six years I
continued to both study and receive Reiki, and my pain level
gradually dropped from 7 and 8 down to 1 and 2 by the summer of 2016.
I then began to learn
more about myofascial pain and its causes from two books purchased on
line, “Trigger Point Therapy for Myofascial Pain” and “The
Trigger Point Therapy Workbook.”
It turned out that I
what I had been experiencing was myofascial pain caused by a muscle
knot called a trigger point, which is a very contracted part of the
muscle that causes spikes in my level of pain. Pain gets the
flare-ups when you further contract a muscle that is already tight.
Now that I knew more
about my condition, and wanting to get rid of the residual pain, I
found a myofascial trigger point specialist named Michele Macomber
who operates Myofascial Trigger Point Therapy of Maryland from her home office. I began treatment with her in
June of 2016. She studied my posture and the condition of my
upper left leg muscles and began to work on releasing all the residual
trigger points or knots in the area. She also prescribed several therapeutic leg
stretches and introduced me to some helpful self-treatment tools that I began to use
and will continue to use. After my first treatment my pain level
became a 0.5. Within a couple of weeks I was describing it as 0.1.
As of the writing of this paper the pain level CONTINUES TO GET LOWER
AND LOWER. I know the discomfort is there, however it does not limit
my movement or exercise in any way. I am not sure if the pain will
completely disappear however I do think that it will continue to
diminish over time as I continue to use the tools, do the stretches
and get treatment from Michele.