Trigger Point Injection Helps with Head Pain in Fibromyalgia: Injection Type Doesn't Matter

[Cort]

Headache is very common in fibromyalgia and chronic fatigue syndrome; in fact, a recent Brazilian study found it was present in 100% of the FM patients tested. Trigger points are common as well but are not always connected with headache. The recent Brazilian study suggested, however, that trigger point manipulation could help relieve FM patients headaches.

Trigger points are tender points found in tight, constricted bands of skeletal muscle which often have a "nodular" feel. Pressing on the trigger point for five seconds usually elicits significant pain found both inside and outside the trigger point area.

Thermal imaging indicates that the increased heat levels in the trigger points are surrounded by cooler areas. The cooler areas are probably caused by reduced blood flows.

[fright]

[/fright]Trigger points are different from the 18 tender points still sometimes used in FM diagnoses. While trigger point manipulation can be effective in reducing pain, manipulating tender points rarely produces results. One review indicated that treating tender points often has no effect while treating trigger points can be "dramatically effective". Trigger points are not synonymous with FM or ME/CFS but appear to be fairly common. Still, trigger point studies in FM are rare.

Trigger point manipulation has been found to be helpful. It's is often used in tension-type headaches, but a 2015 study found that positional release therapy - which is designed to relieve muscoskeletal imbalances by manipulating trigger points - was more helpful in migraine than the use of standard migraine therapy alone.

A recent Brazilian study found that a) headache was present in 100% of the FM patients and b) that it didn't matter whether an anesthetic or saline injection was used: both helped equally when injected into trigger points. The authors noted that there is agreement that the substance used is not important; what is more important is the effect the needle has on the trigger point.

In this study, both local anesthetic and saline were effective in the treatment of trigger points21. Both groups showed a reduction in pain intensity compared with control, with no statistically significant difference between them.

But there is agreement that the effectiveness of the treatment is not related to the nature of the substance injected. Probably the relief occurs by needle contact with the trigger point, breaking its vicious cycle16,24.

Both the intensity and frequency of headaches were significantly reduced. Botulinum is another injectable that can, in the right patients, help significantly with head pain.

FM is thought of as a central sensitization disorder, but these studies suggests that relieving problems in the muscles can reduce at least some of the central sensitization (pain sensitization) problems present in fibromyalgia. It suggests that the pain sensitization problems found in FM are at least partially driven by an ongoing barrage of pain stimuli coming from the body - and that relieving muscoskeletal problems can reduce the body-wide pain in FM.

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Arq Neuropsiquiatr. 2015 Oct;73(10):861-6. doi: 10.1590/0004-282X20150135.Injection of trigger points in the temporal muscles of patients with miofascial syndrome.Sabatke S1, Scola RH2, Paiva ES3, Kowacs PA4[/quote]

 

[AnneVA]

Well, I agree that the substance doesn't matter that much. Dry needling on trigger points gives very effective relief from knotted trigger points.

 

[Cort]

Well, I agree that the substance doesn't matter that much. Dry needling on trigger points gives very effective relief from knotted trigger points.

I wonder what is going on?

 

[AnneVA]

Dry needling was explained this way: acupuncture needle would be tapped into the trigger point or the wad of muscle that was in a spasm. you could see it twitch from the activity in the knot. The knot would eventually release. The physical therapist explained that he could continue to manually work out the trigger points peppering my girl's shoulders, neck, etc. or he could try some dry needling which he thought was much more effective. He saw no need for any type of injections. It worked very well. A routine massage every 3 to 4 weeks in those areas has kept her comfortable since. But I don't know the how's and why's of this or what is going on in the injections. This makes it sound as though it might not be the what that is injected but the needle itself that is doing the work.

 

[jaminhealth]

I was told I have FM in 1999, but already had been taking Grape Seed Extract in 1995, actually started with Pycnogenol that 1995 year and then a year later started on Grape Seed Ex.

I've not been sick or ever had a headache with this FM issue. I just know Grape Seed Ex is a salvation in my life. I have NOT had a headache in going on 24 yrs.

Of course, I wonder about the FM in the first place but I was given that dx in 1999...Paul St. Amand was the doc...

I see a D.O. and will be going back soon and he does trigger point injections, so I'm going to discuss with him....I deal with OA and I think it's worse, but who knows....