Tuesday, December 6, 2011

Trigger Point Acupuncture for Fibromyalgia

Late July, my fibromyalgia flared really horridly. When it gets to the back of the right side of my head and goes down the right side of my neck and into my shoulder, I am doomed. I medicated myself with muscle relaxers, NSAIDs and Norco to no avail for a week before I called my Migraine/headache specialist who also treats Fibromylagia. I asked for a medication and a non-medication treatment. He recommended TPA (Trigger Point Acupuncture).
First TPA treatment July 2011
I had had one prior experience with Chinese acupuncture and it was not a good, and quite painful one, so I was dreading this visit with the Nurse Practitioner for TPA. Since my Norco was not even touching the severe pain, I did not expect little needles to do anything. But lo and behold, those little needles were my miracle. I saw some relief immediately. I could not believe it. My pain had moved from severe to moderate after ten minutes of treatment! It took a few weekly treatments, but eventually I was pain-free in the area shown in the picture above. The rest of my body was another story..

After a quick search, I could not find any good references for TPA and Fibromyalgia, but I found an excellent website that explains myofascial (myo=muscle; fascial=skin covering muscle) pain which can coexist with Fibromyalgia. After reading about myofacscial pain, I believe that is what is happening in the right side of my head, neck and shoulder.

To understand TPA, you must understand that Fibromyalgia has trigger points and tender points. According to Dr. Ian Pardoe who wrote the content for the aforementioned website,
Trigger points are “nervous hot spots” which cause muscles to become abnormally sensitive. This nervous excitability results in the development of tight bands of muscle or fascia that, when pressed, cause local pain, as well as referred pain to somewhere else in the body. Trigger points are essentially nervous excitability in a muscle.
This also explains why massage makes my Fibro pain much worse. A Fibromyalgia flare started Monday with pain in many of my joints including my hips, knees, ankles along with what I'm self-diagnosising as myofacial pain in the right suboccipital region of my head, down the right side of my neck and shoulder.

A phone call to my NP yesterday morning got me a 1pm TPA appointment. I also get TPA for my Migraines/CDH as shown in the photo below. I usually get TPA along with cold laser therapy every three weeks.
This photo was taken in August 2011; Last week, I had 20 needles and most were in my right temple.
Usually when the needles are put in, I do not feel them at all. I was sitting in this photo above because I also had some needles inserted in the back which you can see. Usually with TPA for Migraine I lay down and often feel like falling asleep.

12/6/11; Needles went up the right side of my head.
However, yesterday my body was not happy at all during my session. Apparently all the nervous excitability in my muscle was more than I could take. I stuck out the ten minutes so that my muscle would relax as my NP had explained it to me. But I think Dr. Pardoe explains it better:
12/6/11 Total 26 needles

"Acupuncture causes an immediate relaxation of the muscle because of the effect of the “micro-trauma” to the surface of the muscle being treated. This relaxation will then reduce a degree of the muscle spasm and consequently allow further stretching of the affected muscle group."

Thankfully I was prescribed some prednisone which seemed to help the last few times I've had fibro flares and will help the pain in the rest of my body.

Sunday night, I slept horridly because of this Fibro flare. Last night after the Trigger Point Acupuncture, I slept like a baby.

When I woke up this morning, I felt no pain. I did my Gentle Tai Chi and stretching like I do on a daily basis expecting to feel some pain. My right ankle was bothering me a bit. I took a short walk around the backyard because it was way too cold and windy to be out there without a coat on. And I was cheering inside because another TPA miracle had occured.

Mid-morning, I sat on my couch with my back support cushion behind me and with my computer on my lap began to check my emails. As I was sorting through, I noticed a twinge of pain shoot up my shoulder to my head. If you scroll back to the very first photo, it shows the line that my pain followed. I ignored the moderate pain for five minutes thinking, "oh this is expected." Then, the pain suddenly screamed up the pain scale like a speeding bullet and hit a 9.5/10.

With the exception of right after the surgery I had in March, I almost never say 10. Ten is reserved for the absolute worst, which is why I think it is ridiculous that people say on a scale of 1-10 my pain is a 12 or 100. Those numbers are not on the scale between 1-10! How can you realistically rate your pain on a daily basis if you don't use your high number (in this case 10) as the highest. I digress.

So, I stood up because obviously my posture and use of my right arm was bothering me and stupidly went to massage the area in my head. Immediate ten. It was scary. Ten is terrifying. Couldn't speak. I had already dialed George. Still couldn't speak. He waited. He knows if I don't speak it is because I am not well.

I stood for half an hour before the pain came down to a 9/10. After medicating myself, using a ThermaCare heating pad, sitting on the floor with my back support and mainly using my left hand (I'm right handed.) my pain throughout the day has stayed between 8-9/10. You can imagine my frustration. I am hopeful that sleep tonight will be as healing as it was last night. And that tomorrow I will wake up and avoid-as much as possible-the movements that created today's mess.

Needless to say, I cannot wait until my next TPA session next week.


  1. Wow! I can't imagine. Was today a better day? I was praying for you last night and this morning.

  2. Thanks for the prayers, Caylyn, that means a lot...especially since you are in the hospital! No. It is not better today. :( And I think the prednisone is making me really depressed. I have another TPA appointment on Monday. I cannot wait. I'm hoping that does the trick because we're going out of town for 10 days and I really don't want to have to delay our trip.