PA (Lumbrosacral area and coyccx), trigger points and Ligaments

[Guest guest]

Okay, I don't know how to spell coycxx. For the past 1-2 years I have had

severe back pain that was blamed on fibromyalgia (even though I had sciatica

about 4 years ago). Well, for the past week I have alot of swelling over the

lumbrosacral area and SI areas. Very visual swelling. I have been icing it but

that hasn't been working and it is only getting worse. It's strange too cause I

just started vioxx a couple of weeks ago so you would think that would help with

the inflammation (still on Enbrel too amoung the other increasing daily

meds..uggghhh).

Rheumy dismissed it at first stating that I had trigger points and to try phys.

therapy. If that didn't work he would give me a steroid injection. That was 3

weeks ago. Now I have more trigger points - can someone explain to me what

these are and what causes them? They feel like balls or knots under the skin

and it is my understanding that it is inflammation. Since PA affects soft

tissue too can't this be from the arthritis? They seem to be popping up

everywhere and they are very painful!

My GP did a trigger point injection (depo medrol and xh in the coyccx area and

told me that he thinks that the PA is either in that area including the sacrum

and possibly the SI area too (more swelling there). He said that there is no

way fibro causes that much swelling and it was right on the joint. I told him

that the rheumy said that my x-rays from 1 1/2y yr ago showed no damage

therefore the arthritis couldn't be there. My GP said that doesn't make sense

since PA affects soft tissue too and x-rays won't show that. Luckily that part

is feeling better. It was so bad I could hardly climb the stairs to get to my

2nd story apt. or drive (I had to constantly use the cruise control with the

accelerator button on the steering wheel). Problem is that I have several other

trigger points all over my back. I just hope the injection lasts.

When it rains it pours.

hugs,

[Editor's Note:

, I know (at least some of) what you're experiencing; I've had PA

involvement in the SI joints (and hips, and ankylosing spondilitis-like spine

involvement) for decades. For me, driving can be excruciating, as well as

sitting (especially on hard chairs), and plane flights, in those cramped

confines, are no thrill either. Your docs have probably mentioned this to you:

the pain(s) from the SI site, etc., can, in addition to bone, be muscular (e.g.,

soft tissue) in nature, " complaining " about the misalignment caused by the PsA.

I too have been prescribed physical therapy, the hope being that it will

strengthen and realign things in the SI joints, and ultimately reduce muscle

involvement, trigger points, and area pain.

The trigger points are like tiny " knots " that can and do " refer " pain to

another location, and--for injection purposes--need to be targeted to provide

relief to both the trigger point and referred site(s). So you're certainly right

by me, in noting that it's the arthritis and not something else causing the

grief.

NSAIDs have never done me any good, in terms of pain relief. Muscle

relaxants (one doc gave me valium for the purpose, although there are other

drugs with less stigma attached) might, to my way of thinking, be of more help

than the NSAIDs. And, if your Enbrel (being a DMARD) kicks in, that should

provide a lower overall baseline disease activity, reducing the trigger point

problems.

Good fortunes to you; I know SI joint involvement is no fun.

D.]