Trigger Point Injections (TPI) Not such a pain in the neck. In my column two weeks ago I wrote about pain I was having in my neck, back and shoulders and my fight to get some sort of diagnosis. I wanted to follow up this week with a “solution” a friend has found to manage her pain.
Kim Carver, owner of The High Tech Society and sometimes guest writer here at Eugene Daily News, invited me along to her doctor appointment for her Trigger Point Injection at Oregon Medical Group (OMG) Pain Management office. She thought it might help me to understand what it is and perhaps it could help me in the future.
I have to admit, I was a little nervous to accept her invitation. I had no doubt she was getting relief from the injections, I just know how squeamish I am when it comes to my own body and needles. I would be in the same room with her while the needle went into her so of course I would be a little nervous. I used to be able to watch when I was younger, but something switched in me along the way and I just can’t watch when I get a shot or blood drawn.
Kim and I chatted for a bit and afterwards I bit the bullet and accepted her offer. What could it hurt? I would simply look the other way if it got bad. The last thing they needed was for me to pass out in the exam room.
We only had to wait a couple of minutes before Josh came to get her. Kim introduced Josh (Summerfield) and I; he is an MOA (Medical Office Assistant) and has been working together with Karla Austin for the past 9 months. Josh and Kim discussed how she was feeling; he making notes in her chart. They were laughing and having a very relaxing conversation. He said Karla would be in shortly and excused himself.
Kim and I talked a little about her condition and how long she has been coming here to see Karla to get her injections. Kim has had extensive back problems, having her first injection approximately 8 years ago. Her physician then would put her completely out and under general anesthesia, find her muscles and then inject the medications. In those early times the physician used steroids and this had an adverse affect on Kim. Not only did she put on close to 70 pounds in the course of treatment but the steroids affected her Pituitary Gland causing even more problems. She had to undergo 7 months of treatment, 1 injection a month. Due to the severity of her back issues, she was mostly bed ridden at that time.
As early as 4 years ago she started receiving this particular TPI and has seen a total of three physicians, finding Karla to be the first to be able to give the injections with ease and has been seeing her for about a year now.
“My second doctor referred to my muscles as those of a body builder. Your muscles spasm all the time, never resting so it’s like a constant workout”.
Is it scary to get the Trigger Point Injections?
The first time it may be a bit, but if you’re like me and in so much pain that you will do anything to get relief, then it really isn’t.
How often do you go in for your shots?
Currently I am going in every 2 weeks for these injections. Once we get these injections going every 2 weeks for about 4 times (so over about 6-8 weeks) then I will go back to getting them every 3-4 weeks.
Kim’s back issues began when she was just 11 years old. She found a lump on her back and became temporarily paralyzed. The lump turned out to be a Histiocytoma tumor and after extensive surgery it was removed.
“The tumor was just the size of a pea, however the tail was about 13″ long and ran down my spine. I was at the Mayo Clinic fortunately so I had the best care.”
The doctor had to remove muscle and nerves tissue all the way to my lungs and all on the left side. They had to also cut my rhomboid muscle, shoulder muscle, so much that they had to tack it onto the muscle on the opposite side so I could still use my left arm. I had to relearn how to walk. It was weird telling your legs to move and nothing happening but I did it and I lived a pretty normal life afterwards. I was never able to really work like others, not stand on my feet for long days etc. but as I got older I got stronger through rehabilitation and therapy and really was pretty normal. Actually, that’s the part two to how I got how I am. I really acted as if I was normal and that ended up putting me where I am now.
I hiked, kayaked, and all that great stuff, which was all fine, I recovered each night from these activities but then I began cleaning houses for others. A job I didn’t need but it was helping out a friend so I did it and within a month of scrubbing other houses than just my own, I ended up herniating a disc in my neck at C 5 & 6 and developed Torticollis, which left me in bed for nearly a year (which in turn led to the steroid treatments)”
What can someone expect on their first appointment?
You might be a little nervous, but try not to be. I find humor really helps! The doctor will assess your pain, asking you where you hurt, taking all things into consideration. He or she will then feel around for the muscles and where you feel the pain, letting you know when they will be inserting the needle. With Karla, I don’t even feel the needle. She feels around, and confirms that is the area where my pain is. I can feel the medication running through the muscles and it burns just a little bit, at least for me and only lasts for a few seconds.
How immediate is your relief? Do you have a routine or what can you suggest for someone after their TPI’s?
You will feel elation! At least that is how I feel afterwards with Karla. You can’t over do it after your appointment. You have to relax and let the medications work. I can’t stress this enough. Your pain level should be very manageable and you may feel like you can clean your entire house, but don’t. The TPI will not work if you don’t give it a chance.
How would you rate your pain level before and after your injections?
Before it has been as high as a 9 and drops to a 7 in office and by evening to a 5. That’s a lot really. Lately it’s about 6-7 before and drops to 5 in office and last week dropped to a 2! That’s the lowest it has been in several months so I was very very happy. It has been just over a week now and the pain is back to about a 4 daily and up to a 6 with activity but I go in Wednesday again and I don’t think it will go past a 6 I hope.
How long will this treatment last for you?
It will last almost a month once I get in the routine of getting them again. It makes my pain stay below a 5 for the month, that is with medication and a 5 I can tolerate. The 5 level is normally a bad day and a normal day will be fluctuating between 2-4. I haven’t been below a level 2 since I don’t know when. I have come to live with that and accept it.
I was surprised at myself. Watching the injections had no affect on me at all. I am not sure if it was just do to the fact that it was happening to someone else but that couldn’t be it because I can’t watch on television when someone is getting a shot. Perhaps it was the fact that I knew Kim would get relief soon from her pain and I was at complete ease with Karla. She is a very loving and caring person. She walked me through the process; explaining what was happening and why she was doing what she was doing.
She first had Kim sit in a chair, her back / neck exposed and she felt for the muscles. She could tell where the muscles were tight and this is where she would begin her treatment. For some crazy reason, I thought she would be getting the injections into her spine. This was not the case.
After the first injection, Karla massaged the area a bit to spread the medication around. The medication is Lidocaine and Marcaine. No steroids were used. She felt around a bit more on the other side of her spine to find the tight muscle and repeated the same process; massaging the area to distribute the medication. Kim never flinched once.
Karla is that good, she know’s what she is doing and she takes her time. Kim does admit her eyes will water, but that lasts as long as it takes her to wipe the tear away.
After the injections she put some BioFreeze across Kims back and massaged for a little bit. She explained it helps with the distribution as well.
We all went back to our respective seats and talked a little bit while Karla entered her notes, giving time for the medication to work and then assessing Kim’s pain level once again. Her relief was almost immediate. When we walked in to her appointment her pain level was around an 8. Five minutes after the injections her pain level was around 5.
By the time we left the doctors office Kim felt like she wanted to grab some lunch she was feeling so good. Admitting it had been some time since she had felt this good, but also knowing that she needs to take it easy the first day after her injections. While we had lunch, Kim boasted with a smile that her pain level was down to an astounding 2!
I asked Kim what she would like people to know.
“Please don’t give up. There is help out there. If you have reservations that your insurance may not be accepted at a physicians office, give them a call. There are always exceptions to the rule.”
I would like to thank Karla Austin and OMG for allowing me to take a look inside, photograph and share with the public this incredible way you are helping people live their lives and thank you Kim Carver for sharing your story with us.