caret icon Back to all discussions

Trigger point injections and physical therapy

For years and years now I have been suffering with migraines. I tried numerous medications without success. Recently I heard about another local migraine patient that was seeing a particular PA-C and that this patient was seeing wonderful results with his treatment. I decided that since I've tried just about everything, I would go see this PA. I made the appointment and was met by courteous staff. They conducted a thorough health history questionnaire. The PA came in and told me his theories on migraines. He said that while he does believe migraines are a vascular issue, he firmly believes that muscle spasms in the back, shoulders, neck and head were largely ignored as potential triggers. What he does is find the "knots" and injects them with lidocaine and steroids. He will repeatedly move the needle around in the knot to break it up and relax the muscle. Sometimes by stopping one spasm, it will release another one nearby. While this didn't sound very pleasant, I gave the go ahead. The injections were horribly painful and I hurt for a good full day afterwards. I went every 2 weeks and am now at every 4 weeks. My migraines immediately dropped in both the severity and quantity. He also referred me to physical therapy and I go twice a week. One of the most painful spasms I was having was in my temple. That nagging pain was gone after the second treatment. In addition, he has me on Flexiril 10mg three times a day, Cymbalta 60mg once a day, Zoloft 25mg once daily, Indural 80mg once daily and Ativan 1mg once or twice daily. I still get my Botox injections every three months and see a chiropractor every two weeks.

I feel like a brand new person. The migraines aren't completely gone but since starting this therapy I have gone from daily migraines to having only 2-3 severe ones. From October of last year through February when I started seeing this PA, I was in such misery. I couldn't function at all, I was very often calling off work. I was hospitalized for a week, in the ER frequently and my entire family seemed depressed. I am so thankful that I found this PA. Right now he and I are doing research on migraines that flare with weather changes as I have that issue.

It may be worth looking into for those that just don't know what else to do. The reasons I was having so many spasms was because I have been in several car accidents and had a botched shoulder surgery back in 2005. You may be having spasms just because you're stressed out.

  1. valeriefago - Apparently he has put you on several Migraine preventive drugs too I see.

    I do want to warn you about the use of benzos in Migraineurs though. This is one of the drug classes that can lead to changes in the brain that can make our situations worse. This is not-so-elegantly called Medication Overuse Headache. Its use can also sometimes contribute to the chronification of Migraine. Both can be quite bad if they happen. Let me give you a couple of links that might help to explain:


    Chronic Migraine

    Please read our rules before posting.