Trigger/Tender Points Without Pain on Palpation?

[critthinker]

Hi All,

I've been dealing with pelvic pain for a little over eight months, and it initially started after I received a Botox injection to treat levator ani syndrome and somehow contracted an infection from the procedure (my hypothesis is that this triggered muscle spasms and pain that followed resolution of the infection).

I've made a lot of progress in the past eight months, and have also had some ups and downs. At the moment, my only symptoms are the following:
--Suprapubic pain, and occasional pain closer to the prostate
--Tremendous fatigue (I can barely get out of bed sometimes, and sleep 10 hours per day)
--Small bumps in my suprapubic area (likely about 6-7 bumps)
--Pain gets MUCH worse with stress (to the point of being debilitating), much better after relaxing/meditating

I have had trigger point injections done by Dr. Weiss a few months ago, but at that point his palpation of certain suprapubic areas led to pain (and there weren't really any bumps). Now, these bumps I have don't seem to be related to pain (palpating them doesn't reproduce the pain that I feel in the same general region).

My question is the following: is it possible for taut bands to form WITHOUT there being an accompanying elicitation of pain on palpation of these points? I'm considering having a magnetic resonance elastography test done to determine if this is, indeed, taut muscle bands, and possibly also some additional trigger point injections/dry needling done. It is very difficult for me to accept that the formation of these bumps (they're been around for only two months now) doesn't have something to do with my pain. I'm seeing a pain management doctor soon, but wanted to get some thoughts from you all this.

THANKS!

Any help you can offer would be appreciated.

[webslave]

I have never heard of non-tender bumps forming in the pelvic area in relation to this condition. In your shoes, I'd get an ultrasound of the area to see what's going on. These may not be lumps in the muscle.

[critthinker]

Hmm, yeah this is a good idea I think. Would you see a pain management doctor for this? If not, then who? A general surgeon I visited who specializes in abdominal hernias said the bumps were possibly enlarged lymph nodes, but couldn't be sure without a CT scan. I already had a CT scan done 6 months ago (no bumps were present then), and doubt my insurance would accept another one now (not to mention I don't want to have the equivalent of 400 x-rays done once again).

[webslave]

Enlarged lymph nodes sounds right! I had them too, around the lower margin of my ribs, under the arms, and in the groin. It was part of the co-morbid condition I had — CFS. With the fatigue you have, it sounds as if you are the same.

[critthinker]

Hmm, interesting. I hadn't thought much about the possibility of CFS. Were you able to deal successfully with the CFS? What kinds of strategies did you use to address it? Reading the CFS description on Wikipedia, it definitely sounds like I have gone through an experience that would be consistent with it (illness/ severe stress followed by fatigue). Also, did your lymph nodes eventually shrink? Thanks.

[webslave]

Yes, it eventually subsided, but it took a long time. The things that helped most with the CFS aspect were

• Megadoses of Vit C, even delivered by injection on some occasions
• Gluten avoidance
• Change in lifestyle and philosophy to a more relaxed mode
• Plenty of rest

Once your HPA axis is messed up, it takes a long time to repair!

[critthinker]

Thanks, Webslave.

[critthinker]

BTW...have you heard anything about Dr. Shoskes trial of Tanezumab for CPPS? Are the results in yet?