I’ve talked off and on here about my diagnosis of chronic myofascial pain, provided some thoughts about surviving this disease and the treatment process, and most recently, discussed the trigger-point injection therapy I began a couple of weeks ago.

Here’s a little addendum to the story that I’ll now share with you…

During the first appointment at the doctor’s office where we performed trigger-point injections , skittish-(around-needles)-person that I am, I allowed only four injections. The second time, a few days later, was a session with 19 injections. That extremely-intense ordeal was on a Monday morning, and, as it followed a weekend of suffering through some intense back and foot pain, I experienced some much-needed relief during the course of that day. However, by that evening, I had pretty much returned to “normal.” (This was not a good thing, of course…the pain had returned!) In fact, by the end of the week (on that Friday), I was hurting so much that I made and kept an appointment with my chiropractor in Eugene, where I obtained some pain abatement with the (for me, usual) treatment modes of ultrasound, light massage, and a small chiropractic adjustment.

My injection-therapy doc was going to be out of town for a bit, so the first chance I had to return to him was Monday morning of this week. While there, I reported on my status, including the few-hours-only relief I obtained as a result of the 19 injections last time.

Of course, I had been discouraged at not experiencing more relief as a result of that previous visit, but, still, was rather unprepared for the assessment that injections were not going to be the preferred treatment for me. The “typical patient” tends to respond much more positively than I did, apparently.

I had been warned that this (injection) path might be more problematic for me than others, though. In reporting my medical history, I of course had disclosed that I had been taking lorazepam (“Ativan”) during the last several months in an attempt to cope with the anxiety-factors of my life (job loss, interviewing, moving…that kind of stuff). As it turns out, and as I had been informed, taking a drug in the bezodiazepine class can sometimes (oftentimes) seriously get in the way of having a successful outcome from trigger-point injections. And this doctor, while having treated only a few individuals who were taking (or had taken) this type of drug, had first-hand experience in seeing such cases as mine “fail.” I had been off the drug for a full three weeks at the time of my injections (and, now, as I write this, it’s been over five weeks), but the effect that the drug can have on the body (at least as far as trigger-point injections go) can be much longer lasting than would typically be predicted from the elimination half-life .

So, what to do now? (was the question) I had been studying the Trigger Point Therapy Workbook and doing my own self-massage of trigger points (with the help of a variety of massage “tools” that I now own). But this approach seems to have yielded little progress, especially regarding my back pain. (It’s possible that the condition in my left leg and foot is somewhat improved.)

I asked the doc what we could to do to pursue an alternative treatment path. Fortunately, he had some ideas (several of them, actually). One possible approach that emerged was to take small doses of a drug, naltrexone , once a day (at bedtime) for thirty days. Naltrexone is an “anti-narcotic” usually prescribed to manage alcohol and opiate addiction. However, in low doses (3 mg vs. the typical 50 mg), the drug has been found to be advantageous for a variety of ailments. The hypothesis regarding this drug’s biochemical mechanism (magic?) is that it produces an increase in endorphin levels in the body, which positively impact muscle tissue (and myofascial trigger points, in my case). In people with diseases that are partially or largely triggered by a deficiency of endorphins ( CMP and fibromyalgia are thought to be in this category), or are accelerated by a deficiency of endorphins, restoration of the body’s normal production of endorphins is believed to be the major therapeutic action of (low-dose) naltrexone.

Now, I had never heard of this drug prior to two days ago. But, I admit, this theory and approach are fairly attractive: a low dose of a drug purported to have “no side effects” and that does not involve frequent, multiple and painful needles in my body. Further, the success rate of this approach for individuals with my condition is supposedly quite high (the pharmacist said that, in his experience, this approach works “about 90% of the time”).

I took the first dose last night at bedtime, after discovering that “low-dose naltrexone” (LDN) has its own website and listserv on yahoogroups . I have started to do the reading and the research, though it may be several days before I have any “results” of this experiment to talk about.

Stay tuned for further updates on my naltrexone experience...