Health Organization for Pudendal Education

Saw my physio Sheryn Jarvis today and she recommended trigger point injections, of a steroid and anaesthetic.I think into the obturator internus.She said they do this before botox, because for botox you need sedation and hospital.I am not at all keen.I wanted to try and relax muscle with physio first and stretches.I cant see how injecting a tight,bulky muscle with steroids can help.It doesnt seem to be a common treatment.What do you all think?
Thanks so much for your help,
Best wishes to all
Mirandamolly from Sydney

Hi miraandmolly,

FYI I got your PM and will answer but as I want to do it thoroughly am putting it off til later today. I got TP injections, but of vitamin B-12 not of steroid as my practitioner believed this to be less likely to cause a negative / irritative reaction than a steroid.
Trigger point injection positives: I don't regret it as they did provide some minor temporary relief and were really simple and almost painless, just a little sting. Factor in however that my insurance paid for them and if it had been out of pocket, I don't think it would have been worth it.
Trigger point injection negatives: It is really the same thing as trigger point massage, except that it can pinpoint difficult-to-massage areas such as internal trigger points. The end result is the same, which is in my experience any relief is mild and will be temporary as the underlying cause of the trigger points has not been removed. I see trigger points as a symptom, not a cause; you can work on them and they keep coming back until the underlying cause is found and removed. Meanwhile chasing trigger points might help your quality of life (or might not), but you will have to keep at it which is time consuming.
Also I do recommend something else aside from steroid be injected (or just have the trigger point dry-needled). I have heard from several practitioners that steroids have been known to cause the opposite of the reaction desired; then experienced it myself when I had my piriformis muscles injected with steroid (not trigger points, the whole muscle), which put me into a mild pudendal flair with the added bonus of some brand new sciatica.

PM ya later

Nowadays, trigger point injections are rarely done with a steroid as there is really no good reason to add it to the mix. They usually just use Lidocaine to ease the pain afterward. The "work" is done by the needle that disrupts the trigger points or at least that is the theory.
My experience is that the improvement is very short lived. If you really have an entrapment, no matter what, the muscles around will get back to spasming and your trigger points will be back in a matter of days.

ezer reminded me, I think there was lidocaine in my shots as well as B-12.
Also, I want to add, I really am not sure that there is any advantage to TP injection vs. TP dry needling. My PT only referred me for injections because PT's are forbidden from dry needling in my state for a stupid political reason (Accupuncturist Society lobbies the PT Board against it because they want to be "the" group that can stick needles into people).

I had my tP injections done by a physiatrist (rehabilitation/pain doctor). It was clear that he did not believe a word of the theory and just did them to please me (It was my PT that recommended I do those).

Thankyou Ezer and Hermajesty,
After what youve said, I really cant see the point in having trigger point injections...at best very temporary relief and at worst a reaction to the steroids and more pain.I dont know why they use steroids in the injections here.Ill cross them off my list.
Thanks again
Best wishes Mirandamolly

Hi
I used Pure Vegan B12 spray.There is also a cheaper version that does not advertise vegan but says so on the label called Pure Advantage B12. The ingredients are identical.