How to manage chronic muscle tightness and pain?

Question

Hi doctor,

For the past four years, I have been suffering from debilitating muscle tightness and pain. I have muscle knots or taut bands everywhere in my body. They can be felt with the fingers. I have tried all conventional therapy without success.

As a last resort, I want to try a one to two-week trial on neuromuscular relaxants to relax my muscles. The problem started after I had an allergic reaction to a pill. After that, my muscles started spasming, and they remained that way ever since. I did multiple CT scans and MRIs and lots of blood work, and all came back negative.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

As per your history, my provisional diagnosis would be:

1. Myofascial pain syndrome (MPS).

2. Fibromyalgia with little more inclination towards MPS.

Both are chronic painful conditions. You have tried all oral muscle relaxants, antidepressants, anticholinergics, and antianxiety medications. As you are suffering from chronic pain, other nonpharmacologic modalities of treatment, like physiotherapy exercises, ultrasound therapy, massage therapy, and yoga meditation, will help you reduce the severity of pain and improve your general well-being, though they will not relieve pain to zero.

Also, a psychologist's opinion would help divert your mind or attention towards things that are relaxing to the mind. At sites of severe pain and contracture, Botox injections (a protein made from Botulinum toxin that temporarily paralyzes muscle) may be helpful, but only after specialist consultation.

Chronic pain conditions have always been a matter of interest in medicine, but still, more research is needed to understand their pathophysiology and treatment. Pain waxes and wanes for short to long periods throughout life. Another thing I would advise is trying to look at other faces of life as a happier one. Concentrate on the same for the maximum time possible.

I hope that you get your answer.

Please let me know if you need any help.

Thank you.

Answer 2

Hello,

Welcome back to icliniq.com.

Let me tell you. Neuromuscular blockers (NMB, medications that prevent skeletal muscles from working by blocking transmission at the neuromuscular junction) are drugs that will paralyze you completely from head to toe. You will not be able to even blink, and you can not breathe.

So a patient will be completely motionless, but still conscious inside. So, along with NMB, he will require drugs that will cause unconsciousness. That is, you will need complete general anesthesia.

Also, since you can not breathe with NMBs in your circulation, you will need an endotracheal tube in your windpipe and will require a ventilator to give you much-needed oxygen and mechanical breaths. So the entire procedure is more complicated than you think.

Also, NMB will only relax you for as long as they are in circulation. Once they are removed from the liver and kidneys, you will be back to the same as previously. Though you are willing to pour money, you will not be satisfied at all, as pain will always be there. Please consult a psychiatrist, psychologist, or pain physician rather than an anesthesiologist.

I hope that you get your answer.

Please let me know if you need any help.

Thank you.