So here is an update and I am hoping this can be helpful to others and perhaps if anyone has similar experiences they can share them.

I had trigger point injections this morning into my muscle layers at the site of my pain. I have a focal area of pain that is right off the midline below the xiphoid process. The pain definitely radiates to other areas, but the main area of intense pain has always been this small focal area (for 20 months and counting). the pain feels deep and the injections verify that my rectus muscle is very sensitive and seems to be the offending muscle. Here is some of the conversation that I had with my pain medicine doctor: He says that the pain I have in my mid back can be related - it wraps around like a "belt of pain" from the pain center in my muscle. I also have pain the runs down the entire length of my rectus muscle to my hips. He says that one spot on the muscle being affected can cause the entire muscle to be tight and in pain. I also have pelvic pain that can be related to this muscle as well, or there could be another trigger point area present.

He injected bupivicaine (local anesthetic) and deep-medrol (long acting steroid) into the muscles. I think it was about 5-6 injections total with only the rectus muscle injection causing a "twitch" and a lot more pain. I experienced pain relief (!!) about 30 minutes after the injection. I could stand up straight, take deep breaths and I was laughing as I felt such relief. My back pain disappeared at the same time. The relief was relatively short lived, about 90 minutes later the pain returned first in my abdomen and a few minutes later the back pain came back. This was to be expected, according to the doctor, because the local anesthetic wears off and it may take a while for the steroid to take action. His plan is to repeat the trigger point injections because I did get relief. He says it may take a series of injection to get better and more sustained relief. After all, this has been going on 20 months and for a muscle to cause this much pain, well, it must be pretty severely affected. The steroid could take affect anytime within the next week and could offer more sustained relief. I have to be patient as this process is slow and methodical (as most of you can relate, I've heard this SO many times before).

So, I have hope and I wanted to propose this as an idea for those of you that are suffering from pain like mine, or pain that has no visceral cause and could be related to muscles-fascia and the nerves. I would say that these injections were a cake-walk compared to the pain I've been in and the 90 minutes of relief was a HUGE boost to my outlook as I was starting to feel hopeless and despair these past few weeks especially. This has been the first time that a cause of this pain seems more than likely and a treatment has worked (even for 90 minutes). It also seems to correlate my other pains with the abdominal wall pain, which is another relief as I was struggling with the concept that I have more than one pain area and what could that mean for my life moving forward?

Anyone else have experience with trigger point injections? I hope that my story (to be continued...) can help someone else in a similar situation.