Abstract
The potential of tendon and ligament triggers as primary nociceptors in fibromyalgia led to treatment of primary fibromyalgia patients with tendon and ligament strengthening injection. Trigger injection of ligament and tendon with proliferant (TILT therapy or prolotherapy) offers the advantage of creating increased strength of the connective tissue in the region of injection as well as affecting the pain cycle. Reduction in pain levels and increased functional abilities were seen in excess of 75% of patients with severe fibromyalgia in this study. The implications of this for further study are considered.