Open AccessMyofacial trigger points in advanced cancer patients
Author(s) -
Hideaki Hasuo,
Teruo Ishihara,
Kenji Kanbara,
Mikihiko Fukunaga
Publication year - 2016
Publication title -
indian journal of palliative care/indian journal of palliative care
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.395
H-Index - 26
eISSN - 1998-3735
pISSN - 0973-1075
DOI - 10.4103/0973-1075.173956
Subject(s) - medicine , palpation , cancer pain , myofascial pain syndrome , myofascial pain , cancer , supine position , opioid , anesthesia , physical therapy , surgery , pathology , alternative medicine , receptor
Myofascial pain syndrome is started to be recognized as one of important factors of pain in cancer patients. However, no reports on features of myofascial trigger points were found in terminally-ill cancer populations. This time, we encountered 5 patients with myofascial pain syndrome and terminal cancer in whom delirium developed due to increased doses of opioid without a diagnosis of myofascial pain syndrome on initial presentation. The delirium subsided with dose reductions of opioid and treatment of myofascial pain syndrome. The common reason for a delayed diagnosis among the patients included an incomplete palpation of the painful sites, which led to unsuccessful myofascial trigger points identification. The features of myofascial trigger points included single onset in the cancer pain management site with opioid and the contralateral abdominal side muscles of the non-common sites. Withdrawal reflexes associated with cancer pain in the supine position, which are increasingly seen in the terminal cancer patients, were considered to have contributed to this siuation. We consider that careful palpation of the painful site is important, in order to obtain greater knowledge and understanding of the features of myofascial trigger points.