Indian Journal of Palliative Care
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 CASE SERIES
Year : 2016  |  Volume : 22  |  Issue : 1  |  Page : 80--84

Myofacial trigger points in advanced cancer patients


1 Department of Psychosomatic Medicine, Kansai Medical University, Osaka, Japan
2 Department of Palliative Care, Okayama Saiseikai General Hospital, Okayama, Japan

Correspondence Address:
Hideaki Hasuo
Department of Psychosomatic Medicine, Kansai Medical University, Osaka
Japan
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0973-1075.173956

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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.






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Online since 1st October '05
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