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Vol 8, No 1 (2009)
Original articles
Published online: 2009-02-06
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Myofascial and nerve compression pain as an important factor of uncontrolled pain in advanced disease

Winanda Wolfs, Zbigniew Zylicz
Advances in Palliative Medicine 2009;8(1):13-22.

open access

Vol 8, No 1 (2009)
Original articles
Published online: 2009-02-06

Abstract

Background. To examine how often patients, with advanced disease and in need of improvement of pain control, present with trigger points due to myofascial pain and nerve compression and if these trigger points can be related to the pain spontaneously reported by patients.
Material and methods. Thirty three patients with advanced disease referred to different hospice services for pain control participated in this study, which involved a pain history interview, palpation of areas prone to development of trigger points and measurement of pressure pain thresholds (PPT) of these areas.
Results. On palpation, trigger points were found in 94% of the patients. In 67% of them trigger points could be matched with the pains mentioned during the pain history interview. A significant correlation was found between the low pressure pain thresholds of the control areas and those of the investigated areas (r = 0.83, p < 0.01). An inverse relation was found between the number of trigger points and the mean pressure pain threshold of the investigated areas (r = –0.63, p = 0.01).
Conclusion. Many patients with unrelieved pain in advanced disease may present with trigger points. The origin can be peripheral. However, when multiple, a central cause such as spinal cord sensitisation should be considered. Attention to trigger points and to their treatment has the potential for further improvement of pain control.

Abstract

Background. To examine how often patients, with advanced disease and in need of improvement of pain control, present with trigger points due to myofascial pain and nerve compression and if these trigger points can be related to the pain spontaneously reported by patients.
Material and methods. Thirty three patients with advanced disease referred to different hospice services for pain control participated in this study, which involved a pain history interview, palpation of areas prone to development of trigger points and measurement of pressure pain thresholds (PPT) of these areas.
Results. On palpation, trigger points were found in 94% of the patients. In 67% of them trigger points could be matched with the pains mentioned during the pain history interview. A significant correlation was found between the low pressure pain thresholds of the control areas and those of the investigated areas (r = 0.83, p < 0.01). An inverse relation was found between the number of trigger points and the mean pressure pain threshold of the investigated areas (r = –0.63, p = 0.01).
Conclusion. Many patients with unrelieved pain in advanced disease may present with trigger points. The origin can be peripheral. However, when multiple, a central cause such as spinal cord sensitisation should be considered. Attention to trigger points and to their treatment has the potential for further improvement of pain control.
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Keywords

myofascial pain; nerve compression; trigger point; advanced disease

About this article
Title

Myofascial and nerve compression pain as an important factor of uncontrolled pain in advanced disease

Journal

Advances in Palliative Medicine

Issue

Vol 8, No 1 (2009)

Pages

13-22

Published online

2009-02-06

Bibliographic record

Advances in Palliative Medicine 2009;8(1):13-22.

Keywords

myofascial pain
nerve compression
trigger point
advanced disease

Authors

Winanda Wolfs
Zbigniew Zylicz

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