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Myofascial and nerve compression pain as an important factor of uncontrolled pain in advanced disease
open access
Abstract
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
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.
Keywords
myofascial pain; nerve compression; trigger point; advanced disease
About this articleTitle
Myofascial and nerve compression pain as an important factor of uncontrolled pain in advanced disease
Journal
Advances in Palliative Medicine
Issue
Pages
13-22
Published online
2009-02-06
Page views
518
Article views/downloads
1761
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