Vol 7, No 1 (2008)
Case reports
Published online: 2008-02-25
Myofascial and nerve compression pain simulating bone involvement in a patient with prostate cancer
Winanda Wolfs, Zbigniew Zylicz
Advances in Palliative Medicine 2008;7(1):23-28.
Vol 7, No 1 (2008)
Case reports
Published online: 2008-02-25
Abstract
Many patients with advanced disease suffer of pain. Not all this pain is induced by the disease itself like
tumour growth or infiltration of the nerves. Some of the pains are due to debilitation and degeneration due
to immobilisation, atrophy and poor nutrition and are only indirectly related to the progression of the
disease. Atrophic changes in the subcutaneous tissue, muscles and tendons can be accompanied by the
compression of the nerves against protruding bony edges. This type of pain, not specific to any advanced
disease in particular, can be extremely difficult to be treated. We present here a case of patient with a
metastasised prostate cancer who suffered of this type of pain and did not respond to standard treatment
targeting tumour related pains. Compression of the small cutaneous nerves was successfully treated with
injections of depo steroids and local anaesthetics. Not every pain in disseminated prostate cancer is a bone
pain. It is our impression that this type of pain is much more common among the patients in palliative care.
Abstract
Many patients with advanced disease suffer of pain. Not all this pain is induced by the disease itself like
tumour growth or infiltration of the nerves. Some of the pains are due to debilitation and degeneration due
to immobilisation, atrophy and poor nutrition and are only indirectly related to the progression of the
disease. Atrophic changes in the subcutaneous tissue, muscles and tendons can be accompanied by the
compression of the nerves against protruding bony edges. This type of pain, not specific to any advanced
disease in particular, can be extremely difficult to be treated. We present here a case of patient with a
metastasised prostate cancer who suffered of this type of pain and did not respond to standard treatment
targeting tumour related pains. Compression of the small cutaneous nerves was successfully treated with
injections of depo steroids and local anaesthetics. Not every pain in disseminated prostate cancer is a bone
pain. It is our impression that this type of pain is much more common among the patients in palliative care.
Keywords
myofascial pain; nerve compression pain; opioid resistant pain; steroid injections
Title
Myofascial and nerve compression pain simulating bone involvement in a patient with prostate cancer
Journal
Advances in Palliative Medicine
Issue
Vol 7, No 1 (2008)
Pages
23-28
Published online
2008-02-25
Page views
481
Article views/downloads
1744
Bibliographic record
Advances in Palliative Medicine 2008;7(1):23-28.
Keywords
myofascial pain
nerve compression pain
opioid resistant pain
steroid injections
Authors
Winanda Wolfs
Zbigniew Zylicz