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Myofacial Trigger Points in Advanced Cancer Patients
Hideaki Hasuo1, Tatsuhiko Ishihara2, Kenji Kanbara1
1Department of Psychosomatic Medicine, Kansai Medical University, Osaka, Japan.
Indian Journal of Palliative Care
|March 11, 2016
Summary
Myofascial pain syndrome in terminally-ill cancer patients can cause opioid-induced delirium. Early identification of myofascial trigger points through careful palpation is crucial for effective pain management.
Area of Science:
- Palliative Care
- Pain Management
- Oncology
Background:
- Myofascial pain syndrome (MPS) is increasingly recognized in cancer patients.
- Limited data exists on myofascial trigger points (MTPs) in terminally-ill cancer populations.
Observation:
- Five terminally-ill cancer patients developed delirium due to increased opioid doses, initially undiagnosed MPS.
- Delayed diagnosis stemmed from incomplete palpation and MTP identification.
- Specific MTP features included opioid site and contralateral abdominal muscles.
Findings:
- Delirium resolved with opioid dose reduction and MPS treatment.
- Withdrawal reflexes in supine position may contribute to MTPs in terminal cancer.
Implications:
- Emphasizes the importance of thorough palpation for MTP identification in cancer pain.
- Highlights MPS as a potential contributor to delirium in advanced cancer.
- Suggests MTPs may present uniquely in terminal cancer patients.
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