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Interventions for myofascial pain syndrome in cancer pain

recent advances

why, when, where and how

Thottungal, Athmajaa; Kumar, Pranabb; Bhaskar, Arunc

Current Opinion in Supportive and Palliative Care: September 2019 - Volume 13 - Issue 3 - p 262–269
doi: 10.1097/SPC.0000000000000446
MUSCULOSKELETAL PROBLEMS: Edited by Roberto Casale and Piercarlo Sarzi

Purpose of review Pain is one of the most feared and most common symptoms of cancer, experienced by 38–85% of patients. Pain in terminally ill cancer patients is a multidimensional experience caused by a diverse array of factors – cancer itself, its treatment or other causes. Studies have shown a high incidence of myofascial pain syndrome (MPS) in patients with cancer and the knowledge of myofascial trigger points (MTrPs) is important to address and manage existing pain, and to prevent the recurrence of pain. This review aims to summarize recent advances in interventions for managing MPS in patients with cancer.

Recent findings Database searches were conducted on MEDLINE, CINAHL, and Google Scholar to locate all studies published from inception until April 2019 using the keywords cancer pain, myofascial pain, TrPs with emphasis of any methodological quality that included interventions for MPS. MPS in advanced cancer patients are more commonly observed along with other cancer pains rather than independently with a prevalence of 11.9–48% in those patients diagnosed with cancer of head and neck and breast cancer.

Summary Interventional therapies employing ultrasound guided injection of the MTrPs is gaining popularity in the management of MPS in cancer pain and may be a better alternative than the use of opioid analgesics in the multidisciplinary management.

aDepartment of Anesthesia and Pain Management, East Kent University Hospitals, Kent, United Kingdom

bDepartment of Anesthesia and Pain Management, University Health Network-Toronto Western Hospital, Ontario, Canada

cDepartment of Anesthesia and Pain Management, Charing Cross University Hospital, London, United Kingdom

Correspondence to Arun Bhaskar, MBBS, MSc, FRCA, FFPMRCA, FFICM, FIPP, Pain Management Centre, 2nd Floor South, Charing Cross Hospital Imperial College Healthcare NHS Trust, Fulham Palace Road, London W6 8RF, UK. Tel: +44 203311 7016; fax: +44 20 3311 7566; e-mail:

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