ABSTRACT
BACKGROUND: Pain is a common complaint of cancer patients, experienced by 38%-85% of patients. Some studies have shown a high incidence of myofascial pain syndrome (MPS) in cancer patients. AIMS: 1) To estimate the prevalence of MPS in cancer patients; 2) to examine the efficacy of current treatment options for MPS in cancer patients. METHODS: Narrative review. PubMed, CINAHL, PEDro, and Google Scholar databases were searched from inception until November 2017, for the keywords: cancer; cancer pain; breast cancer; mastectomy; lumpectomy; myofascial pain; trigger points. Trials of any methodological quality were included. All published material with an emphasis on randomized control trials was analyzed. RESULTS: MPS is prevalent in cancer patients who suffer from pain, with a prevalence of between 11.9% and 44.8% in those diagnosed either with neck or head or breast cancer. Clinical studies showed conflicting results. Four interventional studies found that specific treatment for MPS may reduce the prevalence of active myofascial trigger points and therefore decrease pain level, sensitivity, and improve range of motion (in shoulder) in cancer patients. Two recent randomized control trials showed that pressure release of trigger points provides no additional beneficial effects to a standard physical therapy program for upper limb pain and function after breast cancer surgery. CONCLUSIONS: We recommend including the evaluation of myofascial pain in routine clinical examination of cancer patients suffering from pain. Future studies are needed to investigate the long- and short-term effect of MPS treatments in cancer patients.
Subject(s)
Breast Neoplasms/epidemiology , Cancer Pain/epidemiology , Head and Neck Neoplasms/epidemiology , Myofascial Pain Syndromes/epidemiology , Myofascial Pain Syndromes/therapy , Breast Neoplasms/surgery , Cancer Pain/physiopathology , Dry Needling/methods , Exercise Therapy/methods , Humans , Mastectomy/adverse effects , Myofascial Pain Syndromes/physiopathology , Quality of Life , Severity of Illness Index , Therapy, Soft Tissue/methods , Trigger Points/physiopathologyABSTRACT
OBJECTIVES: To evaluate the association between episodic migraines and the prevalence of myofascial trigger points (MTrPs) in the sternocleidomastoid and upper trapezius, forward head posture (FHP), neck range of motion (ROM) and cervical facet joint stiffness. METHODS: 20 physiotherapy students with episodic migraines and 20 age- and sex matched healthy controls were included in this observational case-control study. Demographics and headache status were evaluated through questionnaires. Active neck ROM, presence of MTrPs, and cervical facet joint mobility were assessed by physical examination. FHP was measured using a lateral digital photograph taken in a sitting position. RESULTS: No significant differences were found in neck ROM measurements and FHP between the migraine and control groups. Significant differences were found in the prevalence of cervical facet joints stiffness in Occiput-C1 (χ(2) = 4.444, p = 0.035) and C1-C2 (χ(2) = 10.157, p = 0.001), but not in other segments. Significant differences were found in the prevalence of active and latent MTrPs between the migraine and control subjects in the right trapezius (χ(2) = 11.649, p = 0.003) and right sternocleidomastoid (χ(2) = 8.485, p = 0.014). CONCLUSIONS: Our findings support the hypothesis that the prevalence of MTrPs in neck muscles and hypomobility in the upper cervical facet joints are associated with migraines.
