Prevalence of Myofascial Pain Syndrome and Efficacy of Trigger Point Injection in Patients with Incurable Cancer: A Multicenter, Prospective Observational Study (MyCar Study)

Abstract Objective Myofascial pain syndrome (MPS) is caused by overload or disuse of skeletal muscles. Patients with cancer are often forced to restrict their movement or posture for several reasons. The study was conducted to investigate the prevalence and risks of MPS in patients with incurable ca...

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Published in:Pain medicine (Malden, Mass.) Mass.), 2022-07, Vol.23 (7), p.1259-1265
Main Authors: Ishiki, Hiroto, Hasuo, Hideaki, Matsuda, Yoshinobu, Matsuoka, Hiromichi, Hiramoto, Shuji, Higuchi, Masaki, Yoshida, Kohei, Tokoro, Akihiro, Hatano, Yutaka, Hori, Tetsuo, Kinkawa, Junya, Nojima, Masanori
Format: Article
Language:English
Subjects:
Cancer
Clinical outcomes
Injection
Injections
Metastases
Multivariate analysis
Observational studies
Pain
Pain management
Palliative care
Patients
Risk factors
Skeletal muscle
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Summary:Abstract Objective Myofascial pain syndrome (MPS) is caused by overload or disuse of skeletal muscles. Patients with cancer are often forced to restrict their movement or posture for several reasons. The study was conducted to investigate the prevalence and risks of MPS in patients with incurable cancer. The efficacy of trigger point injection (TPI) was also explored. Methods This was a multicenter, prospective observational study. Patients with incurable cancer who started receiving specialist palliative care were enrolled. We investigated the MPS in this population and accompanying risk factors for restricting body movement. Pre- and post-TPI pain was also evaluated using a Numerical Rating Scale (NRS) in patients who received TPI. The primary outcome was the prevalence of MPS. Results A total of 101 patients were enrolled from five institutions in Japan. Most of the patients (n = 94, 93.1%) had distant metastases, and half of the patients (50, 49.5%) received anticancer treatment. Thirty-nine (38.6%) patients had MPS lesions at 83 sites. Multivariate analysis revealed that the significant risk factor for MPS was poor Performance Status (PS) (odds ratio 3.26; 95% confidence interval [CI] 1.18–9.02, P = .023). We performed TPI for 40 out of 83 MPS lesions. Mean NRS for MPS before TPI was 7.95, which improved to 4.30 after TPI (P 
ISSN:1526-2375
1526-4637
DOI:10.1093/pm/pnab350