1.Scalene Myofascial Pain Syndrome Mimicking Cervical Disc Prolapse: A Report of Two Cases
Nizar Abd Jalil ; Mohammad Saufi Awang ; Mahamarowi Omar
Malaysian Journal of Medical Sciences 2010;17(1):60-66
Scalene myofascial pain syndrome is a regional pain syndrome wherein pain originates over
the neck area and radiates down to the arm. This condition may present as primary or secondary to
underlying cervical pathology. Although scalene myofascial pain syndrome is a well known medical
entity, it is often misdiagnosed as being some other neck pain associated with radiculopathy, such as
cervical disc prolapse, cervical spinal stenosis and thoracic outlet syndrome. Because scalene myofascial
pain syndrome mimics cervical radiculopathy, this condition often leads to mismanagement,
which can, in turn, result in persistent pain and suffering. In the worst-case scenarios, patients may
be subjected to unjustifiable surgical intervention. Because the clinical findings in scalene myofascial
pain syndrome are “pathognomonic”, clinicians should be aware of ways to recognize this disorder
and be able to differentiate it from other conditions that present with neck pain and rediculopathy.
We present two cases of unilateral scalene myofascial pain syndrome that significantly impaired
the patients’ functioning and quality of life. This case report serves to create awareness about the
existence of the syndrome and to highlight the potential morbidity due to clinical misdiagnosis.
2.Myofascial Pain Syndrome in Chronic Back Pain Patients.
Chee Kean CHEN ; Abd Jalil NIZAR
The Korean Journal of Pain 2011;24(2):100-104
BACKGROUND: Myofascial pain syndrome (MPS) is a regional musculoskeletal pain disorder that is caused by myofascial trigger points. The objective of this study was to determine the prevalence of MPS among chronic back pain patients, as well as to identify risk factors and the outcome of this disorder. METHODS: This was a prospective observational study involving 126 patients who attended the Pain Management Unit for chronic back pain between 1st January 2009 and 31st December 2009. Data examined included demographic features of patients, duration of back pain, muscle(s) involved, primary diagnosis, treatment modality and response to treatment. RESULTS: The prevalence of MPS among chronic back pain patients was 63.5% (n = 80). Secondary MPS was more common than primary MPS, making up 81.3% of the total MPS. There was an association between female gender and risk of developing MPS (chi2 = 5.38, P = 0.02, O.R. = 2.4). Occupation, body mass index and duration of back pain were not significantly associated with MPS occurrence. Repeated measures analysis showed significant changes (P < 0.001) in Visual Analogue Score (VAS) and Modified Oswestry Disability Score (MODS) with standard management during three consecutive visits at six-month intervals. CONCLUSIONS: MPS prevalence among chronic back pain patients was significantly high, with female gender being a significant risk factor. With proper diagnosis and expert management, MPS has a favourable outcome.
Back Pain
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Body Mass Index
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Female
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Humans
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Musculoskeletal Pain
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Myofascial Pain Syndromes
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Occupations
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Pain Management
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Prevalence
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Prospective Studies
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Risk Factors
;
Trigger Points
3.Percutaneous T2 and T3 Radiofrequency Sympathectomy for Complex Regional Pain Syndrome Secondary to Brachial Plexus Injury: A Case Series.
Chee Kean CHEN ; Vui Eng PHUI ; Abd Jalil NIZAR ; Sow Nam YEO
The Korean Journal of Pain 2013;26(4):401-405
Complex regional pain syndrome secondary to brachial plexus injury is often severe, debilitating and difficult to manage. Percuteneous radiofrequency sympathectomy is a relatively new technique, which has shown promising results in various chronic pain disorders. We present four consecutive patients with complex regional pain syndrome secondary to brachial plexus injury for more than 6 months duration, who had undergone percutaneous T2 and T3 radiofrequency sympathectomy after a diagnostic block. All four patients experienced minimal pain relief with conservative treatment and stellate ganglion blockade. An acceptable 6 month pain relief was achieved in all 4 patients where pain score remained less than 50% than that of initial score and all oral analgesics were able to be tapered down. There were no complications attributed to this procedure were reported. From this case series, percutaneous T2 and T3 radiofrequency sympathectomy might play a significant role in multi-modal approach of CRPS management.
Analgesics
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Brachial Plexus
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Brachial Plexus Neuropathies
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Chronic Pain
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Humans
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Stellate Ganglion
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Sympathectomy