title: Myofascial pain in patients with postthoracotomy pain syndrome.
abstract: OBJECTIVE
  Postthoracotomy pain syndrome is generally considered to be neuropathic pain due to intercostal nerve injury. However, nonneuropathic pain can also occur following thoracic surgery. We present a series of cases with postthoracotomy pain syndrome in which myofascial pain was thought to be a causative component of postthoracotomy pain syndrome.
  
  
  METHODS
  Twenty-seven patients (17 men and 10 women) were treated with trigger point injections, intercostal nerve blocks, and/or epidural blocks. Clinical criteria were used to diagnose the myofascial pain. A visual analogue scale was used, and sensory disturbances were recorded before and after treatment. A trigger point in a taut muscular band within the scapular region, which we diagnosed as myofascial pain, was observed in 67% of the patients. The existence of this trigger point significantly increased the rate of success for the treatments.
  
  
  CONCLUSIONS
  Postthoracotomy pain may result, at least in part, from a nonneuropathic origin (myofascial pain). It is recommended that each patient be examined in detail to determine whether there is a trigger point in a taut muscular band within the scapular region. If found, this point is suggested as a good area for anesthetic injection.
authors.affiliation: Department of Anesthesiology and Critical Care Medicine, Hiroshima University School of Medicine, Japan. s-daimao@ma4.seikyou.ne.jp
authors.forename: H
authors.initials: H
authors.lastname: Hamada
authors.forename: K
authors.initials: K
authors.lastname: Moriwaki
authors.forename: K
authors.initials: K
authors.lastname: Shiroyama
authors.forename: H
authors.initials: H
authors.lastname: Tanaka
authors.forename: M
authors.initials: M
authors.lastname: Kawamoto
authors.forename: O
authors.initials: O
authors.lastname: Yuge
mesh_terms: D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009209:Myofascial Pain Syndromes / Q000209:etiology*; D010149:Postoperative Pain / Q000209:etiology*; D012189:Retrospective Studies; D013908:Thoracotomy / Q000009:adverse effects*