F-3-04-05
NON VISCERAL CHRONIC ABDOMINAL PAIN: THE ROLE OF MYOFASCIAL AND NEUROPATHIC PAIN SYNDROMES
TY Lin, MJ Teixeira,, A Ungaretti, EI Lin, HHS Kaziyama, ST Imamura. Division of Physical Medicine, IOT, Hospital das Clinicas, School of Medicine, University of Sao Paulo, Sao Paulo, Brazil.
Purpose: Persistent or recurrent abdominal pain is usually associated with visceral abnormalities. Very often, however, visceral structures may not be the site of pain. The purpose of the present study is the evaluation of the role of myofascial pain syndromes (MPS) and of peripheral neuropathies in patients presenting chronic abdominal pain of uncetain aetiology.
Method: Forty five patients presenting non-visceral chronic abdominal pain were evaluated. Clinical, neurological, physiatric and phychiatric examinations were performed. All were treated with of NSAIDs, psychotropics, physical therapy and, when necessary, with acupuncture and/or infiltrations with local anesthetics of the trigger points of MPS. In patients with significant psychiatric and/or psychosomatic abnormalities, a psychotherapeutic program was prescribed.
Result: MPS was diagnosed in 73.5%, and peripheral neuropathy in 52.9% of the cases. Fibromyalgia was also present in 12.5% of the cases, Parkinson's disease in 3%, and hemisensitive syndrome in 3%. The multidisciplinary treatment resulted in significant improvement of 64 % of the patients.
Conclusion: In patients with non visceral chronic abdominal pain, the appropriate evaluation of the myofascial conditions of the abdominal wall muscles and of the neurological status is essential for the correct diagnosis and treatment of this incapacitating chronic painful syndrome.
F-3-04-06
ADOLESCENTS WITH NYOFASCIAL PAIN SYNDROME
Alexei V. Karlov, Vladimir A. Karlov (Russian Medical University)
Aim: To reveal risk factors of development of myofascial pain syndrome in adolescents.
Methods: 50 adolescents without somatic pathology were examined by using clinical, neurological, manual and rhentgenological methods.
Results: All 50 adolescents (age from 14 to 16) suffered from myofascial pain syndrome of different locations. Causes of myofascial pain syndrome were posture disorders (scoliosis, kyphosis) in 35 cases (70%) and walk disorders (cerebral palsy, myelodysplasia, trauma of CNS) in 15 cases (30%).
Conclusion: The main factor promoting development of myofascial pain syndrome in adolescents is a biomechanics disturbance of spinal column as a result of walk and posture disorders. Classical methods of myofascial syndrome treatment should be combined with adequate orthopedic correction of a biomechanics disturbance.
