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Title: Management Of Cancer Pain With Low Dose Neuromodulator, Opioids Along With USGDN (Ultrasonography Guided Dry Needling) A Novel Approach Of Muscle Interventions.
e-poster Number: INSIM74
Category: Pain
Author Name: Prajwal Vasant Kadam
Institute: B.Y.L Nair Charitable Hospital
Co-Author Name: Dr. Varsha S Suryavanshi, Dr. Rohit Pai, Dr. Charulata Deshpande, Dr. Girish Rajadhyaksha
Abstract :
Introduction: To present a novel perspective of neuromyopathy as a cause of pain and its management with USGDN and neuromodulator.
52 yrs, male operated case of CA Buccal mucosa, post-chemotherapy & radiotherapy, vas10/10, mouth opening zero, swelling, erythema of Rt face with a large infected & inflamed cervical lymph node. In ward, patient was on IV Paracetamol 1gm tds.
Pain site: Rt face, neck & scalp.
Methods: Started oral Pregabalin75 mg od, Ultracet bd. After 7 days 30 percent relief.
Started 1st session of USGDN with 32G needles addressing the facial, scalp & neck muscles.
Results: Post 1st session mouth opening improved to 0.5 cm.
After 2 days, VAS 4/10, mouth opening improved to 1.5 cm. pt discharged after 3rd session with 100% pain relief with mouth opening of 2.5cm.
After 15 days lymph node swelling was healed. Expired pain-free after 3 months.
Discussion: Post-treatment myalgia, fibrosis & muscle spasm may cause pain. The uniform lasting pain relief achieved by USGDN for this patient suggests muscle spasms led to the generation of myofascial trigger points in the face, head, neck, and masticatory muscles causing pain. Needles produce a local twitch reflex(LTR) followed by intense muscle relaxation leading to pain relief due to the release of nerve entrapments.
Conclusion: Consider addressing myofascial components equally along with neural elements with USGDN as USGDN proved to be an effective, safer, cheaper modality in intense pain with low-dose neuromodulators and/or Opioids leading to pain-free life & avoiding the side effects of Opioids.
