Myofascial pain in traumatic brachial plexus injury: An important and neglected source of symptoms

Background: It is well accepted that pain in brachial plexus injury (BPI) have a major neuropathic component, but the nociceptive aspects may play an important role in the generation and maintenance of pain in patients with PBI and should be investigated also. An example of a source of nociceptive pain in these individuals is the involvement of myofascial trigger points. Aim: To estimate the prevalence of myofascial pain in individuals with BPI. Methods: This was a cross-sectional study with 31 volunteers who had suffered traumatic BPI, and were treated for a two-year period in three reference centers. All participants were evaluated for the presence of trigger points (TP) in specific muscles. Their demographic and clinical data related to injury and pain were collected in an evaluation form that included the Visual Analogue Scale, Brief Pain Inventory, Douleur Neuropathique 4 and McGill Pain Questionnaire instruments. Results: The sample was predominantly composed of males (93.5%), under the age of 30 years (58.0%), who were injured mainly in motorcycle accidents (77.4%). The prevalence of myofascial pain was 38.7%. The muscles on the injured side were more affected than those on the non-injured side. Interpretation: This study suggests that there may be myofascial components involved in pain of patients with BPI.