ABSTRACT
BACKGROUND AND OBJECTIVES:
Chronic abdominal pain may originate in visceral, somatic or nervous structures. Diagnosis is challenging and, in prolonged cases with atypical development, the possibility of a myofascial pain syndrome should be considered. The objective was to report a case of post-surgical chronic abdominal pain perpetuated by the presence of trigger points in the musculature of the abdominal wall.
CASE REPORT:
Male patient, 15 years old, underwent appendectomy without complications. Due to the persistence of pain after surgery, gabapentin and analgesics were prescribed. After 45 days, the patient still had disabling pain, preventing him from performing usual activities. The patient underwent surgical revision, which was not conclusive, and other attempts at pain control, such as anesthetic block of the abdominal transverse plane and transdermal lidocaine, without success. He was then referred to the acupuncture clinic, presenting antalgic gait, voluntary guarding to palpation of the hypochondrium and right iliac fossa, presence of trigger points in the rectus abdominis and right quadratus lumborum muscles, with pain referred at right iliac fossa, with no signs or symptoms of neuropathic pain. The needling of trigger points, electrostimulation at the motor points of referred muscles and stretching guidance were performed. During the follow-up period, the patient presented a gradual improvement in symptoms, suspension of the drugs in use and return to activities.
CONCLUSION:
Myofascial painful syndrome is one of the most common causes of pain and disability, is still underdiagnosed and should be considered among the differential diagnosis.
Keywords:
Acupuncture; Chronic pain; Myofascial pain syndromes