Pulsed radiofrequency in the treatment of a patient with myofascial pain – a case report

Abstract

In Myofascial pain is a type of chronic soft tissue pain that is localized in muscles, fasciae and/or surrounding tissues and is characterized by the presence of muscle trigger points, the palpation of which causes localized or referred pain. One of the myofascial pain syndromes is the Serratus Anterior Muscle Pain Syndrome. The condition manifests itself as deep, dull, diffuse pain between the 5th and 7th ribs along the midaxillary line that radiates to the front of the chest wall, shoulder, shoulder blade and, less frequently, to the 4th and 5th fingers of the upper limb. It most often occurs in people who work hard physically and in athletes, and is favored by injuries, overstrain and muscle cooling, mental stress, fatigue, and lack of sleep. A medical history, characteristic clinical picture, physical examination with palpation assessment of muscles, and the exclusion of other disease entities with similar symptoms, such as radiculopathies, fibromyalgia, rheumatic polymyalgia, chronic fatigue syndrome, polymyositis, are key in the diagnosis of the Serratus Anterior Muscle Pain Syndrome. It is recommended to combine conservative methods (pharmacotherapy, physiotherapy, psychotherapy) and interventional methods such as needling, blockades, botulinum toxin injection and pulsed radiofrequency in the management. This article describes a patient with Serratus Anterior Muscle Pain Syndrome refractory to conservative management, in which the pulsed radiofrequency of the affected muscle gave significant and long-lasting pain relief without significant side effects. In the opinion of the authors and based on the available publications, pulsed radiofrequency can be considered in the therapeutic management of patients with myofascial pain.