Myofascial and nerve compression pain simulating bone involvement in a patient with prostate cancer

Many patients with advanced disease suffer of pain. Not all this pain is induced by the disease itself like tumour growth or infiltration of the nerves. Some of the pains are due to debilitation and degeneration due to immobilisation, atrophy and poor nutrition and are only indirectly related to the progression of the disease. Atrophic changes in the subcutaneous tissue, muscles and tendons can be accompanied by the compression of the nerves against protruding bony edges. This type of pain, not specific to any advanced disease in particular, can be extremely difficult to be treated. We present here a case of patient with a metastasised prostate cancer who suffered of this type of pain and did not respond to standard treatment targeting tumour related pains. Compression of the small cutaneous nerves was successfully treated with injections of depo steroids and local anaesthetics. Not every pain in disseminated prostate cancer is a bone pain. It is our impression that this type of pain is much more common among the patients in palliative care.Many patients with advanced disease suffer of pain. Not all this pain is induced by the disease itself like tumour growth or infiltration of the nerves. Some of the pains are due to debilitation and degeneration due to immobilisation, atrophy and poor nutrition and are only indirectly related to the progression of the disease. Atrophic changes in the subcutaneous tissue, muscles and tendons can be accompanied by the compression of the nerves against protruding bony edges. This type of pain, not specific to any advanced disease in particular, can be extremely difficult to be treated. We present here a case of patient with a metastasised prostate cancer who suffered of this type of pain and did not respond to standard treatment targeting tumour related pains. Compression of the small cutaneous nerves was successfully treated with injections of depo steroids and local anaesthetics. Not every pain in disseminated prostate cancer is a bone pain. It is our impression that this type of pain is much more common among the patients in palliative care