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Intercostal Nerve Entrapment: Chest Wall

  • Sola OlamikanEmail author
  • Amitabh Gulati
  • Andrea M. Trescot

Abstract

Intercostal nerve entrapment is rarely considered as a cause of chest wall pain, even though the pain is usually dermatomal in nature and therefore should be readily apparent. A history of chest wall injury (trauma, surgery, or infection) should alert the clinician to the possibility of intercostal neuralgia.

Keywords

Intercostal neuralgia Intercostal nerve entrapment Intercostal nerve syndrome Chest wall pain Abdominal wall pain 

Supplementary material

Video 29.1

Physical exam of the intercostal nerve (MOV 49860 kb)

Video 29.2

Landmark-guided injection of the intercostal nerve (MOV 51892 kb)

References

  1. 1.
    Trejo-Gabriel-Galan JM, Macarron-Vicente JL, Lazaro L, Rodriguez-Pascual L, Calvo I. Intercostal neuropathy and pain due to pleuritis. Pain Med. 2013;14(5):769–70.CrossRefPubMedGoogle Scholar
  2. 2.
    Nguyen JT, Buchanan IA, Patel PP, Aljinovic N, Lee BT. Intercostal neuroma as a source of pain after aesthetic and reconstructive breast implant surgery. J Plast Reconstr Aesthet Surg. 2012;65(9):1199–203.CrossRefPubMedGoogle Scholar
  3. 3.
    Davies F, Gladstone RJ, Stibbe EP. The anatomy of the intercostal nerves. J Anat. 1932;66(Pt 3):323–33.PubMedPubMedCentralGoogle Scholar
  4. 4.
    Trescot AM. Shingles and interventional pain treatment. ASIPP News. 2006;(Fall):22–3.Google Scholar
  5. 5.
    Oesch A, Kupfer K, Bodoky A. Intercostal nerve syndrome. Swiss Surg Schweiz Chir Chir Suisse Chir Svizzera. 2001;7(2):82–5.Google Scholar
  6. 6.
    Rasmussen JW, Grothusen JR, Rosso AL, Schwartzman RJ. Atypical chest pain: evidence of intercostobrachial nerve sensitization in complex regional pain syndrome. Pain Phys. 2009;12(5):E329–34.Google Scholar
  7. 7.
    Rogers ML, Henderson L, Mahajan RP, Duffy JP. Preliminary findings in the neurophysiological assessment of intercostal nerve injury during thoracotomy. Eur J Cardiothorac Surg Off J Eur Assoc Cardiothorc Surg. 2002;21(2):298–301.CrossRefGoogle Scholar
  8. 8.
    Wildgaard K, Ravn J, Kehlet H. Chronic post-thoracotomy pain: a critical review of pathogenic mechanisms and strategies for prevention. Eur J Cardiothorac Surg Off J Eur Assoc Cardiothorc Surg. 2009;36(1):170–80.CrossRefGoogle Scholar
  9. 9.
    Gimenez-Mila M, Busquets C, Ojeda A, Fauli A, Moreno LA, Videla S. Neuropathic pain with features of complex regional syndrome in the upper extremity after herpes zoster. Pain Pract. 2014;14(2):158–61.CrossRefPubMedGoogle Scholar
  10. 10.
    Chen SM, Chen JT, Kuan TS, Hong CZ. Myofascial trigger points in intercostal muscles secondary to herpes zoster infection of the intercostal nerve. Arch Phys Med Rehabil. 1998;79(3):336–8.CrossRefPubMedGoogle Scholar
  11. 11.
    Johnson ER, Powell J, Caldwell J, Crane C. Intercostal nerve conduction and posterior rhizotomy in the diagnosis and treatment of thoracic radiculopathy. J Neurol Neurosurg Psychiatry. 1974;37(3):330–2.CrossRefPubMedPubMedCentralGoogle Scholar
  12. 12.
    Pradhan S, Taly A. Intercostal nerve conduction study in man. J Neurol Neurosurg Psychiatry. 1989;52(6):763–6.CrossRefPubMedPubMedCentralGoogle Scholar
  13. 13.
    Sakai F, Sone S, Kiyono K, Imai S, Izuno I, Oguchi M, et al. High resolution ultrasound of the chest wall. RoFo: Fortschr Gebiete Rontgenstrahlen Nuklearmedizin. 1990;153(4):390–4.CrossRefGoogle Scholar
  14. 14.
    Byas-Smith MG, Gulati A. Ultrasound-guided intercostal nerve cryoablation. Anesth Analg. 2006;103(4):1033–5.CrossRefPubMedGoogle Scholar
  15. 15.
    Green CR, de Rosayro AM, Tait AR. The role of cryoanalgesia for chronic thoracic pain: results of a long-term follow up. J Natl Med Assoc. 2002;94(8):716–20.PubMedPubMedCentralGoogle Scholar
  16. 16.
    Engel AJ. Utility of intercostal nerve conventional thermal radiofrequency ablations in the injured worker after blunt trauma. Pain Phys. 2012;15(5):E711–8.Google Scholar
  17. 17.
    Garcia Cosamalon PJ, Mostaza A, Fernandez J, Vinuela J, Mazabel M, Costilla S, et al. Dorsal percutaneous radiofrequency rhizotomy guided with CT scan in intercostal neuralgias. Technical note. Acta Neurochir (Wien). 1991;109(3–4):140–1.CrossRefGoogle Scholar
  18. 18.
    Akkaya T, Ozkan D. Ultrasound-guided pulsed radiofrequency treatment of the intercostal nerve: three cases. J Anesth. 2013;27(6):968–9.CrossRefPubMedGoogle Scholar
  19. 19.
    Graybill J, Conermann T, Kabazie AJ, Chandy S. Spinal cord stimulation for treatment of pain in a patient with post thoracotomy pain syndrome. Pain Phys. 2011;14(5):441–5.Google Scholar
  20. 20.
    Peyravi M, Capelle HH, Fischer S, Haverich A, Krauss JK. Subcutaneous peripheral neurostimulation for the treatment of severe chronic poststernotomy neuralgia. Stereotact Funct Neurosurg. 2011;89(4):253–7.CrossRefPubMedGoogle Scholar
  21. 21.
    McJunkin TL, Berardoni N, Lynch PJ, Amrani J. An innovative case report detailing the successful treatment of post-thoracotomy syndrome with peripheral nerve field stimulation. Neuromodulation. 2010;13(4):311–4.CrossRefPubMedGoogle Scholar
  22. 22.
    Samlaska S, Dews TE. Long-term epidural analgesia for pregnancy-induced intercostal neuralgia. Pain. 1995;62(2):245–8.CrossRefPubMedGoogle Scholar
  23. 23.
    Boelens OB, van Assen T, Houterman S, Scheltinga MR, Roumen RM. A double-blind, randomized, controlled trial on surgery for chronic abdominal pain due to anterior cutaneous nerve entrapment syndrome. Ann Surg. 2013;257(5):845–9.CrossRefPubMedGoogle Scholar
  24. 24.
    Williams EH, Williams CG, Rosson GD, Heitmiller RF, Dellon AL. Neurectomy for treatment of intercostal neuralgia. Ann Thorac Surg. 2008;85(5):1766–70.CrossRefPubMedGoogle Scholar
  25. 25.
    Shapiro S, Woodall B, Muller J. Comparative study of neuroma formation in the rat sciatic nerve after CO2 laser and scalpel neurectomy in combination with milliwatt CO2 laser “sealing”. Surg Neurol. 1989;32(4):281–4.CrossRefPubMedGoogle Scholar

Copyright information

© Springer International Publishing Switzerland 2016

Authors and Affiliations

  • Sola Olamikan
    • 1
    • 2
    Email author
  • Amitabh Gulati
    • 3
  • Andrea M. Trescot
    • 4
  1. 1.Department of Anesthesiology and Pain MedicineUniversity of Texas, Southwestern Medical CenterDallasUSA
  2. 2.Children’s Health Medical CenterDallasUSA
  3. 3.Anesthesiology and Critical CareMemorial Sloan Kettering Cancer CenterNew YorkUSA
  4. 4.Pain and Headache CenterAnchorageUSA

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