Interventional procedures for patients with thoracic pain syndromes


Helen Gharaei

Islamic Azad University School of Medicine, Iran

: Analg Resusc: Curr Res

Abstract


Thoracic back pain is common throughout life however isn’t studying as neck pain or low back pain.Thoracic pain symptoms are significant, however the quantity of publications on the etiology of thoracic pain is limited. The objective of this focused review is to discuss the interventional procedures (flouroscopic or ultrasound guided techniques) commonly used for chronic thoracic pain syndromes and then introduce these syndromes during discussion. Thoracic selective nerve root block is useful in diagnosis and treatment of thoracic radicular pain that can be created by intercostal neuralgia and pressure to nerve root that exists from intervertebral foramen or because of rib pathology, scare of thoracic surgery or due to scoliosis. Intercostal nerve block is useful in the evaluation and management of pain involving the chest wall, upper abdominal wall, post-thoracotomy pain, cancer pain, rib fractures, metastatic lesions of the liver, liver hemangioma and PHN. Thoracic medial branch block should be considered if the patient complains of paravertebralpain that worsens with prolonged standing, hyperextension or rotation of the thoracic spinal column. Thoracic sympathic block is used in the control of chronic benign and malignant thoracic and mediastinal pain syndromes, including: neuropathic pain in thorax, chest wall, thoracic viscera, herpes zoster, PHN, phantom breast pain, cancer of the esophagus, heart, bronchi, trachea, lung, pleura, or other chronic pain of esophagus. Thoracic paravertebralblock is useful in the evaluation and management of pain involving the chest wall, the upper abdominal wall, thoracic spine, post-thoracotomy pain,posterior rib fractures, PHN, cancer pain, including invasive tumors of the thoracic spine.As the intercostal nerve block is a simple block and most of thoracic pain syndromes respond to this injection. It seems, after a correct diagnosis, pain management of thoracic pain syndromesis not difficult.

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