Intercostal Neuralgia Successfully Managed With Peripheral Nerve Stimulation

Cureus, 2024 · DOI: 10.7759/cureus.71964 · Published: October 20, 2024

Neurology Pain Management Rehabilitation

Simple Explanation

Intercostal neuralgia causes nerve pain along the ribs, leading to significant discomfort and impacting daily life. This report discusses a case where a patient with long-term thoracic pain found relief through peripheral nerve stimulation (PNS). The patient had tried many treatments without success until a PNS implant was used. This device delivers electrical impulses to the nerves near the painful area. The patient experienced substantial pain relief and improved daily function. After two years, the patient's pain was significantly reduced, they stopped taking opioid medications, and were able to return to their normal activities. This suggests PNS can be a useful option for managing intercostal neuralgia when other treatments fail.

Study Duration

2 years

Participants

One 40-year-old male patient

Evidence Level

Level 4: Case Report

Key Findings

1
A 40-year-old male with long-standing intercostal neuralgia experienced significant pain relief with a permanent PNS implant after failing multiple other treatments.
2
The patient achieved 80-100% daily pain relief at a six-month follow-up and maintained significant pain relief at the two-year follow-up.
3
The patient was able to wean off opioid medications and return to desired daily activities following the permanent PNS implantation.

Research Summary

This case report describes the successful management of refractory intercostal neuralgia in a 40-year-old male patient using peripheral nerve stimulation (PNS). The patient had a history of decades-long thoracic pain and had failed multiple conservative and interventional treatments. Following a successful PNS trial, the patient underwent placement of a permanent PNS implant, which resulted in sustained pain relief, weaning from opioid medications, and a return to daily activities at the two-year follow-up. This case suggests that PNS can be an effective treatment option for patients with intercostal neuralgia who have failed other conservative measures. The two-year follow-up is the longest-reported outcome in the literature for using PNS for intercostal neuralgia after traumatic injury.

Practical Implications

Effective Pain Management

PNS can be a viable option for managing chronic intercostal neuralgia, especially when other treatments have failed.

Reduced Opioid Use

PNS may help patients reduce or eliminate their reliance on opioid medications for pain management.

Improved Quality of Life

Successful PNS treatment can enable patients to return to their daily activities and improve their overall quality of life.

Study Limitations

1
Single case report limits generalizability.
2
The exact mechanism of PNS is still unknown.
3
Limited literature on long-term outcomes of PNS for traumatic intercostal neuralgia.

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