Patients may experience pain in the chest wall due to various sources. Post-Surgical scars (neuromas) may become a significant source of pain after operations. Shingles pain (post-herpetic neuralgia) may also be a source of discomfort in the chest region. With this syndrome, the pain develops either before or after the lesions have healed. Chest wall pain may also emanate from problems in the spine.
Post-thoracotomy syndrome presents as pain after surgical removal of ribs injured the underlying intercostal nerves. Pain may present as sharp, shooting pain at the surgical site but then radiates to the breastbone. Persistent pain not amenable to physical therapy or nerve pain blocking medications may benefit from intercostal nerve blocks.
Post-herpetic neuralgia is caused by a reactivation of the Herpes Zoster virus at the dorsal root ganglion near the spinal nerve causing pain lasting greater than 3 months. Pain typically precedes any skin blisters, but the pain can often times be debilitating. Spinal nerve root blocks are usually successful in alleviating pain.