Utility of Intercostal Nerve Conventional Thermal Radiofrequency Ablations in the Injured Worker after Blunt Trauma

Abstract

Background: Intercostal nerve blocks offer short-term therapeutic relief and serve as a diagnostic test for intercostal neuralgia. This original case report demonstrates the efficacy of radiofrequency ablations for long-term pain relief of intercostal neuralgia. To date, there have been no studies that demonstrate the efficacy of thermal conventional intercostal nerve radiofrequency ablations for intercostal neuralgia. Objective: Describe the use of conventional thermal radiofrequency ablations of the intercostal nerves to treat blunt chest wall trauma. Study Design: Case report. Setting: Clinical practice. Methods: Six patients suffering from work-related injuries to the chest wall whose treatment focused on conventional thermal radiofrequency ablations of the intercostal nerves. Results: Four of the 6 patients were pain free by their final visit. The remaining 2 patients experienced pain relief until one began wearing a brace after an L5-S1 fusion; the other required repeat treatment after 5.5 months. Limitations: Case series. There was limited follow-up as patients were either discharged after receiving potentially curative care or were lost to follow-up. Conclusions: Following conventional thermal radiofrequency ablations of the intercostal nerves, 5 of the 6 patients experienced either long-term pain relief or required no additional care. The treatment has potential efficacy for injuries, including rib fractures or intercostal neuralgia, stemming from blunt trauma to the chest wall. In addition, there may be a potential for this treatment to help patients suffering from postthoracotomy pain. Key Words: Radiofrequency ablation, intercostal neuralgia, rib fracture, blunt trauma, workers’ compensation.