Myofascial trigger points in intercostal muscles secondary to herpes zoster infection of the intercostal nerve

Archives of Physical Medicine and Rehabilitation
S M ChenC Z Hong

Abstract

Chronic pain in the chest wall is a major complication after herpes zoster infection of intercostal nerves. It is usually difficult to control pain of such origin. Two cases are reported of postherpetic neuralgia after herpes zoster infection involving the intercostal nerves. Both patients had shooting, burning, aching, and localized pain in the muscle supplied by the involved intercostal nerves 1 to 3 months after onset. Compression palpation of a tender spot in one of these muscles induced a referred pain that followed the corresponding interspace, usually in the distal anterior direction. Local twitch responses could be elicited during injection of 0.5% or 1% lidocaine into one of these tender spots; the pain in the interspace was consistently eliminated immediately after injection. One patient had complete pain relief after three series of injections. The effect of pain relief for the other patient lasted for 1 to 2 weeks after the initial injection and lasted progressively longer (up to 2 months) after repeated injections. It appears that many of the tender spots formed in intercostal muscles after herpes zoster are myofascial trigger points that respond to injection with referred pain, local twitch responses, and immediat...Continue Reading

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Citations

Jul 8, 2010·Current Pain and Headache Reports·John Z Srbely
Oct 6, 2012·Drugs & Aging·Srinivas Nalamachu, Patricia Morley-Forster
May 23, 2006·Pain Medicine : the Official Journal of the American Academy of Pain Medicine·Debra K Weiner, Kenneth E Schmader
Dec 18, 2009·The Journal of Pain : Official Journal of the American Pain Society·John Z SrbelyMark Lowerison
Sep 4, 2013·Pain·Christian GeberFrank Birklein
Jun 26, 2001·Clinical Anatomy : Official Journal of the American Association of Clinical Anatomists & the British Association of Clinical Anatomists·J A VilenskyL J Fourie
Apr 24, 2007·American Journal of Physical Medicine & Rehabilitation·Yueh-Ling HsiehChang-Zern Hong
Mar 17, 2017·BMC Infectious Diseases·Liang-Kung ChenChang Won Won
Jun 9, 2020·Pain Research & Management : the Journal of the Canadian Pain Society = Journal De La Société Canadienne Pour Le Traitement De La Douleur·Xiang-Hong LuXiao-Jun Gou

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