Thoracic Wall Pain

Thoracic wall pain is a frequent experience after surgical procedure.
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Thoracic Wall Pain

Thoracic wall pain is a frequent experience after surgical procedure.

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After a surgical procedure involving the thoracic wall, it is frequent to experience chronic pain. Another main cause is post-herpetic pain. In both cases, the patient should be monitored by a specialized pain management team. The Radiofrequency or Crioablation of intercostal nerves or some blocks such as the Epidural, Paravertebral or Erector Spinae Plane (ESP) Block, are outstanding tools for the treatment of this pain, when it does not respond to the conventional treatment.

Most Common Syndromes

Post-herpetic pain among post-surgical syndromes are two of the main causes for Thoracic Pain.


Costochondritis is inflammation of the costal cartilage at the articulation of the ribs and sternum. It is a benign disorder, as in contrast to myocardial ischemia or infarction. The history is often characterized by insidious onset of chest wall pain with a history of repeated minor trauma sometimes with palpation of affected costochondral joints. Pain control with anti-inflammatory drugs may be useful.

Pectoral or intercostal muscles strains

Muscle strains are a common cause of chest pain. A strain of pectorals or intercostal muscles can begin gradually from repetitive motions or it can have a sudden onset. Pain, tenderness and difficulty breathing are often symptoms of these conditions. Ultrasounds (less accurate) can be performed or an MRI can be requested to better evaluate the lesion. Pain control with anti-inflammatory drugs or with an interventional technique may be useful.

Lower rib pain syndrome

Lower rib pain syndrome is characterized by pain in the lower chest or upper abdomen a tender spot on the costal margin, and reproduction of the pain by pressing on the spot. It is more common among women and in those with a mean age in the mid-40s. Even after a definitive diagnosis is made, one-third of patients undergo further evaluations for other causes of pain.

Sternalis syndrome

The sternalis syndrome is a rarely described and generally self-limited condition. It is characterized by localized tenderness overlying sternalis muscle or over the body of the sternum or overlying, and palpation often causes radiation of pain bilaterally. Complementary imaging exams can be requested to well characterize the condition. Sometimes management of pain could be necessary.

Pain from thoracic spine/costovertebral joints

Thoracic spinal pain syndromes are relatively common. Some conditions are: snapping scapula syndrome that is associated with pain in the upper back with overhead or throwing activities of the upper extremities; and thoracic disc herniations (more rarely). Costovertebral joint dysfunction is an uncommon condition characterized by posterior chest wall pain aggravated by coughing or deep breathing.

Treatment Approaches


I had nucleoplasty and radioablation treatment in January 2021. Algarve Pain Centre handled the whole process process in a professional but friendly way and the medical results of the procedure in my case are amazing.

Grzesiak WitoldPoland

Indeed we have been greatly satisfied with your team and professional support over the past months. Great satisfaction with your team including the new facilities in the Center.

Jean-François CristauFrance
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