Rib cage pain

[oscar1325]

I broke my 8th rib on the back flat side. I also damaged the nerve. I have had nerve blocks, cryoablation and finally nerve dissection. I still have bad pain almost constantly around my left side. I have had myoneural blocks but only provided short term relief. My doctor doesn't want to keep injecting me if it only provding short term relief. He has discharged me saying there's nothing more he can do. I still have unbearable pain around the left side of my lower rib cage. Does anyone have any other suggestions for treatments? I am considering acupuncture. I don't know what else to do for it and I can't stand this on a constant basis. I have been dealing with this since April 05. I also want to get off my medication but can't. Neurontin is about the only thing that relieves some pain. Any feedback would be appreciated. Thanks Ann Marie

[Dr. Joshua]

For chronic neuropathic pain, if that's the diagnosis, a consultation with a pain specialist is recommended. In addition to Neurontin, various other medication possibilities are available and should be explored. Also transcutaneous nerve stimulation, physical therapy and in some cases, spinal cord stimulation may provide relief. First, a definite diagnosis needs to be made, based on thorough history, physical examination and radiology (I'm sure your doctor has done these already). Ask for a referral or second opinion if your doctor is unable to help you.

[oscar1325]

Thank you for your reply. I have been to 2 pain specialists. I have been diagnosed by both as having intercostal neuralgia. I have had nerve blocks, cryoablation, nerve dissection, tons of physical therapy, aqua therapy. Nerve blocks worked but only short term. Physical therapy severely aggravated my pain. Spinal cord stimulator was recommended by one but the other disagreed. I have since then been discharged by both and still have awful pain. My next step is accupuncture unless someone has a better solution. Thank You.

[Dr. Joshua]

A complex history of chronic pain, such as yours, presents a very difficult treatment challenge. A thorough psychosocial evaluation is required in addition to considering the physical and medical side of the problem. A logical, solid treatment plan is needed based on those evaluations, and all treatment modalities must be explored in a controlled manner. I'm afraid I can't help you much over the Internet, given that this is such a complex issue. I can only recommend that you find a pain specialist who has high recommendations and one that you feel you can trust, and work with that doctor in trying to find an effective treatment. Good luck!

[oscar1325]

I have been getting nerve blocks on my 10th, 11th and 12th intercostal nerves approx every 8 weeks. I also have accupuncture every 6 weeks. Both combined help significantly with my pain. But I still have pain daily and it's a combination of nerve pain, muscle pain and a tear type of pain. Three different doctors brought up the possibility of 12th rib syndrome. I don't know much about it but the symptoms seem similar to mine. How is this diagnosed? What doctor do I go to for that to be ruled out or a possibility? Any info on this would be appreciated. Thank You.

[Purple98Lady]

I was reading about the Wrights test, Eden test etc. and this link is interesting:

http://www.fpnotebook.com/Ortho/Brachial/ThrcOtltSyndrm.htm

[oscar1325]

Well, after 4 and a half years of treatment It seems I have failed all but two treatment options. In October I did a trial of a peripheral nerve stimulator and had a lot of success. In mid November I had the permanent one put in that runs almost the whole length of my 12th rib. I have had significant pain relief. I no longer take any medication-pain killers, muscle relaxers or nerve medication. This was by far and away the best treatment I've gone through and I'm ecstatic I finally opted to try this treatment. Very happy with the results!