The 68th
Scientific Meeting
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| 19S-025 |
Incidence of concomitant thoracic facet joint syndrome in patients with postherpetic neuralgia
Department of Anesthesia and Pain Medicine, School of Medicine, Pusan National University, Yangsan, Korea
Abstract
Background: Herpes zoster and the following postherpetic neuralgia (PHN) commonly develop in the thoracic dermatome. At the first visit of the patient, the physician usually focuses on inspection of the dermatomal lesions, without palpation of the adjacent spine due to the extreme tactile allodynia of the patients. This study evaluated the prevalence of the coexistence of PHN and thoracic facet joint syndrome (TFJS).
Methods: A retrospective study enrolled 130 patients with PHN in the thoracic dermatomes. They were palpated on the corresponding and adjacent facet joints, and TFJS was confirmed by dual diagnostic medial branch blocks. The prevalence of the coexistence of PHN and TFJS, the interval from the rash onset to TFJIs, the interval from the first visit to TFJIs, the prevalence of concomitant underlying thoracic spine abnormalities, and the patients’ sleeping position related to tactile allodynia were compared between PHN patients with and without TFJS.
Results: Twenty-seven (20.8%, M/F = 11/16) patients with PHN had concomitant TFJS (ipsilateral, contralateral, and bilateral = 10, 1, and 16, respectively). Age, interval from the onset of the rash or the first visit to TFJIs, the incidence of concomitant underlying thoracic spine abnormalities, and sleeping patterns did not show any difference in the groups with and without TFJS.
Conclusions: One fifth of PHN patients had concomitant TFJS, and ipsilateral TFJS affected about one third among them. Instead of up-titration of medication for neuropathic pain, it is necessary to turn attention to comorbid referred pain from TFJS.
Key Words: Attention; Demography; Herpes zoster; Palpation; Prevalence; Postherpetic neuralgia; Posture; Radiating pain; Referred pain; Skin rash; Tactile allodynia; Zygapophyseal joint.
REFERENCES
1.Thakur R, Kent JL, Dworkin RH. Herpes zoster and postherpetic neuralgia. In: Bonica’s management of pain. 4th ed. Edited by Fishman S, Ballantyne J, Rathmell JP, Bonica JJ. Philadelphia (PA), Lippincott Williams & Wilkins. 2010, pp 338-57.
2.Kim KH. Herpes zoster vaccination. Korean J Pain 2013; 26: 242-8.
Background: Herpes zoster and the following postherpetic neuralgia (PHN) commonly develop in the thoracic dermatome. At the first visit of the patient, the physician usually focuses on inspection of the dermatomal lesions, without palpation of the adjacent spine due to the extreme tactile allodynia of the patients. This study evaluated the prevalence of the coexistence of PHN and thoracic facet joint syndrome (TFJS).
Methods: A retrospective study enrolled 130 patients with PHN in the thoracic dermatomes. They were palpated on the corresponding and adjacent facet joints, and TFJS was confirmed by dual diagnostic medial branch blocks. The prevalence of the coexistence of PHN and TFJS, the interval from the rash onset to TFJIs, the interval from the first visit to TFJIs, the prevalence of concomitant underlying thoracic spine abnormalities, and the patients’ sleeping position related to tactile allodynia were compared between PHN patients with and without TFJS.
Results: Twenty-seven (20.8%, M/F = 11/16) patients with PHN had concomitant TFJS (ipsilateral, contralateral, and bilateral = 10, 1, and 16, respectively). Age, interval from the onset of the rash or the first visit to TFJIs, the incidence of concomitant underlying thoracic spine abnormalities, and sleeping patterns did not show any difference in the groups with and without TFJS.
Conclusions: One fifth of PHN patients had concomitant TFJS, and ipsilateral TFJS affected about one third among them. Instead of up-titration of medication for neuropathic pain, it is necessary to turn attention to comorbid referred pain from TFJS.
Key Words: Attention; Demography; Herpes zoster; Palpation; Prevalence; Postherpetic neuralgia; Posture; Radiating pain; Referred pain; Skin rash; Tactile allodynia; Zygapophyseal joint.
REFERENCES
1.Thakur R, Kent JL, Dworkin RH. Herpes zoster and postherpetic neuralgia. In: Bonica’s management of pain. 4th ed. Edited by Fishman S, Ballantyne J, Rathmell JP, Bonica JJ. Philadelphia (PA), Lippincott Williams & Wilkins. 2010, pp 338-57.
2.Kim KH. Herpes zoster vaccination. Korean J Pain 2013; 26: 242-8.
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