Background: Intercostal
neuralgia is
pain associated with the intercostal nerves along the rib, chest, and upper abdominal wall. Intercostal
neuralgia has various etiologies, and current conventional treatment options include intercostal nerve blocks, nonsteroidal anti-inflammatory drugs,
transcutaneous electrical nerve stimulation, topical medications,
opioids,
tricyclic antidepressants, and
anticonvulsants. For a subset of patients, these conventional treatment options provide little relief.
Radiofrequency ablation (RFA) is an emerging procedure for the treatment of
chronic pain and
neuralgias. Cooled RFA (CRFA) is a specific type of RFA that has been trialed as a treatment for intercostal
neuralgia in patients refractory to conventional treatment modalities. This case series assesses the efficacy of CRFA for the treatment of intercostal
neuralgia in 6 patients. Case Series: Three female and 3 male patients underwent CRFA of the intercostal nerves to treat intercostal
neuralgia. The patients had an average age of 50.7 years and demonstrated an average
pain reduction of 81.3%. Conclusion: This case series suggests that CRFA may be an effective treatment option for patients with intercostal
neuralgia that is not responsive to
conservative treatment options. To determine the duration of
pain improvement, large research studies need to be conducted.