2017 Volume 24 Issue 4 Pages 332-335
A 35-year-old man presented with severe pain, numbness, and a cold sensation on the ulnar side of his fifth finger. Although cervical radiculopathy and cubital tunnel syndrome were initially suspected, thoracic outlet syndrome was diagnosed based on a provocation test and the observation of subclavian artery disruption by magnetic resonance angiography. As his activity was impaired due to oral administration of several analgesics, we reconsidered therapeutic treatment. His pain was alleviated with a stellate ganglion block; therefore, we diagnosed his pain as sympathetically maintained pain and performed a left thoracic sympathetic nerve block (TSB). After TSB, his pain was relieved almost completely, and oral analgesics became unnecessary. The patient's pain increased every 6–12 months, and the TSB has been repeated each time, for a total of 6 times, with good clinical results. We conclude that for sympathetically maintained pain caused by thoracic outlet syndrome, careful repetition of TSB may be useful for pain management.
