Patients with chronic pain have various psychosocial and pain problems. Many have issues such as anxiety, depression and loneliness and at times need psychological therapy. Normal psychotherapy is a one-on-one session, as seen in routine counselling. Our trial was to undertake psychological treatment as group therapy for patients with chronic pain. In the psychiatric field, group psychotherapy for depressed and addicted patients is a common practice. Our aim was to provide an opportunity for patients with pain to come together, talk about their worries and thoughts, objectively view their thoughts and perceptions toward their pain, and gain some awareness and insights. Participants were chronic pain patients with complaints of pain in different parts of the body and received this group therapy in parallel with their usual personal consultation with their doctor. This therapy was claimed for medical fee as outpatient group psychotherapy. Herein, we report this unique outpatient group psychotherapy approach.

We report a case of chronic chest pain wherein ultrasound-guided brachial plexus block (BPB) was effective. A 30-year-old man complained of bilateral chest pain. Laboratory and imaging studies revealed no malignant tumor, vascular or collagen disease. Intercostal nerve, epidural, phrenic nerve, and stellate ganglion blocks were ineffective. After a careful re-examination, the pain was found to be in the area of the serratus anterior muscle. Interscalene BPB significantly improved the subjective symptoms. Though this approach is used to treat pain in the upper limbs and shoulders, it can also block the long thoracic nerve innervating serratus anterior muscle. The chest pain, in this case, was speculated to be derived from the serratus anterior muscle, and the block of the long thoracic nerve was effective. The results suggest that it is worthwhile to try an interscalene BPB. It can be safely performed in outpatients with lateral chest pain of the serratus anterior muscle.