[Inpatient treatment for postradical neck pain syndrome by use of complementary medicine]

The standard treatment of papillary thyroid cancer with a diameter >1 cm is thyroidectomy combined with a modified neck-dissection of the central (perithyroideal, prelaryngeal and tracheo-esophageal) lymph nodes and a consecutive radiation. Frequently, postoperative pain syndromes occur after this procedure. The so-called 'postradical neck pain syndrome' (PRNS) is a combination of cervical neuropathic pain, constricted and painful mobility of the shoulder region(s) including inhibited abduction capacity of the shoulder joint and a scapula alata. PRNS is often resistant to conventional therapy such as analgesics and physiotherapy.

A 56-year-old female inpatient, suffering from a severe PRNS after thyroidectomy and neck dissection due to papillary thyroid cancer for the past 2 years, was treated with a combination of hydrotherapy according to Kneipp, conventional physiotherapy, acupuncture and cantharidin blisters in order to reduce neuropathic pain, increase the range of cervical mobility and improve parameters of health-related quality of life (based on SF-36).

Within 4 weeks of combined treatment, the left-cervical neuropathic pain was improved remarkably, and the range of the cervical mobility was increased sufficiently. In addition, the SF-36 scales 'pain' and 'common well-being' were improved to a clinically relevant extent. The multi-modular treatment was well tolerated.

In PRNS, a combination of several methods of complementary medicine may be an effective and well tolerated alternative to conventional treatment. Further clinical studies are required to confirm the results.