Acupuncture and trigger point injection in the management of poststernotomy pain syndrome: A case series study

Poststernotomy pain syndrome (PSPS) is defined as chronic pain after thoracic surgery persisting for at least 2 months and without apparent cause. The incidence of PSPS after surgery is reported to be between 7% and 66%. Currently, there is no standard protocol for management of such cases, and treatment modalities are mainly directed towards the use of various analgesics. Numerous other approaches have been tried in order to relieve this pain, including osteopathy, trigger point infiltration and acupuncture.

A case series study was conducted; data were collected from 20 patients seeking pain relief for poststernotomy pain, at the Outpatient Pain Clinic, National Research Center, Cairo, Egypt. Treatment consisted of local wound infiltration with lidocaine 1% and acupuncture. Each patient was scheduled for twice weekly sessions over a period of 4 weeks. Pain was measured using visual analogue scales (VAS) pre and post each treatment session.

Out of the 20 patients, 15 participants completed all 8 sessions. They reported improvement in their chest wall pain, compared to their initial presenting state. There was a significant decrease in pain score from initial VAS to first measurement (p = 0.001), between 3 and 4 (p = 0.014), 4 and 5 (p = 0.013), 5 and 6 (p = 0.014) and between 6 and 7 measurement (p = 0.008).

The dual approach of acupuncture and trigger point injection for PSPS patients offer a promising means of pain relief. Controlled studies with larger numbers of patients are required.