Cryoneurolysis of Intercostal Nerves for Postherpetic Neuralgia: A Case Report

Cryoneurolysis is a procedure that has been shown to be efficacious in managing pain in various settings. Multiple studies have demonstrated the benefit of cryoneurolysis; however, the literature on managing postherpetic neuralgia with cryoneurolysis is scarce. The current treatment options available include transdermal lidocaine patches, capsaicin, non-steroidal anti-inflammatory drugs, nerve blocks, antidepressants, anticonvulsants, and opioids. Pain-relieving treatments such as opioids can have long-term detrimental effects on a patient or be ineffective for long-term pain relief, so there is cause to explore alternative treatment options. Here, we present a case of ultrasound-guided cryoneurolysis of the intercostal nerves for the management of postherpetic neuralgia after herpes zoster bilateralis symmetricus. After several treatment options were unsuccessful in alleviating this patient's pain, cryoneurolysis of the intercostal nerves proved to be a very effective pain management tool.