Intercostal Nerve Radiofrequency Ablation in the Treatment of Refractory Xiphodynia: A Case Report

Xiphodynia is a debilitating, painful condition characterized by tenderness of the xiphoid process. Initial therapy consists of conservative management and oral medications; however, this is often ineffective. A 68-year-old man presented to the Chronic Pain Clinic with 9/10 pain at the xiphoid process refractory to conservative management. After diagnostic blocks, a bilateral thoracic level 7 and 8 intercostal nerve radiofrequency ablation was performed using a combined fluoroscopy and ultrasound approach. The patient reported greater than 80% pain relief sustained at 2 weeks and 6 months. In patients with refractory xiphodynia, intercostal nerve radiofrequency ablation may offer a therapeutic alternative.