Journal article
Atypical Chest Pain: Evidence of Intercostobrachial Nerve Sensitization in Complex Regional Pain Syndrome
Pain physician, v 12(5), pp E329-E334
01 Sep 2009
PMID: 19787018
Featured in Collection : UN Sustainable Development Goals @ Drexel
Abstract
Background: Atypical chest pain is a common complaint among Complex Regional Pain Syndrome (CRPS) patients with brachial plexus involvement. Anatomically, the intercostobrachial nerve (ICBN) is connected to the brachial plexus and innervates the axilla, medial arm and anterior chest wall. By connecting to the brachial plexus, the ICBN could become sensitized by CRPS spread and become a source of atypical chest pain.
Objective: To evaluate the sensitivity of chest areas in CRPS patients and normal controls.
Design: Prospective investigation of pressure algometry in chest areas to determine chest wall sensitivity.
Methods: CRPS patients and normal controls volunteered to participate in our study. Each individual was examined to meet inclusion criteria. Patients' report of chest pain history was collected from every participant. Pressure algometry was used to measure pressure sensitivity in the axilla, anterior axillary line second intercostal space, mid-clavicular third rib, mid-clavicular tenth rib, and midsternal. Each of these measurements were compared to an intra-participant abdominal measure to control for an individuals generalized sensitivity.
The ratios of chest wall sensitivities were compared between CRPS patients and normal controls.
Results: A history of chest pain was reported by a majority (94%) of CRPS patients and a minority (19%) of normal controls. CRPS patients reported lifting their arm as a major initiating factor for chest pain. To pressure algometry, the ratios of CRPS patients were significantly greater than control subjects (p<0.02 throughout), indicating increased chest wall sensitivity.
Limitations: This study is limited by the relatively small number of patients (n=35) and controls (n=21) used.
Conclusion: The results of this study support the idea that chest pain is greater in CRPS patients than normal controls. The ICBN could be the source of this sensitization by CRPS spread from the brachial plexus.
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Details
- Title
- Atypical Chest Pain: Evidence of Intercostobrachial Nerve Sensitization in Complex Regional Pain Syndrome
- Creators
- Jennifer W. RasmussenJohn R. Grothusen - Drexel UniversityAndrea L. Rosso - Drexel Univ, Coll Med, Dept Neurol, Philadelphia, PA 19102 USARobert J. Schwartzman - Drexel University
- Publication Details
- Pain physician, v 12(5), pp E329-E334
- Publisher
- Am Soc Interventional Pain Physicians
- Number of pages
- 6
- Resource Type
- Journal article
- Language
- English
- Academic Unit
- Neurology
- Web of Science ID
- WOS:000208130200001
- Scopus ID
- 2-s2.0-70449637867
- Other Identifier
- 991019167745904721
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InCites Highlights
Data related to this publication, from InCites Benchmarking & Analytics tool:
- Web of Science research areas
- Anesthesiology
- Clinical Neurology