A person who has had a thoracotomy or penetrating trauma to the chest wall may develop a chronic pain syndrome at the trauma site.


Patient selection: at least 8 weeks after surgery (to allow for adequate healing)


Clinical features:

(1) persistent or recurrent pain localized to a scar in the chest wall

(2) variable sensory loss distal to scar with absence of sweating

(3) variable tenderness to palpation

(4) The pain may be exacerbated by certain movements.


Relief of pain after injection of a local anesthetic suggests traumatic neuroma or nerve entrapment.



(1) infection

(2) tumor involving scar or nerve (seen in patients having surgery for lung cancer)

(3) foreign body reaction

(4) rib fracture


To read more or access our algorithms and calculators, please log in or register.