Peripheral Nerve Stimulation for Chest Wall and Persistent Shoulder Pain After Reverse Total Shoulder Arthroplasty: A Case Report.

BACKGROUND

Persistent pain after reverse total shoulder arthroplasty (RTSA) warrants evaluation for surgical and infectious causes. Peripheral nerve stimulation (PNS) may be considered when these causes have been assessed, but evidence for its use in chest wall and shoulder pain after RTSA is limited.

CASE REPORT: A 70-year-old man had persistent right anterior shoulder pain and new chest wall pain after revision RTSA. Diagnostic testing did not establish a surgical or infectious cause. A right pectoral nerve (PECS I) block provided temporary relief. A temporary PNS lead was placed near the lateral pectoral nerve under ultrasound guidance. After lead removal at 60 days, he reported 90% pain reduction and improved daily activities at 3 and 4 months.

CONCLUSIONS

This case describes sustained patient-reported relief following temporary lateral pectoral nerve PNS. Further study is needed to determine its effectiveness for pain after RTSA.