Peripheral Nerve Entrapments in Cancer Pain

Abstract

Peripheral nerve entrapments can occur anywhere in the head and body and can cause significant pain. Cancer pain can be caused by these entrapments, triggered by a variety of etiologies, including tumor invasion, surgical trauma, chemotherapy, or scarring. Knowing the cause of pain can help the physician treat the problem effectively, and will decrease unnecessary and potentially worsening surgeries and high dose opioid therapies, as well as unnecessary pain. A knowledgeable interventional pain physician can diagnose and treat these nerves entrapments in the most effective manner, providing improved pain relief and quality of life. Key points Nerve entrapments can occur throughout the body in cancer patients due to multiple etiologies such as tumor invasion, surgical trauma, or cancer therapy.The problem of nerve entrapments in cancer pain is under-recognized.Patients with nerve entrapment syndromes frequently complain of a burning tingling sensation and other paresthesias in the nerve distribution which can progress to a complete loss of sensory and motor function.Diagnostic tools include history and physical exam, imaging, nerve conduction studies as well as diagnostic nerve injections/blocks.Treatment of nerve entrapments can range from neuropathic pain medications to nerve blocks and nerve ablations to surgical decompression.