Introduction: The standard treatment of papillary thyroid cancer with a diameter >1 cm is thyroidectomy combined with a modified neck-dissection of the central (perithyroideal, prelaryngeal and tracheo-esophageal) lymph nodes and a consecutive radiation. Frequently, postoperative pain syndromes occur after this procedure. The so-called 'postradical neck pain syndrome' (PRNS) is a combination of cervical neuropathic pain, constricted and painful mobility of the shoulder region(s) including inhibited abduction capacity of the shoulder joint and a scapula alata. PRNS is often resistant to conventional therapy such as analgesics and physiotherapy.
Case report: A 56-year-old female inpatient, suffering from a severe PRNS after thyroidectomy and neck dissection due to papillary thyroid cancer for the past 2 years, was treated with a combination of hydrotherapy according to Kneipp, conventional physiotherapy, acupuncture and cantharidin blisters in order to reduce neuropathic pain, increase the range of cervical mobility and improve parameters of health-related quality of life (based on SF-36).
Results: Within 4 weeks of combined treatment, the left-cervical neuropathic pain was improved remarkably, and the range of the cervical mobility was increased sufficiently. In addition, the SF-36 scales 'pain' and 'common well-being' were improved to a clinically relevant extent. The multi-modular treatment was well tolerated.
Conclusions: In PRNS, a combination of several methods of complementary medicine may be an effective and well tolerated alternative to conventional treatment. Further clinical studies are required to confirm the results.
Copyright 2010 S. Karger AG, Basel.