[Inpatient treatment for postradical neck pain syndrome by use of complementary medicine].
BACKGROUND
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.


METHODS
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.
Schencking
Martin
M
Kneippsche Kliniken, Bad Wörishofen, Germany. naturedoc@web.de
Kraft
Karin
K
D026881:Acupuncture; D000231:Adenocarcinoma, Papillary / Q000601:surgery*; D000279:Administration, Cutaneous; D002193:Cantharidin / Q000008:administration & dosage; D002908:Chronic Disease; D003131:Combined Modality Therapy; D005260:Female; D006760:Hospitalization; D006801:Humans; D006875:Hydrotherapy; D008875:Middle Aged; D009324:Naturopathy; D037981:Neck Dissection; D009437:Neuralgia / Q000628:therapy*; D010149:Postoperative Pain / Q000628:therapy*; D026741:Physical Therapy Modalities; D013964:Thyroid Neoplasms / Q000601:surgery*; D013965:Thyroidectomy
D002193:Cantharidin