Chest Pain

  • Thomas J. Hong
  • Jonathan Chang


Chest pain is a common chronic pain syndrome causing debilitating pain in patients suffering from this condition. Postherpetic neuralgia and chronic postsurgical pain syndrome (i.e., post-mastectomy, post-thoracotomy) remain the most frequently encountered cause of chronic chest pain in a pain management clinic setting. Despite the devastating nature of CPSP and its high prevalence, it is a complex pain syndrome that remains incompletely understood with a lack of definitive treatment options available to patients. Therefore, it is imperative to implement early preventative strategies to minimize risk factors to reduce the incidence of CPSP. Treatment is largely focused on the neuropathic component of the pain, beginning with medications and transitioning to procedures or surgery if the patient continues to have intractable pain. Clinicians should take a stepwise approach initially focused on ruling out cardiopulmonary and neoplastic etiologies which may lead to acute life-threatening events and the urgent treatment timeline often associated with cancer therapies.


Chest pain Post-thoracotomy pain Post-mastectomy pain Postherpetic neuralgia Chronic postsurgical pain syndrome Chest wall pain Persistent postsurgical pain syndrome 


  1. 1.
    Cayley WE. Diagnosing the cause of chest pain. Am Fam Physician. 2005;72(10):2012–21.PubMedGoogle Scholar
  2. 2.
    Johnson K, Ghassemzadeh S. Chest pain. [Updated 4 Jan 2019]. In: StatPearls [Internet]. Treasure Island: StatPearls Publishing; Jan 2018. Available from:
  3. 3.
    Campbell KA, Madva EN, Villegas AC, et al. Non-cardiac chest pain: a review for the consultation-liaison psychiatrist. Psychosomatics. 2016;58(3):252–65.PubMedPubMedCentralCrossRefGoogle Scholar
  4. 4.
    Klinkman MS, Stevens D, Gorenflo DW. Episodes of care for chest pain: a preliminary report from MIRNET. J Fam Pract. 1994;38:345–52.PubMedGoogle Scholar
  5. 5.
    Buntinx F, Knockaert D, Bruyninckx R, de Blaey N, Aerts M, Knottnerus JA, et al. Chest pain in general practice or in the hospital emergency department: is it the same? Fam Pract. 2001;18:586–9.PubMedCrossRefGoogle Scholar
  6. 6.
    Miller CD, Lindsell CJ, Khandelwal S, Chandra A, Pollack CV, Tiffany BR, et al. Is the initial diagnostic impression of “noncardiac chest pain” adequate to exclude cardiac disease? Ann Emerg Med. 2004;44:565–74.PubMedCrossRefGoogle Scholar
  7. 7.
    Macrae WA, Davies HTO. Chronic postsurgical pain. In: Epidemiology of pain. Seattle: IASP Press; 1999. p. 125–42.Google Scholar
  8. 8.
    Gärtner R, Jensen MB, Nielsen J, Ewertz M, Kroman N, Kehlet H. Prevalence of and factors associated with persistent pain following breast cancer surgery. JAMA. 2009 Nov;302(18):1985–92.PubMedCrossRefGoogle Scholar
  9. 9.
    Tiippana E, et al. Post-thoracotomy pain after thoracic epidural analgesia: a prospective follow-up study. Acta Anaesthesiol Scand. 2003;47:433–8.PubMedCrossRefGoogle Scholar
  10. 10.
    Merskey H, Bogduk N. Classification of chronic pain. In: IASP Task Force on Taxonomy. 2nd ed. Seattle: IASP Press; 1994. p. 209–14.Google Scholar
  11. 11.
    Shen J. Clinical manifestations and diagnosis of postmastectomy pain syndrome. In: Chen W, editor; UpToDate. 2018. Retrieved on 1 Feb 2019 at
  12. 12.
    Caviggioli F, Maione L, Forcellini D, Klinger F, Klinger M. Autologous fat graft in postmastectomy pain syndrome. Plast Reconstr Surg. 2011;128(2):349–52.PubMedCrossRefGoogle Scholar
  13. 13.
    Smith WC, Bourne D, Squair J, Phillips DO, Chambers WA. A retrospective cohort study of post mastectomy pain syndrome. Pain. 1999;83(1):91.PubMedCrossRefGoogle Scholar
  14. 14.
    Meijuan Y, Zhiyou P, Yuwen T, Ying F, Xinzhong C. A retrospective study of postmastectomy pain syndrome: incidence, characteristics, risk factors, and influence on quality of life. ScientificWorldJournal. 2013;2013:159732.PubMedPubMedCentralCrossRefGoogle Scholar
  15. 15.
    Jung BF, Ahrendt GM, Oaklander AL, Dworkin RH. Neuropathic pain following breast cancer surgery: proposed classification and research update. Pain. 2003;104(1–2):1.PubMedPubMedCentralCrossRefGoogle Scholar
  16. 16.
    Tasmuth T, Kataja M, Blomqvist C, von Smitten K, Kalso E. Treatment-related factors predisposing to chronic pain in patients with breast cancer--a multivariate approach. Acta Oncol. 1997;36(6):625.PubMedCrossRefGoogle Scholar
  17. 17.
    Poleshuck EL, Katz J, Andrus CH, Hogan LA, Jung BF, Kulick DI, Dworkin RH. Risk factors for chronic pain following breast cancer surgery: a prospective study. J Pain. 2006;7(9):626.PubMedPubMedCentralCrossRefGoogle Scholar
  18. 18.
    Wong L. Intercostal neuromas: a treatable cause of postoperative breast surgery pain. Ann Plast Surg. 2001;46(5):481–4.PubMedCrossRefGoogle Scholar
  19. 19.
    Blades BJ, Dugan DJ. War wounds of the chest observed at the Thoracic Surgery Center, Walter Reed General Hospital. J Thorac Surg. 1944;13:294–306.Google Scholar
  20. 20.
    Gottschalk A, Cohen SP, Yang S, Ochroch EA. Preventing and treating pain after thoracic surgery. Pain Physician. 2006;9:227–36. ISSN 1533-3159.Google Scholar
  21. 21.
    Dureja GP. Intercostal neuralgia: a review. J Neurol Transl Neurosci. 2017;5(1):1076.Google Scholar
  22. 22.
    Kehlet H, Jensen TS, Woolf CJ. Persistent postsurgical pain: risk factors and prevention. Lancet. 2006;367(9522):1618–25.PubMedCrossRefPubMedCentralGoogle Scholar
  23. 23.
    Kraychete DC, Sakata RK, Lannes Lde O, Bandeira ID, Sadatsune EJ. Postoperative persistent chronic pain: what do we know about prevention, risk factors, and treatment. Braz J Anesthesiol. 2016;66(5):505–12.PubMedCrossRefGoogle Scholar
  24. 24.
    Della Corte F, Mendola C, Messina A, Cammarota G. Post thoracotomy pain syndrome. In: Nazari S, editor. Front lines of thoracic surgery: IntechOpen; 2012; ISBN: 978-953-307-915-8.Google Scholar
  25. 25.
    Buvanendran A, Kroin JS. Multimodal analgesia for controlling acute postoperative pain. Curr Opin Anaesthesiol. 2009;22(5):588–93.PubMedCrossRefGoogle Scholar
  26. 26.
    Joshi GP, Ogunnaike BO. Consequences of inadequate postoperative pain relief and chronic persistent postoperative pain. Anesthesiol Clin North Am. 2005;23:21–36.PubMedCrossRefGoogle Scholar
  27. 27.
    Salengros JC, et al. Different anesthetic techniques associated with different incidences of chronic post-thoracotomy pain: low-dose remifentanil plus presurgical epidural analgesia is preferable to high-dose remifentanil with postsurgical epidural analgesia. J Cardiothorac Vasc Anesth. 2010;24(4):608–16.PubMedCrossRefGoogle Scholar
  28. 28.
    Perttunen K, Tasmuth T, Kalso E. Chronic pain after thoracic surgery: a follow-up study. Acta Anaesthesiol Scand. 1999;43(5):563–7. [PubMed: 10342006].PubMedCrossRefGoogle Scholar
  29. 29.
    Gerner P. Post-thoracotomy pain management problems. Anesthesiol Clin. 2008;26(2):355–7.PubMedPubMedCentralCrossRefGoogle Scholar
  30. 30.
    Steegers MAH, et al. Only half of the chronic pain after thoracic surgery shows a neuropathic component. J Pain. 2008;9(10):955–61.PubMedCrossRefGoogle Scholar
  31. 31.
    MacDougan P, Slinger P, editors. Principles and practice of anesthesia for thoracic surgery. New York: Springer Science + Business Media, LLC; 2011.Google Scholar
  32. 32.
    Wildgaard K, et al. Chronic post-thoracotomy pain: a critical review of pathogenic mechanisms and strategies for prevention. Eur J Cardiothorac Surg. 2009;36:170–80.PubMedCrossRefGoogle Scholar
  33. 33.
    Benedetti F, et al. Postoperative pain and superficial abdominal reflexes after posterolateral thoracotomy. Ann Thorac Surg. 1997;64(1):207–10.PubMedCrossRefGoogle Scholar
  34. 34.
    Burke BL, Steele RW, Beard OW, Wood JS, Cain TD, Marmer DJ. Immune responses to varicella-zoster in the aged. Arch Intern Med. 1982;142(2):291.PubMedCrossRefGoogle Scholar
  35. 35.
    Meier JL, Straus SE. Comparative biology of latent varicella-zoster virus and herpes simplex virus infections. J Infect Dis. 1992;166(Suppl 1):S13.PubMedCrossRefGoogle Scholar
  36. 36.
    Denny-Brown D, Adams RD, Fitzgerald PJ. Pathologic features of herpes zoster: A note on ‘geniculate herpes’. Arch Neurol Psychiatr. 1944;51:216.CrossRefGoogle Scholar
  37. 37.
    Glynn C, Crockford G, Gavaghan D, Cardno P, Price D, Miller J. Epidemiology of shingles. J R Soc Med. 1990;83(10):617.PubMedPubMedCentralCrossRefGoogle Scholar
  38. 38.
    Dworkin RH, Portenoy RK. Pain and its persistence in herpes zoster. Pain. 1996;67(2–3):241.PubMedCrossRefGoogle Scholar
  39. 39.
    Dworkin RH, Gnann JW Jr, Oaklander AL, Raja SN, Schmader KE, Whitley RJ. Diagnosis and assessment of pain associated with herpes zoster and postherpetic neuralgia. J Pain. 2008;9(1 Suppl 1):S37–44.PubMedCrossRefGoogle Scholar
  40. 40.
    Arani RB, Soong SJ, Weiss HL, Wood MJ, Fiddian PA, Gnann JW, Whitley R. Phase specific analysis of herpes zoster associated pain data: a new statistical approach. Stat Med. 2001;20(16):2429–39.PubMedCrossRefGoogle Scholar
  41. 41.
    National Center for Immunization and Respiratory Diseases. Shingles (Herpes Zoster). Center for Disease Control. 2017. Retrieved on 1 Feb 2019 at
  42. 42.
    Gialloreti LE, et al. Epidemiology and economic burden of herpes zoster and post-herpetic neuralgia in Italy: a retrospective, population-based study. BMC Infect Dis. 2010;10:230.PubMedPubMedCentralCrossRefGoogle Scholar
  43. 43.
    Oxman MN, Levin MJ, Johnson GR, Schmader KE, et al. A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. N Engl J Med. 2005;352(22):2271–84.PubMedCrossRefGoogle Scholar
  44. 44.
    Johnson RW. Herpes zoster and postherpetic neuralgia. Expert Rev Vaccine. 2010;9(3 Suppl):21–6.CrossRefGoogle Scholar
  45. 45.
    Jung BF, et al. Risk factors for postherpetic neuralgia in patients with herpes zoster. Neurology. 2004;62(9):1545–51.PubMedCrossRefGoogle Scholar
  46. 46.
    Bajwa ZH, Ortega E. Postherpetic neuralgia. In: Eichler A, editor; UptoDate. Retrieved on 1 Feb 2019 at
  47. 47.
    Johnson RW, et al. Postherpetic neuralgia: epidemiology, pathophysiology and management. Expert Rev Neurother. 2007;7(11):1581–95.PubMedCrossRefGoogle Scholar
  48. 48.
    Truini A, et al. Pathophysiology of pain in postherpetic neuralgia: a clinical and neurophysiologic study. Pain. 2008;140(3):405–10.PubMedCrossRefGoogle Scholar
  49. 49.
    Dworkin RH, Johnson RW, Breuer J, et al. Recommendations for the management of herpes zoster. Clin Infect Dis. 2007;44(Suppl 1):S1–26.PubMedCrossRefGoogle Scholar
  50. 50.
    Johnson RW, Rice AS. Clinical practice. Postherpetic neuralgia. N Engl J Med. 2014;371(16):1526–33.PubMedCrossRefGoogle Scholar
  51. 51.
    RG K, Straus SE. Postherpetic neuralgia--pathogenesis, treatment, and prevention. N Engl J Med. 1996;335(1):32–42.CrossRefGoogle Scholar
  52. 52.
    Watson CP, Evans RJ, Watt VR, Birkett N. Post-herpetic neuralgia: 208 cases. Pain. 1988;35(3):289–97.PubMedCrossRefGoogle Scholar
  53. 53.
    Benzon H, et al. Essentials of pain medicine. 3rd ed. Philadephia: Elsevier Saunders; 2011. Chapter 51.CrossRefGoogle Scholar
  54. 54.
    Nalamachu S, Morley-Forster P. Diagnosing and managing postherpetic neuralgia. Drugs Aging. 2012;29(11):863.PubMedPubMedCentralCrossRefGoogle Scholar
  55. 55.
    Gilden DH, Wright RR, Schneck SA, Gwaltney JM Jr, Mahalingam R. Zoster sine herpete, a clinical variant. Ann Neurol. 1994;35(5):530.PubMedCrossRefGoogle Scholar
  56. 56.
    Haanpaa M, et al. CSF and MRI findings in patients with acute herpes zoster. Neurology. 1998;51(5):1405–11.PubMedCrossRefGoogle Scholar
  57. 57.
    Gilden D, Nagel MA, Mahalingam R, et al. Clinical and molecular aspects of varicella zoster virus infection. Future Neurol. 2009;4(1):103–17.PubMedPubMedCentralCrossRefGoogle Scholar
  58. 58.
    Correll D. Chronic postoperative pain: recent findings in understanding and management. F1000Res. 2017;6:1054.PubMedPubMedCentralCrossRefGoogle Scholar
  59. 59.
    Finnerup NB, Attal N, Haroutounian S, McNicol E, Baron R, Dworkin RH, et al. Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. Lancet Neurol. 2015;14(2):162–73.PubMedPubMedCentralCrossRefGoogle Scholar
  60. 60.
    Hamada H, Moriwaki K, Shiroyama K, Tanaka H, Kawamoto M, Yuge O. Myofascial pain in patients with postthoracotomy pain syndrome. Reg Anesth Pain Med. 2000;25:302–5.PubMedGoogle Scholar
  61. 61.
    Hempenstall K, Nurmikko TJ, Johnson RW, A’Hern RP, Rice AS. Analgesic therapy in postherpetic neuralgia: a quantitative systematic review. PLoS Med. 2005;2(7):e164.PubMedPubMedCentralCrossRefGoogle Scholar
  62. 62.
    Edelsberg JS, Lord C, Oster G. Systematic review and meta-analysis of efficacy, safety, and tolerability data from randomized controlled trials of drugs used to treat postherpetic neuralgia. Ann Pharmacother. 2011;45(12):1483.PubMedCrossRefGoogle Scholar
  63. 63.
    Attal N, Cruccu G, Baron R, Haanpää M, Hansson P, Jensen TS, et al. EFNS guidelines on the pharmacological treatment of neuropathic pain: 2010 revision. Eur J Neurol. 2010;17(9):1113.PubMedCrossRefGoogle Scholar
  64. 64.
    Solak O, Metin M, Esme H, Solak Ö, Yaman M, Pekcolaklar A, et al. Effectiveness of gabapentin in the treatment of chronic post-thoracotomy pain. Eur J Cardiothorac Surg. 2007;32(1):9–12.PubMedCrossRefGoogle Scholar
  65. 65.
    Sihoe AD, Lee TW, Wan IY, Thung KH, Yim AP. The use of gabapentin for post-operative and post-traumatic pain in thoracic surgery patients. Eur J Cardiothorac Surg. 2006;29(5):795–9.PubMedCrossRefGoogle Scholar
  66. 66.
    Mishra A, Nar AS, Bawa A, Kaur G, Bawa S, Mishra S. Pregabalin in chronic post-thoracotomy pain. J Clin Diagn Res. 2013;7(8):1659–61.PubMedPubMedCentralGoogle Scholar
  67. 67.
    Brulotte V, Ruel MM, Lafontaine E, Chouinard P, Girard F. Impact of pregabalin on the occurrence of postthoracotomy pain syndrome: a randomized trial. Reg Anesth Pain Med. 2015;40(3):262–9.PubMedCrossRefGoogle Scholar
  68. 68.
    Wiffen PJ, Derry S, Bell RF, Rice AS, Tölle TR, Phillips T, et al. Gabapentin for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2017;6:CD007938.PubMedGoogle Scholar
  69. 69.
    Dworkin RH, Corbin AE, Young JP Jr, Sharma U, LaMoreaux L, Bockbrader H, et al. Pregabalin for the treatment of postherpetic neuralgia: a randomized, placebo-controlled trial. Neurology. 2003;60(8):1274.PubMedCrossRefGoogle Scholar
  70. 70.
    Sabatowski R, Gálvez R, Cherry DA, Jacquot F, Vincent E, Maisonobe P, et al. Pregabalin reduces pain and improves sleep and mood disturbances in patients with post-herpetic neuralgia: results of a randomised, placebo-controlled clinical trial. Pain. 2004;109(1–2):26.PubMedCrossRefGoogle Scholar
  71. 71.
    Max MB, Lynch SA, Muir J, Shoaf SE, Smoller B, et al. Effects of desipramine, amitriptyline, and fluoxetine on pain in diabetic neuropathy. N Engl J Med. 1992;326(19):1250–6.PubMedCrossRefGoogle Scholar
  72. 72.
    Dubner R, Bennett GJ. Spinal and trigeminal mechanisms of nociception. Annu Rev Neurosci. 1983;6:381.PubMedCrossRefGoogle Scholar
  73. 73.
    Basbaum AI, Fields HL. Endogenous pain control mechanisms: review and hypothesis. Ann Neurol. 1978;4(5):451.PubMedCrossRefGoogle Scholar
  74. 74.
    Watson CP, Evans RJ, Reed K, et al. Amitriptyline versus placebo in postherpetic neuralgia. Neurology. 1982;32:671–3.PubMedCrossRefGoogle Scholar
  75. 75.
    Max MB, Schafer SC, Culnane M, Smoller B, Dubner R, Gracely RH. Amitriptyline, but not lorazepam, relieves postherpetic neuralgia. Neurology. 1988;38(9):1427.CrossRefPubMedGoogle Scholar
  76. 76.
    Watson CP, Vernich L, Chipman M, Reed K. Nortriptyline versus amitriptyline in postherpetic neuralgia: a randomized trial. Neurology. 1998;51(4):1166.PubMedCrossRefGoogle Scholar
  77. 77.
    Derry S, Lloyd R, Moore RA, McQuay HJ. Topical capsaicin for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2009;(4):CD007393.Google Scholar
  78. 78.
    Derry S, Rice AS, Cole P, Tan T, Moore RA. Topical capsaicin (high concentration) for chronic neuropathic pain in adults. Cochrane Database Syst Rev. 2017;(1):CD007393.Google Scholar
  79. 79.
    Backonja M, Wallace MS, Blonsky ER, Cutler BJ, Malan P Jr, Rauck R, et al. NGX-4010, a high-concentration capsaicin patch, for the treatment of postherpetic neuralgia: a randomised, double-blind study. Lancet Neurol. 2008;7(12):1106.PubMedCrossRefGoogle Scholar
  80. 80.
    Harden RN, Kaye AD, Kintanar T, Argoff CE. Evidence-based guidance for the management of postherpetic neuralgia in primary care. Postgrad Med. 2013;125(4):191.PubMedCrossRefGoogle Scholar
  81. 81.
    Raja SN, Haythornthwaite JA, Pappgallo M, et al. Opioids versus antidepressants in postherpetic neuralgia. Neurology. 2002;59:1015–21.PubMedCrossRefGoogle Scholar
  82. 82.
    Boureau F, Legallicier P, Kabir-Ahmadi M. Tramadol in post-herpetic neuralgia: a randomized, double-blind, placebo-controlled trial. Pain. 2003;104:323.PubMedCrossRefGoogle Scholar
  83. 83.
    Cohen SP, Anthony S, Wu CL, Larkin TM, Williams KA, Hurley RW. Pulsed radiofrequency of the dorsal root ganglia is superior to pharmacotherapy or pulsed radiofrequency of the intercostal nerves in the treatment of chronic postsurgical thoracic pain. Pain Physician. 2006;9:227–36.PubMedGoogle Scholar
  84. 84.
    Gottschalk A, Cohen SP, Yang S, Ochroch EA. Preventing and treating pain after thoracic surgery. Anesthesiology. 2006;104(3):594–600.PubMedCrossRefGoogle Scholar
  85. 85.
    Davis MP. Recent advances in the treatment of pain. F1000 Med Rep. 2010;2:63.PubMedPubMedCentralGoogle Scholar
  86. 86.
    Weiner RL, Reed KL. Peripheral neurostimulation for control of intractable occipital neuralgia. Neuromodulation. 1999;2(3):217–21.PubMedCrossRefGoogle Scholar
  87. 87.
    Hamza MA, White PF, Craig WF, Ghoname ES, Ahmed HE, Proctor TJ, et al. Percutaneous electrical nerve stimulation: a novel analgesic therapy for diabetic neuropathic pain. Diabetes Care. 2000;23(3):365–70.PubMedCrossRefGoogle Scholar
  88. 88.
    Goyal GN, Gupta D, Jain R, Kumar S, Mishra S, Bhatnagar S. Peripheral nerve field stimulation for intractable post-thoracotomy scar pain not relieved by conventional treatment. Pain Pract. 2010;10(4):366–9.PubMedCrossRefGoogle Scholar
  89. 89.
    Wolter T. Spinal cord stimulation for neuropathic pain: current perspectives. J Pain Res. 2014;7:651–63.PubMedPubMedCentralCrossRefGoogle Scholar
  90. 90.
    Melzack R, Wall PD. Pain mechanisms: a new theory. Science. 1965;150(3699):971–9.PubMedCrossRefPubMedCentralGoogle Scholar
  91. 91.
    de Leon-Casasola OA. Spinal cord and peripheral nerve stimulation techniques for neuropathic pain. J Pain Symptom Manag. 2009;38(2 SUPPL):S28–38.CrossRefGoogle Scholar
  92. 92.
    Jones MJ, Murrin KR. Intercostal block with cryotherapy. Ann R Coll Surg Engl. 1987;69(6):261.PubMedPubMedCentralGoogle Scholar
  93. 93.
    Khanbhai M, Yap KH, Mohamed S, Dunning J. Is cryoanalgesia effective for post-thoracotomy pain? Interact Cardiovasc Thorac Surg. 2013;18(2):202–9.PubMedPubMedCentralCrossRefGoogle Scholar
  94. 94.
    Kurklinsky S, Palmer SC, Arroliga MJ, Ghazi SM. Neuromodulation in postherpetic neuralgia: case reports and review of the literature. Pain Med. 2018;19(6):1237.PubMedCrossRefGoogle Scholar
  95. 95.
    Comez M, Celik M, Dostbil A, et al. The effect of pre-emptive intravenous Dexketoprofen + thoracal epidural analgesia on the chronic post-thoracotomy pain. Int J Clin Exp Med. 2015;8(5):8101–7.PubMedPubMedCentralGoogle Scholar
  96. 96.
    Kotani N, Kushikata T, Hashimoto H, Kimura F, Muraoka M, Yodono M, et al. Intrathecal methylprednisolone for intractable postherpetic neuralgia. N Engl J Med. 2000;343(21):1514.PubMedCrossRefGoogle Scholar
  97. 97.
    Kikuchi A, Kotani N, Sato T, Takamura K, Sakai I, Matsuki A. Comparative therapeutic evaluation of intrathecal versus epidural methylprednisolone for long-term analgesia in patients with intractable postherpetic neuralgia. Reg Anesth Pain Med. 1999;24(4):287.PubMedGoogle Scholar

Copyright information

© Springer Nature Switzerland AG 2020

Authors and Affiliations

  • Thomas J. Hong
    • 1
  • Jonathan Chang
    • 2
  1. 1.Department of Interventional Pain Management, Regency Pain and Therapy InstituteMansfieldUSA
  2. 2.Department of Anesthesiology and Pain ManagementUT Southwestern Medical CenterDallasUSA

Personalised recommendations