TITLE:
Pectoral Muscle Hydrodissection in Postherpetic Neuralgia: A Case Report
AUTHORS:
Amy Ahern, Oisín Pennycook, Dominic C. Harmon
KEYWORDS:
Postherpetic Neuralgia, Hydrodissection, Pectoral Muscle, Ultrasound
JOURNAL NAME:
Pain Studies and Treatment,
Vol.14 No.4,
September
17,
2026
ABSTRACT: Background: Postherpetic neuralgia is a debilitating neuropathic pain condition that is difficult to treat and can persist despite multimodal pharmacological therapy. Interventional approaches have limited benefits. Hydrodissection is a minimally invasive technique involving injection of fluid to separate fascial layers and release entrapped nerves and tendons. The use of pectoral hydrodissection as a treatment for postherpetic neuralgia has not been previously reported. Methods: Case Presentation: We present the case of an 80-year-old male with a two-year history of postherpetic neuralgia and primarily anterior chest wall pain. Pharmacological interventions had limited benefits. Intervention: The patient underwent ultrasound-guided pectoral muscle hydrodissection as a targeted approach to address perineural inflammation and nerve entrapment. A low concentration (5%) dextrose solution (20 ml) was used to free the muscle from surrounding scar tissue and muscle adhesions. The procedure was performed in a theatre setting. Results: Following the hydrodissection procedure, the patient experienced improvement in pain (8/10 NRS to 4/10 NRS) with sustained improvement at two months follow-up. Functional outcomes, including range of motion and daily activities, improved substantially. No complications were reported. Conclusions: This case supports the potential role of pectoral muscle hydrodissection as a minimally invasive treatment option in the treatment of postherpetic neuralgia. Hydrodissection offers an alternative to more invasive interventions and warrants further investigation in the management of postherpetic neuralgia.