I’m not sure if odd is necessarily the right word. They’re odd in the sense that not everyone gets them after these certain types of surgeries. It’s only a subset of patients that tend to get long sequelae of pain after these surgeries. So I guess in that way, it’s odd, but they are actually pretty prevalent for people that experience it.
We try to emphasize a multimodal approach; medical treatment, procedural interventions, psychological interventions like cognitive-behavioral therapy, graded motor imagery. These therapies benefit patients the most when they’re used in conjunction with each another. Some of the non-pharmacological therapies for these neuropathic pain syndromes would be preemptive modalities, meaning targeting pain before a noxious stimuli happens. In a lot of these cases, it will be surgery. So preemptive procedures - like a thoracic epidural or a paravertebral catheter, different types of PEC blocks for mastectomy. Those types of procedures would be alternatives to medications.