{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T14:12:36Z","timestamp":1778249556007,"version":"3.51.4"},"reference-count":12,"publisher":"BMJ","issue":"5","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2026,4,17]]},"published-print":{"date-parts":[[2026,5]]},"abstract":"<jats:p>Posterior cutaneous nerve entrapment syndrome (POCNES) is a rare and often overlooked cause of chronic paravertebral back pain. Treatment options for POCNES are not well established. Herein, we describe a teenage patient with a 3-month history of left parascapular pain and dysaesthesia unresponsive to analgesics or physiotherapy. Physical examination revealed a hyperalgesic and hypoaesthetic area lateral to the eighth thoracic vertebra. Imaging and laboratory tests showed no significant findings. A trigger-point injection provided temporary pain relief, which aided in diagnosing POCNES, although the relief was short-lived. We then performed an ultrasound-guided erector spinae plane (ESP) block, which effectively resolved the patient\u2019s pain without recurrence. Diagnosing POCNES requires a high level of suspicion, thorough history-taking and focused physical examination to identify its neuropathic features. The ultrasound-guided ESP block may be a treatment option for managing POCNES.<\/jats:p>","DOI":"10.1136\/bcr-2025-268847","type":"journal-article","created":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T13:25:28Z","timestamp":1778246728000},"page":"e268847","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":0,"title":["Treatment of thoracic posterior cutaneous nerve entrapment syndrome using an ultrasound-guided erector spinae plane block"],"prefix":"10.1136","volume":"19","author":[{"given":"Takahiro","family":"Minamii","sequence":"first","affiliation":[{"name":"General Internal Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4432-208X","authenticated-orcid":false,"given":"Shogo","family":"Shirota","sequence":"additional","affiliation":[{"name":"General Medicine, Osaka Medical and Pharmaceutical University, Takatsuki, Osaka, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7619-0646","authenticated-orcid":false,"given":"Hiroaki","family":"Nishioka","sequence":"additional","affiliation":[{"name":"General Internal Medicine, Kobe City Medical Center General Hospital, Kobe, Hyogo, Japan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2026,5,8]]},"reference":[{"key":"2026050806250743000_19.5.e268847.1","doi-asserted-by":"crossref","first-page":"2231","DOI":"10.2169\/internalmedicine.2927-23","article-title":"Three Subtypes of Cutaneous Nerve Entrapment Syndrome: A Narrative Review","volume":"63","author":"Otsuka","year":"2024","journal-title":"Intern Med"},{"key":"2026050806250743000_19.5.e268847.2","article-title":"A Combination of Three Nerve Entrapment Syndromes, Which was Difficult to Differentiate from a Vertebral Compression Fracture","volume":"10","author":"Kakura","year":"2023","journal-title":"Eur J Case Rep Intern Med"},{"key":"2026050806250743000_19.5.e268847.3","doi-asserted-by":"crossref","first-page":"145","DOI":"10.2147\/JPR.S99337","article-title":"Anterior cutaneous nerve entrapment syndrome: management challenges","volume":"10","author":"Chrona","year":"2017","journal-title":"J Pain Res"},{"key":"2026050806250743000_19.5.e268847.4","doi-asserted-by":"crossref","first-page":"715","DOI":"10.2147\/JPR.S178492","article-title":"Chronic localized back pain due to entrapment of cutaneous branches of posterior rami of the thoracic nerves (POCNES): a case series on diagnosis and management","volume":"12","author":"Maatman","year":"2019","journal-title":"J Pain Res"},{"key":"2026050806250743000_19.5.e268847.5","doi-asserted-by":"publisher","DOI":"10.1097\/AAP.0000000000000451"},{"key":"2026050806250743000_19.5.e268847.6","article-title":"Ultrasound-guided Erector Spinae Plane Block for the Management of Herpes Zoster Pain: Observational Study","volume":"11","author":"Ayd\u0131n","year":"2019","journal-title":"Cureus"},{"key":"2026050806250743000_19.5.e268847.7","first-page":"71","article-title":"Thoracolumbar syndrome as a cause of low-back pain: a report of two cases","volume":"29","author":"Proctor","year":"1985","journal-title":"J Can Chiropr Assoc"},{"key":"2026050806250743000_19.5.e268847.8","doi-asserted-by":"crossref","first-page":"E455","DOI":"10.36076\/ppj.2017.E458","article-title":"Chronic Localized Back Pain Due to Posterior Cutaneous Nerve Entrapment Syndrome (POCNES): A New Diagnosis","volume":"20","author":"Boelens","year":"2017","journal-title":"Pain Physician"},{"key":"2026050806250743000_19.5.e268847.9","doi-asserted-by":"crossref","DOI":"10.1136\/bcr-2021-248661","article-title":"Diagnosis of posterior cutaneous nerve entrapment syndrome through history and physical examination","volume":"15","author":"Watari","year":"2022","journal-title":"BMJ Case Rep"},{"key":"2026050806250743000_19.5.e268847.10","article-title":"Diagnostic Techniques for Posterior Cutaneous Nerve Entrapment Syndrome","volume":"16","author":"Watari","year":"2024","journal-title":"Cureus"},{"key":"2026050806250743000_19.5.e268847.11","doi-asserted-by":"publisher","DOI":"10.1111\/j.1469-7580.2012.01511.x"},{"key":"2026050806250743000_19.5.e268847.12","doi-asserted-by":"publisher","DOI":"10.1002\/jor.1100100412"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2025-268847","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,8]],"date-time":"2026-05-08T13:25:29Z","timestamp":1778246729000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2025-268847"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,5]]},"references-count":12,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2026,5,8]]},"published-print":{"date-parts":[[2026,5]]}},"alternative-id":["10.1136\/bcr-2025-268847"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2025-268847","relation":{},"ISSN":["1757-790X"],"issn-type":[{"value":"1757-790X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,5]]}}}