Case: A 65-year-old female patient applied to our clinic because of the previously described chronic pain on the right arm and right scapula, the pain intensified and tingling in the last two or three days.
The patient’s VAS was 9-10 and there was no rash or erythema. There was minimal protrusion of C3-4, C4-5, C5-6 in cervical MRI. Nerve roots were free. Right suprascapular block and right paracervical block were performed in this patient. By the end of that, the VAS was 3-4. Gabapentin 300 mg to our patient. Tricyclic anti-deprisant was started due to 3×1 and sleep problems and she came to the control after 15 days. She had rashes 2 days after the blocks were done, her pain increased again after 3-4 days, and her VAS was 7-8. In this patient, it was learned that herpes zoster infection conforming to C 6 – 7 developed.
Right suprascapular block and paracervical block were performed in our patient, and at the follow-up 15 days later, her rash was healed and her VAS was 3–4.
The same blocks were applied to our patient again and 15 days later, VAS was 0 and the rashes disappeared.
Conclusion: It should be considered that incorrect treatment may be applied when acute herpes zoster is atypical localization and the lesions are not very prominent. We think that suprascapular block and paracervical block, which we applied in the acute period in our case, prevented both differential diagnosis and acute pain treatment and post-herpetic neuralgia to develop.
