Subcutaneous Trigger Point Causing Radiating Postsurgical Pain

Background: The immediate onset of severe postoperativepain,especiallypainradiatingdistantfromtheincision site, is uncommon after dermatologic surgery. Observation: A 37-year-old woman undergoing excision of a nevus from the left side of her midback had an exquisitelytenderspotalongtheincisionlines.Thistender spot was hard to anesthetize and was clinically visible, after excision of the nevus, as a fibrous bundle in the subcutaneous plane. She presented in the immediate postoperative period with referred (distant) pain extending down the ipsilateral arm that was caused by a thoracic subcutaneous trigger point. Conclusion: Surgeons and pain management specialists shouldbeawareofthispotentialcauseofimmediatepostoperative pain to prevent unnecessary medical or surgical interventions in the postoperative period.