Hypermobile Ehlers-Danlos Syndrome (hEDS) is the most common type of inherited connective tissue disorder, often presenting with chronic widespread myofascial pain, autonomic dysfunction, soft-tissue fragility, and psychiatric comorbidities. Pain is often multifactorial and refractory to conventional therapies. We describe a young adult with longstanding hypermobility, recurrent subluxations, chronic periscapular pain, migrainous headaches, and dysautonomia who achieved marked clinical improvement with lidocaine-based therapies, including trigger-point injections (TPIs) and scheduled intravenous lidocaine infusion. TPIs provided more than 50% relief of the myofascial pain for over one month, which is significantly longer than the typical duration of conservative treatments. A lidocaine infusion was subsequently administered to provide extended and more widespread pain relief, resulting in a favorable clinical outcome. This case illustrates the value of lidocaine as part of a multimodal strategy in managing complex hypermobility-related pain syndromes.
Keloids are benign fibroproliferative lesions that may develop after trauma or infection, including chickenpox, and can cause chronic pain and functional impairment. Although lidocaine infusions have demonstrated efficacy in treating various neuropathic pain syndromes, their use for keloid-associated pain has not been well described. We present a case of a 45-year-old female with chronic, intractable generalized body pain secondary to multiple large keloids, developed following a chickenpox infection at the age of seven. Conventional treatments, including surgical excision with intralesional corticosteroids, duloxetine, meloxicam, amitriptyline, and acupuncture, provided only transient relief. Moderate pain relief was achieved with pregabalin, nortriptyline, topical lidocaine, and medical marijuana, resulting in a visual analog scale (VAS) score of 8/10. The subsequent addition of intravenous (IV) lidocaine infusions (5 mg/kg administered over one hour) produced significant pain reduction (VAS 3/10) and notable improvements in quality of life and functional capacity, enabling her to maintain employment. The interval between infusions was later extended to every four months while maintaining pain relief, without neuroexcitatory or cardiac complications. This case suggests that periodic IV lidocaine infusions may offer a safe and effective therapeutic option for sustained analgesia in patients with chronic keloid-related pain.
