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Intercostal Neuralgia: Causes, Symptoms and Treatment

Among the nervous diseases of neuralgia of various localization and etiology (origin) occupy a special place.

This is because with neuralgic diseases, the leading clinical symptom is severe pain, which is practically not encountered in other diseases. One of the most common types is intercostal neuralgia. About her today and will be discussed.


Intercostal neuralgia, what is it?

Intercostal neuralgia, what is it?

As you know, pain is the "watchdog of the body." It does not matter what nerve receptors perceive pain impulses: vegetative from the internal organs, or somatic - from the skin and sensory organs. In any case, the sensation of pain is indicative of “disarray on the ground.”

For example, swelling of a pancreatic capsule causes very severe pain, and a bone fracture causes another severe pain, which differs in nature from the first.

But it turns out that there is a special kind of pain - neuralgia. In this case, the source of pain is not the receptor, but the transmitting nerve fiber, that is, the nerve itself. The pain is born "inside" the nervous system, and its role is completely different - it simply "deceives" the person.

For example, very strong bouts of trigeminal neuralgia pass without a trace, without any harm to the facial structures.

The harm of neuralgia is that it simply "poisons life." Attacks of pain are like a discharge of electric current. They begin suddenly, last a few seconds, and then disappear just as suddenly. The frequency of such "flashes" can reach several dozen times a day.

Causes of intercostal neuralgia

In cases of acute pain in the chest and back, most often the cause is intercostal nerve edema at the exit of the intervertebral foramen. Edema can occur due to compression of the nerve of the intervertebral hernia, as well as spasmodic deep back muscles.

This condition is called “myofascial tonic syndrome”.

The code for ICD - 10 (international classification of diseases) - M 79.2. It is taken out in diseases of the musculoskeletal system, in the defeat of soft tissues. This is due to the role of spastic muscles in the genesis of pain.

Symptoms of intercostal neuralgia, photo

Symptoms of intercostal neuralgia, photo 2

intercostal neuralgia, photo 2

As described above, the main symptom of this disease is acute, paroxysmal pain, similar to an electric shock. As a rule, one nerve suffers on the one hand, and the pain sensations are localized in one intercostal space.

The duration of pain is calculated in seconds, but they seem very long to the patient. The signs of intercostal neuralgia are provoked by a certain behavior of the patient.

The appearance of pain contribute to:

  • cough;
  • sneezing;
  • laugh;
  • cry;
  • sharp movement or turn;
  • straining;
  • deep and sharp breath, which "stretches" the intercostal space.

The above facts indicate that the pain is caused by a concussion of the swollen nerve. This is called “radicular symptomatology.”

Intercostal neuralgia, the symptoms and treatment of which depend on rest and the absence of nerve concussion, is a good example of the role of muscle spasm in the development of pain.

How long does intercostal neuralgia hurt?

left intercostal neuralgia, photo 3

left intercostal neuralgia, photo 3

A very important factor is the psychological factor that joins afterwards: waiting for pain becomes very painful, and sometimes worse than the pain itself. As a rule, the duration of this disease is several days.

After all, this pain is often an exacerbation of osteochondrosis of the thoracic spine. The average duration of back pain is about 7 to 10 days, and pain in intercostal neuralgia is the “peak” of clinical symptoms, and this condition can last for 3 to 5 days.


Intercostal neuralgia is one of the amazing diseases.

On the one hand, she has such a clear clinical picture, which allows the doctor to make a diagnosis almost immediately - according to the nature of the pain, localization, and the “guarding posture” of the patient. When percussion (tapping) with a neurological hammer at the exit points of the nerves, you can set the level of the lesion with high accuracy.

On the other hand, an attack of severe pain in the chest, especially in old age, should always alert the doctor, especially if there is such a concomitant diagnosis as ischemic heart disease or myocardial infarction in history.

Therefore, intercostal neuralgia on the right, as a rule, causes less concern - in contrast to its left-sided variant.

How to distinguish symptoms of intercostal neuralgia from signs of heart disease?

First of all, by the nature of the pain. The pain of "heart" is compressive, painful in nature. Can give in the left hand, left half of the neck, in the jaw. The pain in neuralgia is so sudden that the patient often does not have time to get scared.

And with the "heart" pain, the patient becomes anxious, may be shortness of breath, fear of death, a drop in blood pressure, cold sticky sweat.

difference from heartache, photo 4 Patients with intercostal neuralgia want to "arrange" the chest in a comfortable position and do not move, and during a heart attack a person can rush, because a change in posture, a deep breath does not affect pain. In addition, with heart pains, blue ear lobes and a nasolabial triangle may develop, that is, acrocyanosis may develop.

This is due to lack of oxygen, and can be a terrible sign of a violation of myocardial contractility.

With the development of acute myocardial ischemia, nitroglycerin taken under the tongue can relieve pain. At the same time with intercostal neuralgia, it will not bring any effect.

Intercostal neuralgia on the left, the symptoms of which are not clear enough, requires an urgent ECG recording, since only this study can detect myocardial ischemia with high accuracy and initiate a specific treatment.

In addition, neuralgia can simulate a number of diseases, for example, acute pancreatitis, or perforation of a stomach ulcer, which is located in an “atypical place.” In the first period of the disease, this can lead to misdiagnosis.

Therefore, you need to carefully understand the patient's history: if he had two heart attacks, or multiple stomach ulcers, it is better not to be lazy and take him to the surgical department, or to the emergency room.

It is necessary to remember that neuralgia does not have such serious complications as the above listed diseases.

Intercostal Neuralgia Treatment

What doctor treats intercostal neuralgia? Ideally, a neurologist, but, given the long queues to the neurologist at the clinic for a month in advance, the local therapist can do this well.

The main principle of treatment is rest, anesthesia and removal of swelling of nerves and muscles. This leads to a marked reduction in pain, and then it disappears completely.

- drug treatment:

The main group of drugs that relieve pain are non-steroidal anti-inflammatory drugs (NSAIDs). They are used both for the purpose of pain relief (“Ketans”) and for the purpose of relieving inflammatory edema (“Movalis”).

On the first day, light potassium-saving diuretics can be used to relieve edema (Veroshpiron2).

Muscle relaxants (“Mydocalm”) have a good effect.

Initially, they are administered intramuscularly, and then transferred to taking pills.
Preparations for the treatment of intercostal neuralgia should be prescribed by a doctor taking into account individual contraindications and concomitant diseases.

- home treatment:

Treatment of intercostal neuralgia at home

Intercostal neuralgia: home treatment involves calling a doctor to prescribe medications.

After removing the pain, it is recommended to use physiotherapy: warming with dry heat, using the Lyapko and Kuznetsov iplicator, rubbing ointments in the back to improve the blood supply to the muscles, and relieving their painful spasm.

In the phase of subsiding exacerbation, massage of the back and neck - neck area, exercise therapy is shown. After relief of pain and in order to prevent patients, an active lifestyle, swimming is shown.

Complications of intercostal neuralgia

"The devil is not so bad as he is painted." This remark is fully applicable to intercostal neuralgia. All complications concern not her, but undiagnosed more dangerous cardiovascular diseases, which are hidden under her mask.

In some cases, persistent neuralgia, for example, with a herpetic infection (especially after it), can lead to insomnia, irritability, depression and even suicide attempts.

Therefore, the main place is given to the prevention of this disease, especially among employees of "mental labor". Constant sitting in the office in a sitting position impairs blood supply to the back muscles, and overweight provokes attacks of acute back pain.

Movement and a healthy lifestyle, as well as the absence of hypothermia back and weight lifting will help in this.


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