Intercostal neuralgia is a disease in which irritation or compression of the intercostal nerves occurs. This can happen for various reasons. The disease is relatively rare, its main manifestation is pain along the affected nerve.
Our expert in this field:
Lashch Natalia Yurievna
Neurologist of the highest category, candidate of medical sciences, associate professor. Laureate of the Moscow City Prize in the field of medicine.
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How are intercostal nerves arranged? What functions do they perform?
Two nerve roots emerge from the spinal cord: the anterior one is formed by the processes of motor nerve cells, the posterior one - by sensory ones. Then, while still inside the spinal canal of the spine, these roots are connected to form the spinal ganglion. Two spinal nerves depart from it: anterior and posterior.
In the thoracic spinal cord, the anterior branches of the spinal nerves pass into the intercostal nerves. They pass in the spaces between the ribs - each of them is located along the lower edge of the corresponding rib - and, unlike the anterior spinal roots, are mixed, that is, they are responsible for both movement and sensitivity:
- provide movement of the chest muscles involved in the breathing process;
- provide sensitivity to the skin of the chest and upper abdomen.
Treatment of intercostal neuralgia
How to treat intercostal neuralgia? Therapy is carried out in two directions:
- It is necessary to alleviate the main symptom of the disease - chest pain.
- At the same time, it is necessary to identify the cause - the disease that led to compression or irritation of the nerve - and treat it.
In the acute stage of the disease, the doctor prescribes bed rest and recommends sleeping on a flat and firm bed. To combat pain, non-steroidal anti-inflammatory drugs are used, and various ointments help. In case of severe pain, a novocaine blockade is performed: the place where the affected nerve is located is injected with an anesthetic solution. There are also special patches with anesthetics.
Vitamins are prescribed to improve the condition of nervous tissue, muscle relaxants to relieve muscle spasms. Prolonged pain leads to a person becoming overly excitable and nervous, in which case sedatives are prescribed. Physiotherapy procedures help: Sollux, electrophoresis, UHF. A neurologist can prescribe massage and acupuncture sessions.
Is it possible to cope with the disease on your own? Over-the-counter pain medications and folk remedies can help relieve pain for a while. But in order to prescribe truly effective treatment for intercostal neuralgia on the right or left, you need to understand what causes it. Improper self-medication can be harmful.
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The main symptom of intercostal neuralgia is pain. It spreads along the rib, as if encircling the right or left half of the chest, and can be sharp, stabbing, burning, or dull, aching. The pain intensifies during inhalation, because of this the person cannot breathe deeply. Movements, changes in body position, coughing, and sneezing also lead to aggravation.
Painful sensations occur if you press on certain points between two adjacent ribs along their course. This symptom is checked by a neurologist during an examination.
Other possible symptoms of intercostal neuralgia on the right and left (as well as pain, occur in the area of the affected nerve):
- twitching of the chest muscles;
- increased sweating;
- redness or paleness of the skin;
- numbness.
With intercostal neuralgia on the left, a person may complain that his heart and stomach hurt. Pain may radiate under the shoulder blade, to the collarbone area.
Similar chest pains can occur with diseases of the heart, lungs, pleura, and spine. An incorrect diagnosis and lost time can lead to serious consequences.
How to distinguish the signs of intercostal neuralgia from the symptoms of other diseases?
It is especially important to distinguish in time between irritation of the intercostal nerves and angina pectoris, a condition in which the heart muscle does not receive enough oxygen-rich blood. Main differences:
- With intercostal neuralgia, pain persists for a long time. With angina pectoris, they last about 5 minutes and go away if you take nitroglycerin.
- With neuralgia, pain intensifies during deep inspiration, movements, sneezing and coughing, but with angina pectoris this does not happen.
Other dangerous conditions that need to be distinguished from intercostal neuralgia are myocardial infarction and PE ( pulmonary embolism) . Typically, a heart attack occurs after physical exertion or after a person becomes very nervous. The pain is accompanied by signs of dysfunction of the cardiovascular system:
- The man turns pale. Fingertips, nose, lips may become bluish.
- Sticky cold sweat appears.
- Shortness of breath that persists even when the person is resting - lying or sitting.
- Blood pressure drops.
- The fear of death arises.
You should not engage in self-diagnosis - erroneous conclusions are fraught with serious consequences. See your doctor. Get examined at the clinic. In any case where there is a suspicion of a heart attack, it is better to play it safe and immediately call an ambulance.
Symptoms of trigeminal neuralgia in a pregnant woman
Any neuralgia is manifested by pain. Typically, the stage of clinical manifestations occurs in the form of attacks. Patients complain of sensations similar to an electrical discharge. Attacks usually develop during the day during active wakefulness. The condition lasts for a few minutes, after which pain relief occurs for a while. The pain is most often concentrated at the level of the upper or lower jaw, less often in the supraorbital region. A feature of the disease can be considered the presence of places on the face, the impact of which provokes an attack. Usually this is the cheek, mouth and nose. The immediate factors that cause pain are washing, chewing food, and brushing teeth. At the same time, facial redness, lacrimation and profuse salivation are observed.
Usually, during an attack, a woman freezes, afraid to make an unnecessary movement, so as not to increase the pain.
Treatment of symptoms of intercostal neuralgia on the right and left
The leading symptom of the disease – pain – is helped by painkillers (non-steroidal anti-inflammatory drugs), anesthetic patches, novocaine blockades, and physiotherapy.
But coping with the symptoms does not mean curing the disease. Therefore, treatment should also be aimed at the cause. A thorough diagnosis must first be carried out - this is only possible in a clinical setting.
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“Intercostal neuralgia” is not one specific diagnosis, but a collective term. It refers to different conditions that lead to damage to the intercostal nerves and, as a result, to chest pain.
Why is it important to understand the cause of this condition in each specific case? This will allow you to prescribe effective treatment that will help you recover or keep your chronic disease under control.
What can a pregnant woman take for a debilitating dry cough?
Antitussive drugs, like mucolytics, are prohibited from taking during pregnancy at all or are allowed under the supervision of a doctor after assessing the risks and benefits. Thus, the popular centrally acting antitussive drug butamirate can be taken only in the second and third trimesters and only after consultation with a doctor. The peripheral drug prenoxdiazine is also used with caution during pregnancy. Thus, when counseling a pregnant woman with a dry cough, she should be advised to immediately visit a doctor.
The main causes of intercostal neuralgia
Most often, the following reasons lead to compression and irritation of the intercostal nerves:
- Osteochondrosis. A degenerative disease that primarily affects the intervertebral discs. Their height decreases - the distance between adjacent vertebrae decreases, this leads to compression of the nerve roots.
- Hypothermia, exposure to drafts.
- Intense physical activity, sudden awkward movements.
- Working in an awkward position when your back is constantly under tension.
- Injuries to the chest and thoracic spine, previous surgeries.
- Frequent and severe stress.
- Viral infections. The most common cause is a cold, shingles.
- Chronic spasm of the back muscles. It promotes irritation of nerve receptors.
Most often, intercostal neuralgia occurs in older people, when the causes of the disease are layered with age-related changes in the spine and blood vessels.
What is trigeminal neuralgia and why does it occur?
Considering the tendency of a woman expecting a child to edema, the most common cause of nerve damage is considered to be compression of its root by vessels in the cranial cavity. This effect is aggravated by the changes in the body that accompany pregnancy:
- state of stress and exposure to nervous stress;
- hormonal changes;
- change in the balance of microelements.
The reluctance of medical scientists to properly highlight this problem and the lack of publications on this topic is mainly explained by the difficulties of treatment.
What other diseases lead to girdle pain in the chest?
Often people tend to dub “neuralgia” any girdle pain along the ribs. But this symptom may have other causes, including:
- Spondylosis is an inflammatory disease that causes damage to the vertebral bodies and deformation of the spinal column.
- Hormonal spondylopathy is a pathology that develops in older people, for example, in women after menopause. The spine is deformed, and disorders occur in the vessels that supply it.
- Malignant tumors - those that arise in the spine itself or metastases from other parts of the body.
- Ankylosing spondylitis is a chronic inflammatory process that leads to decreased mobility in the spinal column.
- Gastritis and other diseases of internal organs.
How does the treatment of intercostal neuralgia depend on the cause?
With intercostal neuralgia, it is not enough to eliminate the main symptom of the disease - pain. You should always look for and treat the underlying cause. The doctor prescribes therapy individually, depending on the pathological changes detected during examination and examination, and the final diagnosis.
Make an appointment at the Medica24 International Clinic - get a consultation with an experienced neurologist and undergo an examination using our modern equipment. This will help to quickly and accurately establish a diagnosis and prescribe the correct treatment in a timely manner.
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The main manifestation of intercostal neuralgia – chest pain – can also occur with many other diseases. And figuring out the correct diagnosis is not always easy.
The diagnostic process begins with a visit to a neurologist. The doctor will ask you some questions:
- When did you first experience pain? How did this happen? What preceded this?
- What is the nature of the pain, when does it usually occur, how often, how long does it last?
- Do you have chronic lung or heart diseases? Are you monitoring your blood pressure?
- What infections have you had? Have you had any chest injuries or surgery?
- What other symptoms bother you?
You may be asked to complete a special “pain questionnaire”. The doctor will perform a complete neurological examination to rule out other neurological diseases. You will then be given an examination.
To understand the causes of irritation or compression of the intercostal nerve, the doctor may prescribe x-rays, CT, MRI, and, if necessary, other studies.
Is it possible for a pregnant woman to apply mustard plasters and pepper plaster?
Despite the fact that both mustard plasters and pepper plaster act externally and do not affect the development of the fetus, they are potentially dangerous for pregnancy. Heat treatments can increase uterine contractility, which is associated with an increased risk of miscarriage or premature birth. In addition, increased microcirculation, which occurs under the influence of mustard plasters or pepper patches, can change uteroplacental blood flow, which is also undesirable. The greatest danger is posed by thermal procedures in the first and last trimester of pregnancy - in the first they increase the risk of miscarriage, in the last - premature birth.
Instrumental methods for diagnosing intercostal neuralgia
At the Medica24 International Clinic, you can undergo examination using our own diagnostic equipment, which meets the most modern standards. It will help diagnose the disease at an early stage and take timely measures.
First of all, it is important to carry out a differential diagnosis of intercostal neuralgia with certain diseases of the spine, cardiovascular system, and lungs. To do this, if necessary, the neurologist will refer you for a consultation with a cardiologist or pulmonologist.
You may be prescribed an ECG, Holter monitoring, cardiac ultrasound, X-ray, CT and MRI of the chest, biochemical blood test, and bacteriological studies.
