Update: November 2018
Intercostal neuralgia or thoracalgia implies
pathological process arising due to compression,
inflammation or irritation of the intercostal nerves. The disease causes
very strong and painful painful phenomena that are often
disguised under the symptoms of diseases affecting the organs of the thoracic and
abdominal and spine.
The word neuralgia literally means nerve pain.
When neuralgia pain spreads along the nerve, making
extremely painful natural chest movements
�“Inhale-exhale”. Intercostal neuralgia is a symptom of having
specific reasons. Symptoms of neuralgia bright, but similar
the severity of the clinic often makes you think about serious pathologies
heart, stomach and spine, forcing the doctor to go for a false
diagnostic path. About intercostal neuralgia, symptoms and treatment
this syndrome is our article.
Causes of intercostal neuralgia
Causes of neuralgia have completely different origins. Rare
but still a possible cause of intercostal neuralgia is
pathological change of intercostal nerves due to damage
membranes (demyelination of nerves).
- Injuries, intoxication
Microtraumas, injuries and
intoxication of the body, as external (bacterial toxins, severe
metals, some medicines) and internal (due to
diseases of internal organs).
- Infectious diseases and pathologies of the spine
Pathology of the spine and musculo-ligament apparatus are
the main cause of neuralgia is osteochondrosis, osteoporosis, scoliosis,
displacement of the vertebrae, additional ribs, herniated intervertebral discs,
spondylosis deformans. Muscle spasm and inflammation of the intercostal
muscles cause compression of the intercostal nerves and also provoke
neuralgic symptom complex. A number of diseases and infections in the end
can lead to neuralgia – polyradiculoneuritis, diffuse
sclerosis, tuberculosis, SARS, shingles, pleurisy, aneurysm
aorta. Nerve compression by tumor-like formations and
sclerotic tissue leads to the development of neuralgia.
- Other factors
Significant role in the development of neuralgia have common factors
such as alcohol abuse, reduced immunity,
chronic fatigue and endocrine system pathologies
(diabetes, thyrotoxicosis), digestive tract
due to vitamin B deficiency (peptic ulcer, gastritis,
hepatitis, colitis), heart disease and circulatory system
(cerebral arteriosclerosis, arterial hypertension,
- Hormonal adjustment, age
A certain risk of developing intercostal neuralgia is subjected to
menopausal women when osteoporosis occurs in the background
hormonal changes, as well as older people who have noted
age-related changes in tissues and organs (see osteoporosis: causes and
Summing up, it should be noted that intercostal neuralgia is extremely
rarely develops under the influence of a single factor. Usually,
provocateur intercostal neuralgia serves several reasons
acting simultaneously or sequentially.
Symptoms of intercostal neuralgia
A patient with a diagnosis of intercostal neuralgia, the symptoms of this
diseases literally poison life because
extremely painful from the first manifestation. There is a pain syndrome
pronounced intensity spreading along the intercostal
gaps, i.e. spreading along the nerve. Intensity
pain increases with inspiration, during movements and turns
torso, coughing and loud talking. Piercing pain not
stops at rest and bothers the patient, intensifying without any
visible reasons. The duration of the painful attack varies from
several hours to several days.
Distinctive features of intercostal neuralgia characteristic of
classical course of the disease:
- pain syndrome can range from minor stabbing to high
intensity, with a sensation of burning, intense pain, comparable to
- palpation of the intercostal space with the affected nerve causes
a sharp increase in pain;
- the person clearly feels the movement of pain along the intercostal nerve and
may show the propagation of a pain wave;
- skin over the affected area can be fully or partially
Secondary symptoms of neuralgia at this location:
- excessive sweating
- hyperemia or pale skin
- contraction of individual muscle segments
With the above symptoms of neuralgia diagnosis is not
presents problems, but the disease may be disguised as others.
diagnoses due to its various painful symptoms.
The nature of the pain can be dull and even dull, with periodic
increased or ever present painful discomfort.
In addition to typical localization in the intercostal spaces, pain
can give in the lower back, shoulder, heart and stomach. Is explained
it’s simple – the intercostal nerves have small branches that
depart to the above organs and parts of the body.
Despite this disguise, neuralgic pain is still simple.
distinguish from pain associated with a particular pathology: when
localization of pain in the heart, it will not be removed
nitroglycerin, but it will decrease under the influence of sedatives and
sedative medications (Corvalol, Validol, Valocordin); at
projecting pain at the location of the stomach will not help
Как отличается сердечная боль от боли at невралгии? Pain
ощущения at межреберной невралгии постоянны, усиливающиеся at
body bends, tilting, deep breath, sneezing, coughing,
at прощупывании ребер и промежутков между ними. With CHD
(стенокардии) боль четко связана с нагрузкой (возникает at
physical activity and passes after its termination) and is not
piercing, and compressing (less often oppressive) character. Pain arises dramatically
и проходит быстро, особенно at atеме нитроглицерина, боли в
сердце не усиливаются at изменении положения или глубоком вдохе,
most often heart pain is accompanied by a change in blood pressure (decrease
or increase) and violation of the rhythm of the pulse.
Intercostal Neuralgia Treatment
Необходимый объем лечебных мероatятий назначается после
examination of the patient and confirm the diagnosis. Can not engage
self-diagnosis because pain can mask
renal colic, heart disease. Should be timely
See a doctor who can prescribe an x-ray of the lungs, an ECG,
Ultrasound of the abdominal organs.
Если atчиной заболевания явилось ущемление корешков
spinal nerves, then only neuralgia can cope
лечение патологии, atведшей к ущемлению – остеохондроза, грыжевого
formation of the intervertebral disc, etc. Specific
drug therapy – nonsteroid and steroid painkillers
drugs (including in the form of epidural injections), muscle relaxants,
therapeutic massage and gymnastics, manual therapy. In severe cases
spinal traction or surgical traction
Correction of identified pathologies.
When viral etiology of neuralgia (shingles, SARS)
назначается специфическое противовирусное лечение с atменением
immunostimulating therapy, sedatives.
Общие терапевтические мероatятия
With strong painful manifestations, the patient is prescribed strict
bed rest with staying on a hard surface and
maximum immobilization – the exclusion of sudden movements,
Pain relievers are prescribed for pain relief.
(analgin, spazgan and others), as well as novocainic and lidocaine
blockades allowing local anesthesia for sore
Drug treatment of intercostal neuralgia consists in
atеме противовоспалительных препаратов в таблетках (вольтарен,
целебрекс, индометацин), они atменяются для снятия воспаления в
affected area (see all NSAIDs in tablets and pain shots in
back). Muscle relaxants are prescribed (sirdalud, tizanidine, baclofen)
for relieving muscle spasm and B vitamins, without which
normal functioning of the nervous tissue is impossible.
To reduce pain syndrome are also used.
- novocaine iontophoresis
- reflexology with effects on special areas of the skin,
responsible for intercostal nerve sensitivity
- vacuum therapy
- pharmacopuncture with the introduction of drugs in acupuncture points
- magnetic therapy and laser treatment
В комплексе терапевтических мероatятий не последнее место
plays a local treatment – creams and ointments with painkillers,
warming and anti-inflammatory effects that have
relaxing and warming effect and indirectly reducing pain
порог чувствительности (см. мази от боли в back). Good at this
the plan has proven local preparations containing poisons
some insects, as well as muscle relaxation and pain reduction
The syndrome contributes to pepper patch.
Intercostal Neuralgia Treatment народными способами
- Effectively rubbing tincture valerian, or infusion
birch buds – their action is not inferior to ointments
industrial production. However, at night alcohol compresses
лучше не atкладывать — длительное воздействие спирта может
atвести к ожогам.
- Прогревание также помогает, но тепловое воздействие at
intercostal neuralgia should not be direct, that is, not
atкладывать грелку, горячую картошку или яйцо, а укутаться пуховым
handkerchief, knitted wool thing. If it is very hot
painful place, the pain will go away for a short time and then this
воздействие лишь усилит отек мягких тканей и atнесет еще большие
- Внутренне рекомендуется atнимать отвар:
- camomile pharmacy
- infusion of medicinal mixture of lemon balm leaves, honey, skins
valerian orange and tincture
- infusion of immortelle flowers
- barberry decoction.
- Для местного atменения на пораженные участки используется сок
black radish or horseradish juice. Good help based compresses
steamed flax seeds.
- Room geranium helps to reduce pain, a sheet
which rub painful area and wrap affected area
- Sage baths help relieve tension and reduce pain.
- For the prevention of chronitization of neuralgia, it is important to exclude
action of harmful concomitant factors such as
psycho-emotional overstrain, heavy physical exertion,
alcohol abuse, as well as treat existing diseases
nervous system, systems and organs, etc.
Early contact with specialists helps quickly and efficiently.
treat intercostal neuralgia, the symptoms of which should be distinguished
from other diseases and exclude the possibility of transition pathology in
stage of chronic course.
Автор: врач-гигиенист, эпидемиолог