Intercostal Neuralgia - Symptoms, Causes, and Treatment

Intercostal neuralgia is a reflex pain syndrome that occurs when compression, irritation or inflammation of the intercostal nerves. Otherwise, it is also called thorakalgia. This phenomenon is unpleasant, as it is accompanied by intense pain.

The clinical symptoms of intercostal neuralgia are very similar to the symptoms of a number of diseases of the internal organs, in particular, the heart. That is why many patients, frightened by an attack of intercostal neuralgia, turn to a cardiologist or start self-treatment at home, taking heart medications.

In this regard, along with the lack of proper diagnosis and adequate treatment of neuralgia, aggravates the patient's condition. And the loss of time can lead to quite serious complications.

The reasons

Why does intercostal neuralgia occur, and what is it? The main cause of neuralgia is compression and irritation of the intercostal nerves due to inflammatory and degenerative changes in the spine. Most often, the pathology does not arise independently, but develops against the background of another disease.

In this regard, there are certain reasons that lead to the appearance of intercostal neuralgia:

  • back and chest injuries;
  • hypothermia;
  • spinal pathologies - scoliosis, deforming spondylosis, osteochondrosis, herniated intervertebral discs;
  • internal (diseases of internal organs) and external (medication, the effects of heavy metals) intoxication;
  • past infectious diseases (tuberculosis, shingles, brucellosis);
  • malignant tumors of the lungs and pleura;
  • nervous system diseases (multiple sclerosis, polyradiculoneuritis);
  • reduced immunity;
  • allergy.

In the overwhelming majority of cases, the “culprit” is osteochondrosis, which leads to the destruction of cartilage tissue, as a result of which the roots of the nerves are compressed and sharp pain occurs. Pathological changes in the spinal column cause the musculo-tonic syndrome (a violation of muscle tone), which greatly complicates the situation.

Symptoms of intercostal neuralgia

In general, intercostal neuralgia is capable of being felt by a number of specific symptoms, which can be observed both complexly and selectively. It all depends on the individual characteristics of the organism of each individual person. And it depends on the same and how clearly these signs will be expressed, and which side - on the left or on the right.

The main symptom of this disease is pain along the intercostal space on the right or left. The intensity of pain can be different: from sharp, sharp, severe, shooting (more often) to constant, medium intensity. The pain increases with the movements of the patient, with coughing and sneezing, and even with breathing. Often a person takes a forced position: leans in the affected side to minimize the amount of movement in it. When coughing, laughing or sneezing, some patients firmly press their palm to the affected intercostal space for the same purpose: to reduce the amount of movement in this area so that it hurts less.

In addition, the disease is accompanied by: numbness of the affected areas, muscle tension, seizures, increased sweating, feeling of goosebumps on the skin, sleep disturbances, tearfulness. Intercostal neuralgia increases after exercise or stress.

The difference between the symptoms of neuralgia from heart disease

This disease often mimics damage to the heart. For the correct diagnosis, it is important to remember that in the pathologies of the cardiovascular system, there are concomitant changes in pulse and blood pressure. With the defeat of the intercostal nerves such a pattern is absent.

In addition, with pain syndrome, which is associated with disorders of the heart, a change in body position does not affect the intensity of unpleasant sensations. When an attack of intercostal neuralgia develops, any movement, as well as deep breathing, provokes increased pain. The diagnostic criterion is that nitroglycerin or similar drugs do not give a positive effect.

If you doubt or suspect that paroxysmal pain associated with other diseases, you should seek medical advice as quickly as possible and do not hesitate with treatment. The sooner the disease is diagnosed, the easier it will be to recover.

The list of diseases with similar symptoms:

  • angina pectoris;
  • shingles;
  • myocardial infarction;
  • ankylosing spondylitis;
  • lung disease;
  • tumor diseases.

It is very important to distinguish intercostal neuralgia from other diseases that can even lead to death.


To understand how to treat intercostal neuralgia, it is necessary not only to diagnose a symptom, but also to determine the cause of its development.

Differential diagnosis of clinical manifestations is an important step in the treatment of patients. First of all, it is necessary to eliminate the pathology of the heart, since the treatment of intercostal neuralgia and heart disease require different therapies, and incorrect diagnosis and lost time in cardiac pathology can be crucial for the patient's condition.

To exclude other diseases, the doctor may prescribe an ECG, radiography of the lungs, an ultrasound examination of the abdominal cavity organs, and other necessary studies. After the final verification of the diagnosis, treatment of intercostal neuralgia can be initiated.

Intercostal Neuralgia Treatment

Symptoms of intercostal neuralgia cannot be ignored. And intense pain is unlikely to allow it. The essence of the treatment of neuralgia is as follows:

  1. Removal of pain and other manifestations of intercostal neuralgia with pills.
  2. Elimination of pinching and / or inflammation of the affected nerve.
  3. Elimination of the root causes of the disease, which, strictly speaking, leads to the development of intercostal neuralgia.

The treatment regimen includes the use of the following methods:

  1. Drug therapy (analgesics and blockades, nonsteroidal anti-inflammatory drugs, vitamins);
  2. Sparing mode and limiting the mobility of the spine (chest) at the level of the lesion, wearing a corset;
  3. Physiotherapy treatment;
  4. Manual and reflex therapy;
  5. Massage and physical therapy.

If the cause of the disease was the infringement of the roots of the spinal nerves, then neuralgia can only be treated by treating the pathology that led to the impairment - osteochondrosis, hernial formation of the intervertebral disc, etc.

At home, the use of ointments with anti-inflammatory and analgesic effects has been shown as a local therapy. Thanks to the effects of their components, is blood circulation in the affected area improved? and muscle relaxation occurs.

Physiotherapy and exercise therapy

The effect of electromagnetic and magnetic fields, ultrasound, infrared and UV radiation, electrophoresis and other physiotherapeutic methods helps to fight intercostal neuralgia.


It improves metabolic processes and blood flow, relaxes muscles, normalizes the conduction of nerve impulses, has a slight analgesic effect. Duration of treatment is 10 sessions.

Manual therapy

The effect of the massage is fixed by manual therapy. In its implementation, the manual therapist acts with his hands directly on the displaced vertebrae. During this action, the vertebrae return to their original position, the gaps between the vertebrae widen, the pinched nerves are released. The method is effective, but in case of violation of the method, serious complications are possible.

How to treat intercostal neuralgia at home

If for any reason it is not possible to seek help from a doctor, you can resort to popular methods. Traditional medicine also has many proven self-help recipes to relieve symptoms of intercostal neuralgia.

So, the most effective folk remedies for the treatment of intercostal neuralgia at home can be considered the following:

  1. Rubbing the affected area with alcoholic extract of birch buds or valerian tincture has a good effect. Substances that are part of these tinctures, act like components of industrial ointments. But you should not put compresses with alcohol at night, because alcohol can cause skin burns.
  2. Warming up also helps, but the heat effect during intercostal neuralgia should not be direct, that is, not to apply a heating pad, a hot potato or an egg, but to wrap itself in a downy scarf, a knitted wool thing. If the sore spot is strongly heated, the pain will go away for a short time and then such an impact will only strengthen the swelling of the soft tissues and bring even more pain.
  3. Inside it is good to take a decoction of peppermint: 200 ml. Boil water, add 1 tablespoon of dried peppermint leaves to boiling water, leave. Take 100 ml. in the morning and in the evening. In the broth, you can add 2 teaspoons of honey.
  4. Pain along the nerves helps to reduce the juice of horseradish or black radish, which must be rubbed into the affected areas, as well as compresses with steamed flax seeds.
  5. It should take 4 tbsp. spoon dry sage and pour them with one glass of hot water. Let the broth stand for 60 minutes, then strain. The resulting tincture needs to be poured into a bath (not higher than 37 degrees), pour sea salt there (4 tablespoons) and take a bath at bedtime for no longer than 10 minutes, for 10 days.

But we should not forget that all home self-help products only relieve pain for a while, but do not eliminate its main cause. Therefore, your main task is to undergo a full examination and, if necessary, a course of treatment, as soon as possible (to avoid possible complications).


The essence of intercostal neuralgia prophylaxis is to observe elementary rules, such as:

  1. Watch your diet and lifestyle.
  2. Avoid hypothermia.
  3. Avoid spinal injury.
  4. Promptly treat internal diseases of the musculoskeletal system.
  5. Exercise daily, especially when your work activity is associated with sedentary work. Follow the correct posture.
  6. If there is any internal disease of infectious or non-infectious origin, seek the help of doctors, conduct a full course of treatment, this will help avoid possible complications.

Prophylactic massage using special warming ointments that improves blood circulation and lymphatic drainage has also proven itself well.

Which doctor to contact

With the appearance of acute chest pain, you can contact the therapist, who will necessarily refer the patient to an electrocardiogram and a chest X-ray. After exclusion of heart and lung diseases, the patient will be treated by a neurologist. Physiotherapist, physiotherapy and massage specialist, reflexologist, manual therapist participate in the therapy of the disease.

Watch the video: Trigeminal Neuralgia: Frequently Asked Questions (February 2020).


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