Symptoms of intercostal neuralgia on the left under the ribs, in the side, under the scapula - how to treat?

Pain and limited mobility are the main signs of thoracalgia. Pain surrounds the chest when intercostal neuralgia occurs. Symptoms on the left indicate a unilateral course of the disease. They are often confused with signs characteristic of cardiovascular disease.

The appearance of pain syndrome is provoked by pinching, irritation or inflammation of the nerves located in the intercostal spaces. Thoracic radiculitis does not develop independently; it is caused by diseases of the spine. Middle-aged and older patients are at risk. In children, thoracic radiculitis occurs in exceptional cases.

Some patients, before the onset of thoracic thoracalgia, are not aware of the presence of ailments that cause serious threat their health and life.

Thoracalgia is a secondary disease. Defeat nerve fibers cause long-term pathological processes in the body. Often intercostal neuralgia on the left occurs due to:

• tumor growth on the spinal cord;
• constant poisoning with chemicals;
• inflammation;
• damage to the myelin sheath;
• deficiency of B vitamins;
• diseases spinal column;
• diabetes mellitus;
• infections (flu, tuberculosis);
• rib diseases;
• deformed sternum;
• aortic aneurysm;
• pleurisy;
• allergies;
• multiple sclerosis.

Some patients, before the onset of thoracic thoracalgia, are not aware of the presence of ailments that pose a serious threat to their health and life. Therefore, the doctor tries to understand not only the signs of neuralgia, but also to determine the reasons that caused it. Treatment gives positive results, if you simultaneously eliminate the root cause of thoracic radiculitis and its symptoms.

The following are recognized as direct provocateurs of intercostal neuralgia:

• injury to the chest and spinal column;
• hypothermia of the thoracic spine;
• intoxication of the body (food, medicinal, alcohol, chemical);
• hormonal imbalance;
• age-related changes;
• overstrain of the back muscles, leading to muscle inflammation or spasm (prolonged stay in static positions, excessive physical exertion, jerking during movement);
• stressful situations;
• infection of nerve tissue;
• menopause in women.

Symptoms

The pain syndrome with intercostal neuralgia is intense, long-lasting, and does not go away. It causes a burning sensation.

Due to the similarity of symptoms, intercostal neuralgia is often mistaken for other pathologies. Doctor during diagnosis, comparing distinctive features, differentiates thoracic radiculitis from: ulcers, pancreatitis, pleurisy, atypical pneumonia, cardiovascular diseases.

The pain syndrome with intercostal neuralgia is intense, long-lasting, and does not go away. It causes a burning sensation. With increased tone or spasms of muscle tissue, the pain increases when the patient bends the body, moves the shoulder or scapula.

In heart disease, the pain is short-term, paroxysmal. Their appearance is provoked by stressful conditions and overwork. When symptoms of intercostal neuralgia on the left arise and radiate to the heart, this does not pose a threat to life.

However, they can easily be confused with the pain syndrome that appears during myocardial infarction. The patient in this situation requires emergency hospitalization. Heart pain is distinguished by the following characteristics:

• pain syndrome with neuralgia it is constant and prolonged, movements increase its intensity;
• with thoracalgia, pulse and pressure are unchanged;
• nitroglycerin does not relieve pain caused by thoracic radiculitis;
• with myocardial infarction, pain is accompanied by an attack;

General signs

Symptoms of intercostal neuralgia on the left include:

• acute persistent pain on the left side;
• burning and tingling sensation;
• increase in pain when performing movements;
• increased pain causes sneezing, coughing;
• muscle tension;
• muscle spasms;

The skin on the left side becomes numb, loses sensitivity, turns pale or red. The patient has difficulty breathing full breasts. He experiences dizziness and fainting due to oxygen deprivation. The pain subsides when the patient takes a forced fixed position. The main symptoms include: sweating, sudden surges in pressure, pain in lumbar region spine.

The nerves are formed by sensory, motor and autonomic bundles. The symptoms are influenced by the degree of damage to these fibers:

1. If the sensory bundles are damaged, the patient suffers from piercing pain that is neuralgic in nature.
2. When the motor bundles are affected, the patient suffers from shortness of breath (they are responsible for motor functions diaphragm and muscles, regulate respiratory rhythm).
3. If the vegetative bundles are irritated, the person sweats profusely (they regulate the functioning of sweat glands and vascular tone).
4. With uniform pressure on the nerve endings, a combination of various symptoms appears.

Symptoms associated with the underlying causes of the disease

Since left-sided intercostal neuralgia is considered a complication of prolonged pathologies of adjacent organs, it manifests symptoms of concomitant ailments.

The disease is accompanied by symptoms inherent in:

• osteochondrosis of the thoracic region;
• displacement of the vertebrae;
• intervertebral hernia;
• injuries of the musculoskeletal system;
• curvature of the spinal column;
• colds;
• herpes zoster;
• tumor tumors of the spine;
• ankylosing spondylitis.

If the patient has difficulty breathing, diagnose pleurisy, pneumonia, and bronchial asthma. If there is pain in the lumbar region, the doctor will prescribe an examination to detect kidney disease. If you complain of colic in the abdomen, tests are done to detect peptic ulcers, cholecystitis and pancreatitis.

Symptoms in men and women

Signs of thoracic radiculitis differ slightly between men and women. Men suffer from severe discomfort and piercing pain on the left side. But their duration is shorter.

Acute pain radiating to mammary glands, severe muscle tension are signs of intercostal neuralgia in women. Men never experience pain in the area mammary glands. Pain radiating to the lower back in women is sometimes mistaken for signs of gynecological diseases.

Treatment methods

Intercostal neuralgia requires serious treatment. Only a doctor can determine the root causes, symptoms and treatment. If you do not treat the disease, it will become severe.

Eliminating pain is the first priority complex therapy. At acute course Intercostal neuralgia requires strict adherence to bed rest. The patient is placed in a bed with a hard surface. They recommend that he find a comfortable position in which the pain will subside.

Drug treatment

For pain on the left side, medications with analgesic and anti-inflammatory effects are prescribed. They quickly relieve pain in the hypochondrium and significantly alleviate the patient’s condition.

Medicines are prescribed taking into account the patient’s age, severity of the disease and pathology digestive system. For treatment the following is prescribed:

• non-steroidal anti-inflammatory tablets or injections: Diclofenac, Meloxicam, Indomethacin, Rofecoxib;
• medications that relieve spasms: Tolperil, Mydocalm, Baklosan, Siralud;
• drugs with sedative effect: Persen, Sedasen, motherwort extract, Novopassit;
• B vitamins: Neurorubin, Neurobion, Milgamma. (they restore nerve fibers).

Intercostal neuralgia is treated with local medications. To relieve symptoms the following is prescribed:

• drugs with anti-inflammatory effect: DIP-relief, Dolobene, Fastum-gel;
• ointments and gels that have an anesthetic effect: Capsicam, Voltaren, Menovazin, Finalgon;

Physiotherapy, massage and exercise therapy

Helps fight intercostal neuralgia:

• acupuncture;
• exposure to ultrasound and laser;
• manual therapy;
• electrophoresis;
• magnetic therapy;
• therapeutic exercises;
• massage.

Traditional medicine

Helps treat illness traditional medicine. Using them, they get rid of pain and relieve inflammation. Signs of intercostal neuralgia are eliminated using the following recipes:

1. Place in gauze flaxseeds, steam them. Make an application on the left side.
2. The juice is squeezed out of horseradish root. Apply the product to the affected side.
3. Steamed wormwood is combined with sea ​​buckthorn oil. Make applications on left side chest, at the location of the pain.
4. The affected side is treated with alcohol, wiped dry, and a pepper plaster is fixed to the skin.
5. Apply to the affected side dry heat: bags of heated salt or sand.

The disease quickly recedes if the patient takes medicinal baths. Warm water with herbal decoctions eliminates pain and inflammation. Baths are prepared using a specific composition:

1. Take 500 g of aspen branches, boil them for 30 minutes, and leave. The product is filtered and added to the bath. Bath in the medicinal solution for 15 minutes. After the procedure, fir oil is rubbed into the affected side.
2. Brew 4 tbsp in 250 ml of boiling water. spoons of sage, leave for 1 hour, filter. 100 g is poured into the bath sea ​​salt and add sage infusion. The duration of the procedure is 15 minutes.
3. Add 5 drops of eucalyptus and lavender oil to a mixture of milk and honey (100 ml and 1 tablespoon, respectively). Pour the composition into the bath and bathe for 10 minutes. Do not wash off after the procedure medicinal solution, simply dry the skin with a towel. The procedure is performed every other day.

Prevention

Daily exercise prevents the development of intercostal neuralgia therapeutic exercises, kneading the body, self-massage, proper nutrition. It is necessary to give your body adequate physical activity every day. Do not be in a draft or be exposed to hypothermia. The diet should contain foods rich in B vitamins.

Intercostal neuralgia is a lesion of the intercostal nerves, accompanied by intense pain. The pathology itself does not pose a threat to life, however, the symptoms of intercostal neuralgia can mask serious diseases, which include, first of all, cardiovascular pathologies, in particular myocardial infarction. In some cases, intercostal neuralgia indicates the presence of other diseases, such as neoplasms spinal cord or chest organs, pleurisy.

Intercostal neuralgia is one of the most common diseases nervous system person

The intercostal nerves contain both sensory and motor nerves, as well as sympathetic fibers. In the human body, there are 12 pairs of nerves in the intercostal region, each of which passes below the edge of the corresponding rib in the intercostal space as part of the neurovascular bundle. Intercostal nerves innervate the skin and muscles of the peritoneum, costal and diaphragmatic parts of the pleura, anterior abdominal wall, mammary gland, chest. Neuralgia occurs when the roots of the intercostal nerves are compressed at their exit from the spine, usually as a result of muscle spasm.

Intercostal neuralgia occurs equally often in men and women. Susceptibility to the disease increases with age.

Synonyms: neuralgia of the intercostal nerves, thoracic radiculitis.

Causes of intercostal neuralgia and risk factors

The most common causes of neuralgia of the intercostal nerves are:

• osteochondrosis, spondylitis, ankylosing spondylitis and other diseases of the thoracic spine;
• tumors of the thoracic spinal cord;
• sudden unsuccessful movement;
• chest injury;
• forced awkward body position;
• general hypothermia of the body, hypothermia of the chest and back;
• pathologies of the upper part gastrointestinal tract;

In women, intercostal neuralgia can be caused by wearing tight underwear, as well as being underweight. In children and adolescents, intercostal neuralgia can occur during a period of intensive growth of the bone skeleton.

The contributing factors are:

• metabolic disorders (diabetes mellitus);
• age-related changes in blood vessels;
• diseases of the nervous system;
• infectious and inflammatory diseases;
• uncomfortable workplace.

Forms of the disease

There are two main forms of intercostal neuralgia:

• radicular – caused by irritation of the roots of the spinal cord and is accompanied by pain in thoracic region, can masquerade as cardiac pathology;
• reflex – occurs due to muscle tension in the intercostal spaces.

Intercostal neuralgia occurs equally often in men and women. Susceptibility to the disease increases with age.

Depending on the location, intercostal neuralgia is classified into unilateral and bilateral. The latter often occurs against the background of immunodeficiency, radiation sickness, herpetic infection and a number of other diseases.

Symptoms of intercostal neuralgia

The main symptom of intercostal neuralgia is paroxysmal piercing pain, which can be shooting, burning, stabbing, or resemble a blow. electric current. The pain intensifies when laughing, coughing, deep breathing, body turns, lifting upper limbs. In addition, pain increases with palpation of the affected area and can become unbearable for the patient. The patient takes a forced body position (antalgic postures) to reduce or stop pain. The pain is long-lasting, often persisting day and night, although its intensity may vary.

The pain may have different localization. Women in the background hormonal changes in the menopausal and/or postmenopausal period, pain is often noted in the area of ​​​​the projection of the heart, pain can radiate to the mammary gland. In men, pain is more often localized at the level of the lower ribs, on the left side of the chest. Depending on the location of the lesion, the pain may radiate to the heart, scapula, and epigastrium. When pain is localized along one or two intercostal nerves, it can acquire a girdling character.

A characteristic sign of intercostal neuralgia is that pain does not decrease at night. In the early stages of the disease, pain in the chest may be less intense, manifesting itself in the form of tingling, but increase with the progression of the pathology. Pain with intercostal neuralgia can be either unilateral or bilateral. During the first few days from the moment of occurrence pathological condition attacks of intercostal neuralgia can lead to sleep disturbances (including insomnia) and worsening general condition patient.

In children, intercostal neuralgia manifests itself as severe pain in the affected area and is accompanied by convulsions, sleep disturbances, increased excitability, speech disorder.

The clinical picture of the disease may include:

• muscle spasms in the affected area;
• numbness of the affected area;
• increased sweating (hyperhidrosis);
• paleness or redness skin;
• feeling of crawling sensations;
• shortness of breath (due to incomplete breathing during attacks of pain); etc.

Signs of intercostal neuralgia, which is caused by herpetic viral infection, are skin rashes and itchy skin, occurring even before the rash appears. Skin rashes are pink spots that transform into vesicles and dry out. The rash is localized on the skin of the intercostal space. Temporary hyperpigmentation of the skin is observed in place of the rash elements during the period of convalescence.

Diagnosis of intercostal neuralgia

The primary diagnosis of intercostal neuralgia is carried out on the basis of complaints and anamnesis, as well as an objective examination of the patient. Often the data obtained is sufficient to diagnose the disease. In complex diagnostic cases, as well as for the purpose of differential diagnosis with other pathologies that have similar manifestations, additional examination, which, depending on the indications, includes:

• magnetic resonance and computed tomography (to exclude neoplasms, hernia);
• X-ray examination of the chest and spine in direct, lateral and oblique projections;
• electroneurography (if the consequences of injuries are suspected);
• electrocardiography (to exclude diseases of the cardiovascular system);
• ultrasound examination;
• contrasting discography;
• gastroscopy (to exclude pathologies of the gastrointestinal tract);
• general and biochemical blood test;
• serological blood test; etc.

Information content computed tomography increases when combined with X-ray contrast examination of the spinal cord fluid-conducting tracts (myelography).

In some cases, intercostal neuralgia indicates the presence of other diseases, for example, neoplasms of the spinal cord or chest organs, pleurisy.

Identify pathology on early stage, and also monitor the effectiveness of treatment using electrospondylography. The method allows you to assess the condition of the spine and determine the extent of damage.

Required differential diagnosis intercostal neuralgia with other diseases:

• cardiovascular pathologies (angina pectoris, coronary heart disease, myocardial infarction);
• intervertebral hernia;
• thoracic radiculitis;
• lung cancer and other chest tumors;
• diseases of the gastrointestinal tract (gastritis, acute pancreatitis, gastric ulcer);
• renal colic; etc.

Treatment of intercostal neuralgia

Patients with intercostal neuralgia are prescribed bed rest for a period of several days to several weeks.

Acute pain syndrome accompanying intercostal neuralgia is relieved by parenteral administration of analgesics. If this is not enough, they resort to novocaine blockade of the intercostal nerves. After the pain intensity decreases, the patient is transferred to parenteral painkillers.

Treatment of intercostal neuralgia is complex. For increased muscle tone, muscle relaxants are used central action. Swelling in the affected area is eliminated with the help of diuretics, as well as venotonics. In order to improve the functions of the nerve involved in the pathological process, parenteral use of ascorbic acid and B vitamins is indicated. Non-steroidal anti-inflammatory drugs are used according to indications (for patients with heartburn, gastritis or peptic ulcers, their prescription is supplemented with drugs from the group of organotropic gastrointestinal drugs), sedatives, antidepressants, vitamin complexes.

In case of development of intercostal neuralgia against the background of a herpetic infection, it is prescribed antiviral drugs, antihistamines. Treatment is supplemented local application antiherpetic drugs in the form of ointment.

In women, intercostal neuralgia can be caused by wearing tight underwear, as well as being underweight. In children and adolescents, intercostal neuralgia can occur during a period of intensive growth of the bone skeleton.

As a complement to the main treatment of intercostal neuralgia in the area of ​​pain localization, physiotherapy and manual therapy can be used after relief acute symptoms intercostal neuralgia

In case of intercostal neuralgia due to displacement of the vertebrae or osteochondrosis, gentle manual therapy or traction of the spinal column can be performed. For intercostal neuralgia that has developed against the background of spinal pathologies, it is recommended to supplement the main treatment physical therapy, including a set of rehabilitation exercises.

For intercostal neuralgia caused by a tumor, treatment is carried out in the oncology department.

Possible complications and consequences

In the absence of adequate treatment, intercostal neuralgia can have complications:

• circulatory disorders with subsequent development of muscle pathologies and internal organs;
• chronic pain syndrome;
• exacerbation chronic diseases digestive system;
• promotion blood pressure, hypertensive crisis;
• transient ischemic attack, stroke;
• angina attack accompanied by intense pain; etc.

Forecast

With timely treatment, the prognosis of the disease is favorable. In the case of intercostal neuralgia caused by herpetic infection, relapses are common.

Prevention

Specific prevention of neuralgia of the intercostal nerves has not been developed; general strengthening measures will help prevent the development of pathology. Recommended:

• a healthy lifestyle, including regular moderate physical activity and a rational, balanced diet;
• timely treatment of spinal diseases, chest injuries, pathologies of internal organs;
• measures to help prevent spinal curvature or treat an existing curvature;
• avoiding hypothermia;
• work in comfortable conditions, with prolonged forced body positions, take breaks for a short warm-up.

Video from YouTube on the topic of the article:

Severe pain in the ribs prompts a person to go to the doctor to find out how to treat intercostal neuralgia and what medications to suppress the symptoms of the disease.

Intercostal neuralgia does not belong to the category of dangerous diseases. But it develops against the background serious pathologies and develops into serious complications. Neuralgia is caused by intervertebral protrusions and hernias, tuberculosis, diabetes mellitus, multiple sclerosis, tumors.

The symptoms of neuralgia are such that they can easily be confused with signs renal colic, cholecystitis, angina pectoris. Only a doctor can make a correct diagnosis and prescribe treatment based on diagnostic studies.

Usage medicines – main way treatment of intercostal neuralgia. To treat the disease and the cause that caused it, the following is prescribed:

• pills;
• injections for intramuscular and intravenous administration;
• ointments, gels or creams.

The form of medication for intercostal neuralgia is chosen by the doctor. Medicines are prescribed taking into account the severity of the disease, the patient’s well-being and contraindications.

Tablets are considered an ineffective treatment for intercostal neuralgia. In addition, they irritate the mucous membranes of the gastrointestinal tract, causing adverse reactions. Erosive gastritis and stomach ulcer - possible harm from uncontrolled use of tablets.

Pain relievers

The primary goal of drug therapy is to relieve pain – the main symptom of the disease. Pills and injections help get rid of prolonged debilitating pain. For pain relief the following is usually prescribed:

• Spazgan;
• Analgin;
• Baralgin;
• I took it.

To relieve unbearable pain that occurs with swelling of nerve fibers and root compression syndrome, the following is used:

• Ketoprofen;
• Ibuprofen;
• Celebrex;

Analgesics are used to relieve pain and prevent new attacks:

• Panadol;
• Tylenone;
• Pentalgin.

These drugs are available in tablets, injection solutions, in the form of ointments and gels. They are taken in tablets. To quickly relieve pain, injections are given and IVs are placed.

The course of treatment with anesthetics is short, it does not exceed 4-5 days. They disrupt the normal functioning of the gastrointestinal tract.

Local painkillers

Local anesthetics relieve swelling and pain of a neuralgic nature. They are prescribed for temporary relief of acute pain. Reduce pain and eliminate muscle tension with ointments, gels, and injection solutions.

The drugs are applied or injected directly into the lesion. They are used to make blockades. Pain is suppressed with injections of Lidocaine, Novocaine or Xylocaine. The use of local anesthetics is limited in time. They are highly toxic agents that can cause great harm body. Unbearable pain removed with one-time blockades.

Anti-inflammatory medications

Inflammatory processes occurring in nerve fibers lead to swelling and pain. The swollen tissue puts pressure on the nerves. Pinched nerve roots are accompanied by pain. Relieving inflammation, eliminating pain.

Inflammatory processes are suppressed with non-steroidal anti-inflammatory drugs:

• Ortofen;
• Nimesulide;
• Ketoprofen;
• Voltaren;
• Movalis.

The products effectively relieve inflammation. If you use them correctly, according to the scheme given by the doctor, you can get a long lasting stable remission. To eliminate inflammation, take a tablet 2 times a day, give an injection, or use rectal suppositories.

The body's susceptibility to drugs is almost the same. But they are best absorbed through the mucous membranes. Long-term treatment anti-inflammatory drugs cause exacerbation of certain ailments (for example, gastritis or ulcers). They should not be used without a doctor's prescription.

Muscle relaxants

IN drug treatment intercostal neuralgia include muscle relaxants - drugs with a sedative effect. They eliminate pain, relax muscles, and improve the patient’s well-being. Which of them can be used for treatment:

• Tizanidine;
• Tolperisone.

The taken muscle relaxant eliminates congestion in muscle tissue and swelling. For treatment, use a drug prescribed by a doctor.

Vitamin therapy

To suppress inflammatory processes, replenish vitamins and minerals, and strengthen the immune system, it is necessary to take special complexes. Medicines with B vitamins are involved in blocking acute inflammatory processes that erupt in nerve tissues. Vitamin complexes relieve muscle spasms, neutralize negative impact medications used.

Sedatives

Painful sensations worsen the well-being of patients, plunge them into a state of prolonged stress, create a feeling of discomfort, and reduce the quality of life. Taking sedatives for intercostal neuralgia helps relieve nervous tension, relax skeletal muscles, normalize the condition of a sick person.

To this end, in drug therapy You can include a product with an extract of a soothing medicinal plant. Suitable for treatment:

• Chamomile;
• Mint;
• Motherwort.

Herbs with a sedative effect are used separately or preparations are made from them. It is worth drinking infusions and decoctions from them. Have an effective impact pharmaceutical drugs: syrups, tinctures.

They drink a sedative at night. It promotes good sleep, good rest, relieves nervous and muscle tension. Have an excellent relaxing effect essential oils: lavender and mint.

Medicines with bee and snake venom

Eliminate intercostal neuralgia with medications based on snake and bee venom. The effectiveness of ointments and gels with these poisons is quite high. They warm up the skin, accelerate blood circulation, remove metabolic products, and saturate tissues with bioactive substances. The drugs regenerate damaged nerve tissue.

The product with poison is used externally, it is rubbed into the lesions with soft massaging movements, bypassing the heart area. For treatment use:

• Apisatron. Ointment with bee venom suppresses pain and inflammation, restores blood flow.
• Viprosal. Ointment with viper venom eliminates pain and improves blood circulation. Camphor and fir, which the drug contains, have an analgesic effect.

These ointments are used as prescribed by a doctor. They are not always used for treatment of:

• lactation;
• pregnancy;
• allergies;
• heart diseases.

Antiviral agents

Problem: how to treat intercostal neuralgia of a viral nature is easily solved. Antiviral medications are used to suppress it. Effectively fight pathology:

• Amiksin;
• Remantadine.

Ointments and gels

Remedies for neuralgia in the form of ointments and gels quickly relieve pain. They instantly penetrate through the skin pores into the deep tissues, to the lesion, reduce the severity of pain and eliminate swelling.

External agents stimulate blood circulation, distract from pain, and remove nervous tension. Thanks to them, blood supply to the sore spot improves, nutrition of damaged tissues, and pain goes away.

To treat intercostal neuralgia use:

• Fastum-gel. The product relieves pain, stimulates blood flow, and eliminates swelling.
• Capsicam. The ointment, due to its effective warming effect, accelerates the supply of blood to tissues. It restores tissue trophism and helps replenish nutrients.
• Finalgon. The ointment warms up. Thanks to her blood vessels are expanding. Blood flow increases. Oxygen and nutrients enter the tissues.
• Indomethacin, Ortofen, Naklofen, Ibuprofen. Ointments fight inflammation, swelling and pain.
• Menovazin. The ointment has a pronounced analgesic effect.
• Chondroxyl. The chondroprotector restores mobility to the spine.

Preference is given to ointments. Their rate of penetration into tissue is higher than that of gels. On early stages and at severe pain use ointments that can relieve muscle spasms and relax muscles.

Patients suffering from sharp pain, try not to prescribe ointments with a burning effect. By increasing stimulation at the site of the lesion, it is possible to provoke the development of an ischemic crisis or heart attack due to excessive outflow of blood from the coronary vessels.

Antispasmodics

For neuralgia muscle tissue, surrounding the damaged nerve fibers, spasm, their tone is excessively high. Without eliminating muscle spasms, you cannot get rid of pain. Increased tone relieved with antispasmodics:

• Besalol;
• Halidor;
• No-spy;
• Papazol.

To eliminate spasms, they take pills and give injections.

Intercostal neuralgia requires comprehensive therapeutic treatment. Thanks to it, pain is quickly relieved, the patient’s well-being is improved, and the inflammatory processes that cause the disease are blocked. Prescription of treatment by the doctor - prerequisite. Prescribed medications will give maximum healing effect, will not allow complications to develop.

Most often, pain in the chest is mistaken for a heart attack, various diseases spine or gastrointestinal tract organs, although these may be manifestations of intercostal neuralgia. The pathology occurs due to pinching or irritation of the intercostal nerve and manifests itself in the form of acute pain. Intercostal neuralgia has strictly defined symptoms and treatment that every person needs to know about. In our article we will try to understand the causes of damage to the intercostal nerves, clinical manifestations, principles of diagnosis and treatment of an abnormal process.

To understand the cause of this pathology, you first need to know what intercostal neuralgia is, the symptoms and treatment of this condition.

Damage to the intercostal nerves serves as a definite warning of serious diseases of the body structures. Intercostal neuralgia is characterized by pinching, irritation or inflammation peripheral nerves located in the narrow intercostal space. It is typical for her sharp pain, which significantly worsens a person’s quality of life: performance decreases, irritability appears.

Pinched intercostal nerve is not a “terrible” diagnosis, but it has similarities with the symptoms of more serious illnesses. Intercostal neuralgia can affect older people, as well as young people who are prone to sedentary style life or involved in professional swimming.

This pathology in children is observed only in in rare cases, for example, during a period of intensive growth.

Irritation of nerve tissue indicates that something is happening in the body. pathological change. There are many reasons for the development of this process. Therefore, consultations with a neurologist and diagnostics in this matter are extremely important in order to make an accurate diagnosis of the patient and begin treatment in a timely manner.

The most common causes of intercostal neuralgia are:

It is necessary to correctly identify the causes of intercostal neuralgia and fight not only its symptoms, but also eliminate the root cause of its development.

Main symptoms

The main symptom of intercostal neuralgia is pain. Moreover, there is always an immediate acute pain. Nerve inflammation can take you by surprise because it can appear suddenly. A person begins to experience severe discomfort, and it becomes difficult for him to perform everyday duties.

The pain may intensify with emotional conversation, coughing, or turning the body. Even in a state of rest, a person does not feel better. High intensity pain may persist for 4-7 days.

The skin in the area where the irritated nerve is located usually loses sensitivity. But if you feel the affected area, the pain can sharply intensify.

Secondary symptoms of intercostal neuralgia may be:

• pallor of the skin or, conversely, redness;
• increased sweating;
• involuntary muscle contraction;
• loss of consciousness (possible with a low pain threshold in some people).

Most often, pain occurs in the chest and spreads along the ribs. Depending on the root cause of intercostal neuralgia, pain can spread beyond the chest, and this misleads the doctor in making the correct diagnosis.

Inflammation of the nerve in the intercostal space provokes pain from all sides. In addition, the pain can spread beyond the affected area: to the lower back, back, shoulder blades.

You can independently distinguish the pain of a pinched intercostal nerve from cardiac pain. It is necessary to take one of the heart medications, according to the instructions: Validol, Nitroglycerin or Corvalol. If after some time there is no relief, it means intercostal neuralgia. In this case it is necessary diagnostic test in a specialized institution to determine the cause of the pathology.

It will not be difficult for a neurologist to establish a diagnosis of intercostal neuralgia. Judging by the patient’s symptoms, complaints and palpation (feeling), he will be able to determine treatment tactics.

To establish the primary source of pain, the following diagnostic methods are prescribed:

• X-ray of the chest organs (survey);
• MRI of the spine;
• Ultrasound of the abdominal organs.

Treatment methods

Treatment of intercostal neuralgia occurs in two directions:

• relief of the patient’s condition, reduction of pain;
• treatment of the underlying disease against which intercostal neuralgia occurred.

In most cases, intercostal neuralgia is treated on an outpatient basis. For the first few days, the patient must remain in bed. To do this, you need to properly arrange the bed: it must be firm. Also use an orthopedic mattress or place a backboard under a regular mattress.

The treatment regimen consists of the following points:

• drug therapy;
• physiotherapy and exercise therapy;
• acupuncture;
• manual massage;
• traditional medicine.

First of all, the specialist will help the patient reduce the pain of intercostal nerve entrapment and may prescribe the following medications.

1. Non-steroidal anti-inflammatory drugs (Diclofenac, Meloxicam), they will relieve pain and provide direct action on inflammatory process in the body. These tools have several dosage forms: injection solutions, tablets, ointments, suppositories.
2. Muscle relaxants (Sirdalur, Tolperil), which reduce the severity of spasm muscle fibers.
3. Sedatives based on herbal components (Sedasen, Persen, Novo-Passit).
4. B vitamins (Neurobion, Neurorubin). Vitamin B restores damaged nerve structures, improve the passage of impulses through them.
5. Painkillers. Ointments based on bee and snake venom: Apizartron, Viprosal.

Physiotherapy and exercise therapy

Electromagnetic and magnetic fields, UV rays, infrared radiation, ultrasound, electrophoresis and other physiotherapeutic methods.

Therapeutic physical training (PT) is most effective when the nerve is pinched between the ribs. On an individual basis, the specialist selects a set of activities for the patient, taking into account the severity of the pathology, the patient’s well-being and the symptoms of the disease.

Manual massage

To speed up recovery, the attending physician may advise the patient to undergo additional manual therapy. One of common methods its implementation is massage. Using the fingers, the specialist will influence the intercostal spaces, as well as the spine if neuralgia occurs due to diseases of the spine.

Manual therapy can help improve metabolic processes and blood flow in the affected tissues, relax muscles and normalize the conduction of nerve impulses.

Acupuncture

Sometimes with intercostal neuralgia, acupuncture can significantly alleviate the patient's condition.

This method of treatment helps to quickly eliminate pain and relieve muscle imbalance.

Folk remedies

Most often as a first aid medical care use mustard plasters or pepper plaster. They warm up well soft fabrics and have a beneficial effect on the blood circulation process.

You can also use it at home special ointments, herbal infusions, compresses that have an anti-inflammatory and analgesic effect.

1. Glycerin and honey. The ingredients must be taken in equal quantities, mixed and applied to the affected areas. Use once every two days.
2. Chamomile and peppermint. Fill hot water 1 tbsp each dry herbs mint and chamomile. Leave to infuse for approximately 1 hour. Strain the infusion and drink it throughout the day. The course of treatment lasts no longer than 5 days.
3. Indoor geranium. Pluck several leaves of the plant, put them on a linen or cotton napkin and bandage them to the affected area, wrap them with a downy scarf on top. The compress must be kept for 40 minutes.
4. Turpentine and Vaseline. Mix turpentine and petroleum jelly until smooth in a 1:2 ratio. Gently rub the resulting mixture into the area of ​​intercostal neuralgia.
5. Geranium and lemon balm. Pour boiling water over these ingredients and let it brew for a while. This decoction must be consumed regularly in the form of tea until the intercostal neuralgia completely disappears.

It should be remembered that self-medication may cause potential threat for your health. Before use folk remedies for intercostal neuralgia, you should consult your doctor, as there is a possibility of intolerance to individual components. In addition, the manifestation of pain along the way intercostal nerve may indicate more serious problems in the body.

If the diagnosis was made correctly and all the doctor’s instructions were followed, then full recovery person. To reduce the likelihood of intercostal neuralgia, it is necessary to promptly treat primary diseases, as a result of which pathology occurs.

Preventive measures for intercostal neuralgia consist of following the well-known rules:

• monitor your diet, it should be rational;
• avoid hypothermia of various kinds, stress;
• take care of your health;
• treat internal diseases of the musculoskeletal system;
• ensure correct posture;
• exercise regularly;
• treat infectious diseases at the first manifestations.

Conclusion

Intercostal neuralgia is a fairly common pathological condition. A timely visit to a neurologist will help prevent serious complications and identify the root cause of inflammation/pinching of the intercostal nerve.

Intercostal neuralgia (neuritis) is characterized by severe pain that occurs due to compression of the roots spinal nerves. This symptom accompanies an infectious infection, toxic damage body, injury and more. Intercostal neurosis often develops against the background of osteochondrosis or herpes zoster. The nature of the manifestation of the syndrome is determined by the localization zone.

Causes of the disease

The causes of intercostal neuralgia and accompanying symptoms are determined anatomical structure bodies. The thoracic region contains 12 pairs of nerves that arise from the spinal cord. These elements consist of sympathetic, sensory and motor fibers. A separate nerve runs in the space between the ribs in the area where the external and internal muscles are located. They provide respiratory function body.

The nerves located in the intercostal space innervate the muscle fibers of the following areas of the body:

• breast;
• rib cage;
• costodiaphragmatic part of the pleura;
• anterolateral and anterior parts of the abdomen.

The spinal nerves are intertwined, which explains why intercostal neuropathy affects several areas of the body at the same time.

Shingles is one of the most common causes of the disease. The appearance of intercostal neuralgia can also be caused by:

• osteochondrosis of the spine;
• injuries and fractures of ribs;
• pleurisy;
• chronic vertebrogenic pain syndrome;
• arthrosis;
• chest deformation;
• pathologies of the spine.

In the absence of an inflammatory process caused by herpes zoster, intercostal neuralgia can be caused by irritation or compression of nerve fibers.

This condition develops against the background of:

In addition, intercostal neuralgia manifests itself due to a deficiency of B vitamins, which is often observed against the background of metabolic disorders. These same pathologies and a number of others can cause intercostal nerve pinching in women. In adults, this condition also occurs with excessive alcohol abuse. The appearance of intercostal neuralgia in children is explained by pathologies of the digestive system, diabetes mellitus, and hypothermia.

Symptoms of neuralgia

With intercostal neurosis, the symptoms are determined depending on the reasons that led to it. The leading sign of a pinched nerve is pain (thoracalgia) in the chest. Unpleasant sensations often radiate to other parts of the body.

The pain syndrome resembles an electric shock or a “lumbago” and clearly spreads from the spine to the sternum. The intensity of pain varies depending on the degree of nerve damage.

IN serious cases when the causative factor provokes constant spasmodic contraction of muscle fibers, this leads to the development of dystonia. There is an increase in pain associated with any movements in the chest: coughing, heavy breathing, sneezing. Intercostal dystonia is relieved by pressing on the problem area. In this case, the amplitude with which the chest moves decreases, thereby reducing the intensity of unpleasant sensations.

Depending on the stage of development of the pathology that caused neuralgia, pain may manifest itself in the form of burning and tingling. In advanced cases, patients note numbness in the problem area.

If the intercostal nerves experience pressure, then clinical picture supplemented:

• redness and paleness of the skin;
• local hyperhidrosis (increased sweating).

The development of neuralgia is characterized by a paroxysmal course, the duration of which is 2-3 minutes.

During this period, patients try to hold their breath to reduce the intensity of symptoms. Between attacks, sensations in the form of “goosebumps” and tickling occur in the problem area.

Intercostal neuralgia on the left side

With intercostal neuralgia on the left, symptoms also manifest themselves in the form of intense pain, the nature of which depends on the factor of its manifestation. Unpleasant sensations radiate to the heart area, so thoracalgia is often mistaken for signs of myocardial infarction.

The development of left-sided intercostal neuralgia in men and women is accompanied by different symptoms. In women, the pain syndrome affects the mammary glands, and attacks in men pass faster.

The localization and intensity of pain with intercostal neuralgia in the heart region depends on the number of affected nerves. In some cases discomfort acquire an encircling character.

How to recognize intercostal neuralgia?

Since it is quite difficult to distinguish intercostal neuralgia from cardiac pathology, in order to exclude the latter in case of pain in the sternum, an ECG is prescribed. Also, to differentiate neuralgia from myocardial infarction, you must take a nitroglycerin tablet. This drug does not help cope with intercostal neuralgia, so the intensity of the pain syndrome does not subside.

Neuralgia in the heart area is accompanied by the following symptoms:

• pain syndrome, the intensity of which does not change when performing movements;
• blood pressure surges;
• tachycardia.

These symptoms are not typical for intercostal neuralgia. It is distinguished from cardiac pathologies following symptoms:

• strict localization of pain in the left side of the body (with a heart attack, it sometimes spreads to other areas);
• muscle spasms;
• increased pain when making movements, coughing, sneezing;
• the pain syndrome lasts for a day or more;
• decreased skin sensitivity in the problem area.

In contrast to the clinical picture when the intercostal nerve is pinched, the symptoms of cardiac pathologies are short-term. Discomfort in the sternum disappears after a few minutes or hours, but a number of symptoms coincide with manifestations of heart disease:

• dyspnea;
• attacks of dizziness;
• paleness of the skin;
• fainting.

The appearance of shortness of breath with intercostal neuralgia and other symptoms described above is explained by oxygen starvation due to insufficient air supply to the lungs. In cardiac pathologies, these phenomena are caused by impaired circulation in the body.

Symptoms of neuralgia (except for pain), unlike myocardial infarction and other heart diseases, do not always appear

For example, shortness of breath is a concern only if the nerve bundles responsible for motor functions are affected.

In case of pain on the left side, an additional examination of the patient is always carried out. It is important to rule out heart disease before determining how to relieve intercostal neuralgia.

Intercostal muscle pinching on the right

With intercostal neuralgia, symptoms on the right often occur with liver damage and inflammation of the appendix. This is explained by the fact that these conditions are characterized by intense pain in this area.

If neuralgia appears on the right under the ribs caused by liver pathologies, in addition to pain, the patient experiences the following symptoms (depending on the type of disease):

• increased body temperature;
• enlargement of local lymph nodes;
• yellowing of the skin;
• darkening of urine;
• disorder of the gastrointestinal tract;
• increased fatigue;
• nosebleeds, etc.

The development of intercostal neuralgia on the right and in front is due to the course of pathologies thyroid gland. Women with such a lesion require consultation with a mammologist. Often intercostal nerves provoke painful sensations due to breast diseases.

The following symptoms indicate pathology of the thyroid gland:

• the appearance of goiter;
• sudden change in weight;
• arrhythmia;
• fatigue;
• hair loss;
• hot flashes or chills;
• skin problems.

The appearance of discomfort with right side under the scapula may indicate pulmonary pathologies. The course of these diseases is accompanied by:

• violation of voice timbre;
• cough;
• difficulty breathing;
• increased body temperature;
• constant fatigue;
• shortness of breath.

Neuralgia on the right behind is explained by pinching of the lower parts of the intercostal nerves.

Pain in this area can also be a consequence of kidney disease, and in addition to discomfort in the lumbar region, the following pathologies may appear:

• change in urine volume;
• increased body temperature;
• pain when urinating;
• swelling on different parts bodies.

The appearance of pain on the right side is explained by the course of many diseases. Moreover, some of similar pathologies signs of neuralgia are characteristic. In particular, the intensity of pain may increase when changing position, which is detected mainly against the background of compression of nerve fibers.

A neurological disorder can be distinguished from other pathologies by local hyperhidrosis. The active work of the sweat glands in certain parts of the body is often caused by compression of nerve bundles. However, an accurate diagnosis can only be made after a comprehensive examination of the patient.

Postherpetic intercostal neuralgia

Intercostal neurosis often occurs against the background of active herpetic infection. More than 90% of the planet's population are considered to be its carriers. After infection, herpes penetrates into the DNA of the nerve fibers of the spinal cord, so after an exacerbation of pathology, pathologies are possible intense pain in the affected area.

The development of intercostal neuralgia, its symptoms and treatment in this case do not depend on the type of virus. More often, the appearance of pain in the chest area is explained by an exacerbation of herpes zoster (herpes type 3). Less commonly, discomfort occurs due to a relapse of the first or second type of virus. This is explained by the fact that these pathogens mainly affect the face and genitals, respectively.

Postherpetic intercostal neuralgia differs in the nature of the manifestation of pain:

1. Periodic. They arise abruptly, but pass relatively quickly.
2. Sustainable. Pain in the chest area is felt until the herpetic rash disappears. Some immunocompromised patients experience discomfort in this area for several months.
3. Allodic. Pain of this type occurs upon contact with clothing and disappears after the irritant is removed.

Postherpetic neuralgia can be distinguished from other diseases with a similar clinical picture by its characteristic blistering rashes, which develop along the affected nerve. Moreover, pain precedes the appearance of skin tumors. Over time, the intensity of the symptom increases, reaching a maximum during the period when the herpetic rash disappears.

On average, pain subsides within 15-20 days.

Diagnostics

The development of intercostal neuralgia requires the participation of a neurologist. This condition requires a comprehensive examination of the patient. Important diagnostic sign the behavior of a sick person is considered: he tilts his torso in healthy side, thereby trying to reduce pressure on the problematic nerve.

With thoracic radiculitis or intercostal neuralgia, the intensity of the pain syndrome increases with palpation of the problem area. However, the latter condition is often characterized by redness or paleness of the skin in the area where the affected nerve lies. To exclude thoracic radiculitis, x-rays are prescribed. If an intervertebral hernia is suspected, an MRI of the spine is performed.

For staging correct diagnosis intercostal neuralgia must be differentiated from cardiac pathologies (in particular, angina pectoris). Diseases of this type cause squeezing pain that usually occurs after physical activity. The absence of such characteristic feature allows you to exclude heart pathologies even at the examination stage. To confirm the assumptions, the doctor prescribes an ECG.

Diagnosis of pinched nerves between the ribs is complicated by the fact that the clinical picture of such disorders manifests itself as diseases of the pancreas and stomach. To exclude these diseases, blood tests for pancreatic enzymes, gastroscopy and other examinations are performed.

Treatment methods

Eliminate discomfort and suppress the inflammatory process. In severe cases, medications are used in the form of injections.

Muscle relaxants are indicated for the treatment of muscle spasms:

• "Mykodalm";
• "Sirdalud";
• "Tolperil."

If necessary, treatment is supplemented with sedatives. Typically, herbal medicines are used to restore the nervous system:

To reduce the intensity of general symptoms, it is recommended to apply dry heat to the problem area. These can be knitted or woolen items. It is impossible to warm up the affected nerves. This tactic temporarily relieves pain, but as the problem area cools, the intensity of the symptoms will increase.

For intercostal neuralgia it is indicated local treatment, which involves treating the affected area with gels or with an anti-inflammatory effect:

The use of physiotherapy for intercostal neuralgia is effective in cases where it complements medications. In the treatment of the pathological condition the following is used:

• therapeutic massage;
• electrophoresis;
• magnetic therapy;
• reflexology.

If compression of nerve fibers is caused by intervertebral hernia or a tumor, then it is prescribed surgery. For herpes zoster, vitamin complexes with both local and systemic action are recommended.

Prevention

For prevention to be effective, it is important to know how to recognize intercostal neuralgia and the causes of the syndrome, as well as which doctor to contact.

You can avoid exacerbation of pain caused by compression or inflammation of nerve fibers if you treat concomitant pathologies in a timely manner and lead an active lifestyle.

In addition, it is necessary to maintain immunity to prevent recurrence of shingles.

If persistent pain occurs in the ribs, spine or lower back, you should immediately seek help from a neurologist.

Possible complications

With advanced intercostal neuralgia, the consequences are determined depending on the reasons that caused it. In the absence of adequate treatment and with progression pathological process, which causes pinching of nerve fibers, circulatory disturbances may occur, which leads to dysfunction of internal organs and muscle diseases.

IN extreme cases there is a risk of developing chronic intercostal neuralgia, in which patients have difficulty breathing. Persistent pain syndrome causes sleep problems, depressive state and dysfunction of the heart muscle. In the future it is possible to develop hypertensive crisis and other dangerous conditions.