Intercostal neuralgia

Intercostal neuralgia - this is a fairly strong pain in the intercostal nerve, which is subjected to pressure. The disease is typical for adults, in children due to physiological features and a fairly stable musculoskeletal system, intercostal neuralgia is practically not found. Pain is caused by reflex irritation of specific intercostal nerve endings. 

[1], [2], [3],

Causes of the intercostal neuralgia

Intercostal neuralgia is a disease that occurs as a result of compression of the intercostal nerves, often a consequence of the advanced stage of osteochondrosis.

In addition to osteochondrosis, intercostal neuralgia can be provoked by such pathological changes in the spine: 

• Spondylitis - inflammatory processes in the spine of infectious, bacterial etiology; 
• Dyshormonal spondylopathy - osteoporosis of hormonal etiology; 
• Kyphosis - deformation of the upper zone of the spine; 
• Bechterew's disease; 
• Oncoprocess in the spine; 
• Herpetic infection; 
• Reflex compensation in the pathology of nearby organs.

Intercostal neuralgia also appears due to such pathologies as inflammation of the vertebral joints, hormonal osteoporosis, curvature of the spine.

Also, intercostal neuralgia can debut as a consequence of acute respiratory infection, severe hypothermia, excessive force loads and even severe stress. If you combine all the causes and classify them, you get three categories: 

• Overcooling, excessive load - as an external factor; 
• Causes of infectious etiology; 
• Intoxication.

[4], [5], [6], [7]

Symptoms of the intercostal neuralgia

Intercostal neuralgia has a distinctive feature - pain in the intercostal spaces, which usually becomes much more palpable with deep breaths, coughing, sneezing, sharp bends. The patient is characterized by a kind of antalgic posture, which he takes to reduce or prevent pain. 

At palpation numerous painful sites are revealed: along a backbone, lines of axillas, on edges of a sternum, the pain as though girdles a thorax, is often accompanied by pricking sensations.

• Acute pain, short-lived (up to three minutes), along the intercostal nerve; 
• Attacks of pain in the intercostal space, periodically subsiding and recurring; 
• Pain along the line of the intercostal nerve that occurs when you rotate your torso, cough and sneeze, you may have pain when swallowing, raising your voice; 
• Pain if desired to take a strong breath (full chest); 
• Pain in the intercostal nerves during palpation.

These painful sensations cause a person to unconsciously analge the condition by changing the posture - the body instinctively leans to the side that does not hurt. As a rule, neuralgia occurs in the zone, beginning from the fifth to the ninth rib. Pain often has an irradiative character, is given to the arm or shoulder blade. At palpation it is easy enough to reveal the main place of infringement of nerve endings, palpation passes on standard lines - paravertebral (spine), axillary line.

Often intercostal neuralgia manifests itself as a characteristic pain, which seems to encircle the trunk in the sternum zone. Due to the fact that the symptoms are similar to cardio-neurological, the patient is more often worried about a heart attack. If there is pain in the area of the scapula or heart, the tips of the fingers become numb, the person usually starts taking cardiac preparations. Of course, such an independent therapy not only does not give a result, but also allows the disease to develop further.

[8], [9]

Diagnostics of the intercostal neuralgia

Intercostal neuralgia is characterized by a constant pain level, which practically has no gradation. Angina pectoris, other cardiovascular pathologies, can usually be accompanied by transient, labile pain. Painful sensations can subside, repeat again, often have the character of pulsation. Pulsating pain resembles a general disturbance in the rhythm of the heart pulse, and changes in arterial pressure are also frequent - it can increase or decrease.

Intercostal neuralgia does not give such a symptomatology and can not in any way affect the blood pressure or pulse. In addition, heart pain does not change in intensity with a change in the position of the trunk, posture. It does not change when coughing or sneezing, which is typical for pain associated with neuralgia. Also, neuralgic pain, irradiating into the lumbar part, can be overlooked, as they are mistaken for a symptom of renal colic.

Self-medication, as well as an independent choice of diagnosis, are unacceptable. At the slightest alarm signs it is necessary to immediately seek medical help, only a specialist will be able to competently differentiate the nature of pain and make an accurate diagnosis. Intercostal neuralgia, kidney pathology or cardiac pathology - these diseases are considered serious not without reason, self-medication in such cases can lead to harmful consequences.

[10], [11], [12], [13]

Treatment of the intercostal neuralgia

Therapeutic measures should begin as soon as possible, immediately after the diagnosis of intercostal neuralgia. The first stage - anesthesia, blockade of pain. The second stage is a set of actions that are aimed at normalizing trophic tissue in a deformed area. The standard is the appointment of non-steroidal anti-inflammatory drugs, antiepileptic drugs and a complex of B vitamins. Acupuncture, acupuncture, acupuncture is also shown. If intercostal neuralgia is diagnosed as secondary, the therapy is symptomatic. Any stress on the spine is excluded, a diet with the inclusion of products containing gelatin (gelatus - fixing), like glucosamine (jelly, jelly, cold) is shown.

Intercostal neuralgia in the initial stage is treated based on the neutralization of the pain syndrome. Effective methods of treatment are:

• acupuncture (introduction of special needles into necessary points);
• pharmacopuncture (introduction to the necessary points of drugs effective for this disease);
• vacuum therapy (the method of therapeutic effect with the help of special vacuum cans, which activates the microcirculation of fluid in the body, and also helps to cleanse the body of accumulated harmful substances);
• massage procedures (massage is performed using warming creams and ointments, both in the back area and on the chest, starting from the less affected side, not exceeding the pain threshold);
• manual therapy (used to restore the function of ligaments and muscles, normalization of the cervical and thoracic spine);
• osteopathy (restoring the correct position of the ribs by determining the squeezed nerve and affecting the right parts of the body);
• quantum therapy (simultaneous exposure to the body of several types of radiation).

From medical preparations, intramuscular injections of anti-inflammatory drugs, ointments, gels, and vitamin B are used. For severe pain, ibuprofen, ketaprofen, diclofenac, voltaren, indomethacin, piroxicam are used. At the time of treatment, any physical activity is excluded, a set of necessary exercises is prescribed depending on the severity and course of the disease.

If you have intercostal neuralgia, you should also hang on the bar in a relaxed position for one to two minutes. To strengthen the muscles on the arms, the shoulder and neck have a good effect, pulling, for the muscles of the back and the lumbar region - the torso of the trunk back, stretching the spine.

With a sedentary lifestyle associated, for example, with professional activities, stagnation is formed in all parts of the spine, which causes numbness in the hands or feet, a feeling of crawling. Often this leads to the appearance of intercostal neuralgia.

Prevention

Intercostal neuralgia is not a typical disease, it can and should be prevented. The rules are fairly simple: 

• Do not overcool and intelligently distribute the load on the spine; 
• if there is a basic somatic disease, it should be treated not until the disappearance of the first symptoms, but completely; 
• follow the posture and with a sedentary lifestyle regularly engage in gymnastics; 
• maintain in an active, working condition, immunity and nervous system; 
• observe a reasonable diet and diet.

For preventive purposes during the day, it is recommended to perform such simple exercises:

• in the sitting position, swing the body back, rest in the back of the chair, bring your hands up, lift up and three or four times, bend;
• slowly move your shoulders up and down;
• without hurrying, carefully rotate your head;  
• bend sideways, touching the floor with your fingers, then repeat the tilt in the opposite direction;
• Leave the shoulder blades together and stay in this position for eight to ten seconds;
• tilt the head, then touch the chest with the edge of the chin, repeat the exercise three or four times.

Such a disease, as intercostal neuralgia, must necessarily be diagnosed by a doctor with the purpose of prescribing a correct and effective treatment. In acute stages of the disease, a patient may be recommended for bed rest for two or three days. Lying must be on a hard surface. In order to prevent the transition of the disease into a chronic form it is necessary to minimize physical exertion, to abandon bad habits, to try to avoid stresses.

[14], [15]