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Intercostal neuralgia
Last reviewed: 04.07.2025

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Intercostal neuralgia is a rather strong pain sensation in the area of the intercostal nerve, which is subject to pressure. This disease is typical for adults; in children, due to physiological characteristics and a fairly stable musculoskeletal system, intercostal neuralgia is practically not encountered. The pain is caused by reflex irritation of specific intercostal nerve endings.
Causes intercostal neuralgia
Intercostal neuralgia is a disease that occurs as a result of compression of the intercostal nerves and is often a consequence of an advanced stage of osteochondrosis.
In addition to osteochondrosis, intercostal neuralgia can also be caused by the following pathological changes in the spine:
- Spondylitis is an inflammatory process in the spine of infectious, bacterial etiology;
- Dyshormonal spondylopathy – osteoporosis of hormonal etiology;
- Kyphosis is a deformation of the upper part of the spine;
- Bechterew's disease;
- Oncologic process in the spine;
- Herpes infection;
- Reflex compensation for pathology of nearby organs.
Intercostal neuralgia also appears as a result of such pathologies as inflammation of the vertebral joints, hormonal osteoporosis, and curvature of the spine.
Also, intercostal neuralgia can debut as a consequence of an acute respiratory infection, severe hypothermia, excessive strength loads and even severe stress. If you combine all the causes and classify them, you will get three categories:
- Hypothermia, excessive stress - as an external factor;
- Causes of infectious etiology;
- Intoxication.
Symptoms intercostal neuralgia
Intercostal neuralgia has a distinctive feature - pain in the area of the intercostal spaces, which usually becomes much more noticeable with deep breaths, coughing, sneezing, and sharp turns. The patient is characterized by a peculiar antalgic pose, which he takes to reduce or prevent pain.
Palpation reveals numerous painful areas: along the spine, the armpit line, along the edges of the sternum, the pain seems to encircle the chest, often accompanied by tingling sensations.
- Acute pain, short-term (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, which occurs when turning the body, coughing and sneezing, pain is possible when swallowing, raising the voice;
- Pain when trying to take a deep breath (with full chest);
- Pain in the area of the intercostal nerves upon palpation.
These painful sensations make a person unconsciously analgesic the condition by changing the position - the body instinctively leans to the side that does not hurt. As a rule, neuralgia occurs in the area starting from the fifth to the ninth rib. The pain often has an irradiating character, radiating to the arm or shoulder blade. When palpating, it is quite easy to identify the main place of pinched nerve endings, palpation goes along standard lines - paravertebral (spine), axillary line.
Often intercostal neuralgia manifests itself with characteristic pain, which seems to encircle the body in the sternum area. Due to the fact that the symptoms are similar to cardio-neurological ones, the patient most often worries about a heart attack. If pain appears in the shoulder blade or heart area, the fingertips go numb, the person usually begins to take cardiac medications. Of course, such independent therapy not only does not give results, but also allows the disease to develop further.
Where does it hurt?
Diagnostics intercostal neuralgia
Intercostal neuralgia is characterized by a constant level of pain, which has virtually no gradations. Angina pectoris and other cardiovascular pathologies, as a rule, can be accompanied by transient, labile pain. Painful sensations can subside, recur again, and often have a pulsating character. Pulsating pain echoes a general disturbance of the heart rhythm, and changes in blood pressure are also common - it can increase or decrease.
Intercostal neuralgia does not give such symptoms and cannot affect blood pressure or pulse in any way. In addition, heart pain does not change in intensity when changing the position of the body, posture. It does not change when coughing or sneezing, which is typical for pain associated with neuralgia. Also, neuralgic pain, radiating to the lumbar region, can be missed, as they are taken for a symptom of renal colic.
Self-medication, as well as independent choice of diagnosis, are unacceptable. At the slightest alarming signs, it is necessary to immediately seek medical help, only a specialist will be able to correctly differentiate the nature of the pain and make an accurate diagnosis. Intercostal neuralgia, renal pathology or cardiac pathology - these diseases are considered serious not without reason, self-medication in such cases can lead to disastrous consequences.
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Treatment intercostal neuralgia
Therapeutic measures should begin as early as possible, immediately after the diagnosis of intercostal neuralgia is clarified. The first stage is anesthesia, pain blockade. The second stage is a set of actions aimed at normalizing tissue trophism in the deformed area. The standard is the prescription of non-steroidal anti-inflammatory drugs, antiepileptic drugs and a complex of B vitamins. Acupuncture and acupuncture are also indicated. If intercostal neuralgia is diagnosed as secondary, therapy is symptomatic. Any load on the spine is excluded, a diet is indicated with the inclusion of products containing gelatin (gelatus - fixing), similar to glucosamine (jelly, jellied dishes, aspic).
Intercostal neuralgia in the initial stage is treated based on the neutralization of pain syndrome. Effective treatment methods are:
- acupuncture (insertion of special needles into the desired points);
- pharmacopuncture (introduction of drugs effective for a given disease into the necessary points);
- vacuum therapy (a method of therapeutic intervention using special vacuum cups that activates microcirculation of fluid in the body and also helps cleanse the body of accumulated harmful substances);
- massage procedures (massage is performed using warming creams and ointments, both in the back and chest area, starting from the less affected side, without exceeding the pain threshold);
- manual therapy (used to restore the functions of ligaments and muscles, normalize the condition of the cervical and thoracic spine);
- osteopathy (restoring the correct position of the ribs by identifying the compressed nerve and acting on the necessary areas of the body);
- quantum therapy (simultaneous exposure of the body to several types of radiation).
Intramuscular injections of anti-inflammatory drugs, ointments, gels, and vitamin B are used as medical preparations. For severe pain, ibuprofen, ketoprofen, diclofenac, voltaren, indomethacin, and piroxicam are used. Any physical activity is excluded during treatment, and a set of necessary exercises is prescribed depending on the severity and course of the disease.
If you have intercostal neuralgia, it is also useful for you to hang on the horizontal bar in a relaxed position for one or two minutes. Pull-ups have a good effect on strengthening the muscles in the arms, shoulders and neck, and bending the torso back and stretching the spine are good for strengthening the muscles of the back and lumbar region.
With a sedentary lifestyle, associated, for example, with professional activity, stagnation occurs in all parts of the spine, which causes numbness in the arms or legs, a feeling of crawling ants. Often this leads to the appearance of intercostal neuralgia.
More information of the treatment
Drugs
Prevention
Intercostal neuralgia is not a typical disease, it can and should be prevented. The rules are quite simple:
- avoid overcooling and distribute the load on the spine wisely;
- if there is an underlying somatic disease, it should be treated not until the first symptoms disappear, but completely;
- monitor your posture and, if you lead a sedentary lifestyle, do gymnastics regularly;
- maintain the immune system and nervous system in an active, working condition;
- maintain a reasonable diet and eating regimen.
For preventive purposes, it is recommended to perform the following simple exercises during the day:
- in a sitting position, lean your body back, rest your weight on the back of a chair, bring your arms together, raise them up and bend three or four times;
- slowly move your shoulders up and down;
- slowly and carefully make rotational movements with your head;
- bend to the side, touching the floor with your fingers, then repeat the bend in the opposite direction;
- Bring your shoulder blades together and hold this pose for eight to ten seconds;
- Throw your head back, then touch your chest with the edge of your chin, repeat the exercise three to four times.
A disease such as intercostal neuralgia must be diagnosed by a doctor in order to prescribe correct and effective treatment. In the acute stage of the disease, the patient may be recommended bed rest for two or three days. It is imperative to lie on a hard surface. In order to prevent the disease from becoming chronic, it is necessary to minimize physical activity, give up bad habits, and try to avoid stress.