Thoracalgia or intercostal neuralgia: symptoms, treatment with NSAID tablets, muscle relaxants and painkillers. Treatment with drugs, injections and medications for intercostal neuralgia

Quite often, with insufficient experience on the part of the doctor, such a disease as intercostal neuralgia remains not only unrecognized, but also untreated. The consequences of this inevitably affect later in the form of constant pain, which can occur after physical exertion or hypothermia.

This disease can occur at any age. It is worth considering the anatomy of the chest. It consists of 12 pairs of costal arches, which are attached to the thoracic vertebrae. Nerve endings emerge from the foramen of the vertebrae, which innervate certain areas of the body. They also extend to the intercostal muscles. They are responsible for the breathing process, in which alternate expansion and contraction of the chest occurs.

With intercostal neuralgia, the nerve endings with which all muscle fibers are richly permeated are affected. The person feels severe pain, which can intensify with inhalation and movement.

Among the causes of pathology, viral and bacterial etiologies should be noted. Some microorganisms have excellent adaptability to nervous tissue and can use these cells for invasion and subsequent reproduction. Infection with the herpes virus is in first place among the causes of intercostal neuralgia.

injuries, including chest bruises;
osteochondrosis of the thoracic spine;
pinched nerve roots;
violations of posture with curvature of the spinal column and displacement of the costal arches while reducing the spaces between them on one side;
overstrain of muscle fibers during attacks of dry, painful cough.

Regardless of the cause, this disease requires early diagnosis and treatment.

Symptoms of intercostal neuralgia

The main symptom of intercostal neuralgia is pain, which at the initial stage is quite acute, sometimes even unbearable. Most patients with damage to the nerve fiber on the left initially seek medical help with suspicion of acute myocardial infarction. When localized on the right, the first suspicion arises regarding hepatic or biliary colic. Pancreatitis is sometimes misdiagnosed. To exclude these pathologies, which require immediate medical attention, a series of laboratory tests should be performed. They include:

biochemical blood test with determination of pancreatic amylase, liver and kidney tests;
electrocardiographic study to exclude an attack of ischemia in the myocardium;
Ultrasound of the kidneys, liver, gallbladder and heart.

After 24 hours, the pain becomes paroxysmal, periods of rest are replaced by acute cutting or stabbing pain. Some patients may notice a feeling of pins and needles crawling over the inflamed area and decreased sensitivity.

A visual examination reveals muscle tension in the back and torso; the affected half of the chest may lag behind during breathing. A person experiences an exacerbation of pain when trying to take a deep breath.

With an intense inflammatory process or with intercostal neuralgia of an infectious nature, body temperature rises. In this case, the symptoms become similar to herpes zoster. The skin is covered with sticky cold sweat. Lability of blood pressure is observed.

In order to independently exclude an attack of angina pectoris, it is necessary to place a nitrosorbide or nitroglycerin tablet under the tongue. If after 2 - 3 minutes the pain does not subside, then your diagnosis is intercostal neuralgia.

When the nerve roots in the lower part of the thoracic spinal column are affected, the clinical picture of neuralgia may resemble renal colic, acute pyelonephritis and glomerulonephritis. Therefore, a repeat general blood test is mandatory.

When palpating the intercostal spaces, the patient feels severe pain. However, an accurate diagnosis can only be established by excluding more serious pathologies of internal organs. After this has been done, it is necessary, if possible, to find the cause of inflammation or pinched nerve roots. Treatment must necessarily include action on etiological factors.

Drug treatment of intercostal neuralgia

It is worth noting that at present, non-traditional treatment methods such as osteopathy and manual therapy provide quite high effectiveness in the treatment of intercostal neuralgia. In some cases, even one session of osteopathy is enough to completely relieve pain. However, final recovery is possible only after completing the full course of treatment.

At home, pharmacological preparations in the form of tablets of injection solutions and external ointments are used to treat intercostal neuralgia.

To begin with, you should ensure complete rest. A sick leave certificate is provided and bed rest is prescribed until the pain syndrome decreases. Drinking plenty of fluids and warming compresses are prescribed. Before treating intercostal neuralgia with ointment, it is necessary to conduct a skin test in the area of the front of the forearm. This is necessary in order to exclude an allergic reaction, which will aggravate the patient’s condition.

If there is reliable data on the presence of osteochondrosis of the thoracic spine, non-steroidal anti-inflammatory therapy is prescribed:

intramuscular baralgin 5 ml every other day;
intramuscularly ortofen (diclofenac iburofen) 3 ml every other day;
nicotinic acid 1 ml subcutaneously daily.

For viral etiology, it is advisable to prescribe an antiviral drug. One of the most effective is amixin or rimantadine.

Be sure to use B vitamins, which restore the structure of nervous tissue. Physiotherapy with the use of alternating currents, magnets, and UHF is also indicated. To relieve acute pain, a single novocaine blockade can be used.

Tablets for the treatment of intercostal neuralgia are ineffective. It is worth considering that almost all drugs from the group of non-steroidal anti-inflammatory drugs, which are prescribed to relieve swelling and pain, irritate the mucous membrane of the stomach and duodenum. This can lead to erosive gastritis and stomach ulcers.

Ointments are used with various medicinal components:

capsicam or finalgon have a warming effect, due to the expansion of peripheral blood vessels, the flow of blood, oxygen, and nutrients is ensured;
indomethacin, ortofen, naklofen, ibuprofen - anti-inflammatory and anti-edematous effect with the elimination of pain;
pepper tinctures have local irritant properties;
menovazin includes an anesthesin that relieves pain;
ointments with bee and snake venom effectively restore the damaged structure of nervous tissue.

If treatment of intercostal neuralgia does not bring visible relief within 72 hours, then hospitalization in the neurological department is necessary for a detailed examination and constant monitoring by a doctor. Remember that in advanced cases of this disease, problems may arise with the innervation and functioning of the internal organs of the abdominal and thoracic cavity.

It is useful to know how to treat intercostal neuralgia. Indeed, with this disease, a person experiences acute pain in the chest area. This occurs when the intercostal nerves are compressed.

The skeleton of each person includes 12 pairs of ribs, between which the intercostal nerve is located. At the moment of their irritation and pinching, thoracic neuralgia occurs.

As practice shows, the painful condition provokes acute muscle spasm as a result of an uncomfortable position of the body, drafts, as well as physical overexertion after intense training.

This disease mainly affects middle-aged and elderly people, which indicates age-related changes occurring in the human body.

Therefore, young people do not think about how to treat intercostal neuralgia.

Thoracalgia (compression or inflammation of the nerves) is not considered as a separate disease; it always appears during the onset of other painful conditions, such as scoliosis or osteochondrosis, as well as other pathologies.

How to treat intercostal neuralgia and medications

When the first symptoms of the disease are identified and an accurate diagnosis is made, the doctor prescribes appropriate treatment, which may include both medications and various traditional medicine recipes.

The task of the attending physician is to reduce or eliminate areas of pain, overcome the inflammatory process and directly treat the cause of intercostal neuralgia.

At the initial stage of the disease state, a positive effect is achieved through physiotherapy, acupuncture, and the use of B vitamins.

During an attack and severe pain, it is recommended to remain in bed. It is best to use a firm and even mattress.

Taking analgesics and carrying out physiotherapeutic measures: SW, electrophoresis and magnetic therapy, as well as therapeutic massage have a good effect on pain relief.

For local treatment, various pain-relieving ointments are prescribed, which improve blood circulation in the painful area and allow the muscles to relax. A similar effect is created by a pepper patch.

Drug treatment is fundamental among the entire range of necessary procedures.

What medications does the doctor prescribe:

Painkillers. This is Analgin, Sedalgin or Spazgan. These remedies help relieve pain. It is recommended to use the drugs no more than 4 times a day.
Drugs that have an anti-inflammatory effect. These include: Voltaren, Ibuprofen and Piroxicam. These medications eliminate foci of inflammation, which also leads to a reduction in pain.

The best effect is achieved by using suppositories or ampoules.

Nimid is prescribed to relieve acute pain. The ointment has an anti-inflammatory effect and relieves the main symptoms of the disease.

Muscle relaxants are used to eliminate muscle spasms. This group of drugs includes: Clonazepam and Baclofen. The dosage and course of treatment are strictly determined by the attending physician.
Taking a complex of vitamins, especially B1, B6, B12. Duration of use is up to 1 month.
Anesthetics (Lidocaine and Novocaine) help eliminate acute pain. The number of blockades is determined by the attending physician.

Important: the selection, prescription and dose of medications is determined by the doctor after the examination. In order not to harm your health, you should not self-medicate and take medications at your own discretion.

Reasons or factors

Factors that provoke the development of intercostal neuralgia may be:

The effect of too low temperatures on the body.
Inflammatory processes.
Suffering a spinal or chest injury.
The presence of a spinal cord tumor in the chest area.
Negative effects of toxins and harmful substances (at work or in an unfavorable region of residence).
Deficiency of B vitamins.
Diseases of the stomach and digestive organs, as well as the presence of diabetes.
Disorders and diseases of the spine.
Stressful situations and age-related changes.
Infection and susceptibility to colds.

Symptoms of intercostal neuralgia

The symptoms of the disease are extremely varied. They can manifest themselves in the form of shooting and sharp pain or persistent dull pain, which makes breathing difficult and does not allow bending.

The following symptoms are identified:

piercing pain signal in the chest area, or prolonged pain,
it is impossible to take a breath during an attack,
The duration of the painful sensation is up to several minutes,
there is pain in the heart,
pain is more noticeable when bending, moving, coughing or sneezing,
pain is localized in the area of the shoulder blade, neck, lower back and arm,
intercostal neuralgia is also characterized by symptoms such as profuse sweating, redness of areas of the skin,
in some cases, a burning sensation and a feeling of numbness may be felt in the area of the irritated nerve.

In most cases, the patient feels pain either on the left side or on the right. If we consider the first option, then the occurrence of an attack should be associated with an exacerbation of heart disease.

In females, pain most often occurs in the area of the heart, and in males - in the area of the lower ribs, usually on the left side.

To make a correct diagnosis, it is necessary to conduct a comprehensive examination. For these purposes, laboratory tests are carried out, ultrasound examinations are prescribed, as well as MRI and ECG.

Relief of pain symptoms and treatment of intercostal neuralgia should be prescribed by a doctor!

Video about the disease and doctor’s diagnosis

Massage for intercostal neuralgia

Back and chest massage is often prescribed as a pain reliever. During rubbing, the muscles warm up, which reduces pain.

To carry out the procedure, you must determine exactly the painful location. If there is pain on one side, the massage is carried out first on the healthy area, and only then they move on to massaging the painful side. If pronounced pain signals appear on both sides, it is recommended to start the procedure with the one where the pain is less felt.

The massage should always be carried out with light stroking movements, and then proceed to kneading. During chest massage, similar actions are carried out, supplemented by various rubbing.

During the procedure, the body should be lubricated with oil or special cream. Massage after visiting the sauna is especially effective.

First aid and traditional medicine recipes

Traditional medicine has a good therapeutic effect at the time of exacerbation of the disease. To treat intercostal neuralgia at home, there are many recipes that help relieve symptoms and prevent relapse of the disease.

To relieve pain, steamed flax seeds are used, which are applied to the painful area.
Radish or horseradish juice helps relieve pain. For these purposes, the painful area is treated with the solution.
Rue herb is used to prepare the tincture. You will need a few tablespoons of herbs and 1 glass of alcohol. Infuse the product for 7 days. At the time of the attack, lotions are given.
A burdock leaf is applied to the painful area with the inside of the plant, then insulated and left overnight.
Mumiyo is used both for rubbing and ingestion. Before using the product, you should consult your doctor.
Prepare a saline solution in a ratio of 2 tablespoons and 0.5 liters of boiling water. The fabric is soaked in the prepared liquid and applied to the sore spot for several hours.
An effective remedy is mint decoction. To do this, take 1 tablespoon of the herb and brew it in a glass. The resulting solution is drunk on an empty stomach in the morning and evening, 0.5 cups each.

Swimming and yoga.
Avoid drafts and avoid overcooling.
When working sedentarily, do exercises systematically.
Treat diabetes and other diseases in a timely manner.
Proper and dietary nutrition.
Quitting bad habits (smoking and alcohol).
Avoid stressful situations.

Symptoms of intercostal neuralgia on the right

A distinctive feature of this disease is that it is quite difficult to identify. The symptoms are quite difficult, so the doctor will have to try very hard to make the correct diagnosis. To make a diagnosis, the doctor will be helped by the patient himself, who will tell and show about all the pain that happened to him during the course of the disease.

The causes of intercostal neuralgia on the right can be inflammatory processes that can easily injure the nervous system. In addition, the disease can be detected after hypothermia.

Neuralgia on the right most often occurs due to compression of the intercostal nerves. Another most common cause is irritation of the intercostal nerves.

Other reasons without which intercostal neuralgia on the right itself is not inclined to develop:

stress or overwork;
weakened immune system;
tumor diseases;
consequences of scoliosis;
diabetes;
lack of vitamins and mineral compounds in the body;
osteochondrosis;
past infectious diseases;
intoxication with drugs or other substances.

It is very important to correctly diagnose the pain syndrome of the affected nerve intercostal endings on the right, since this disease is very easily confused with other diseases.

Treatment should be prescribed only by the attending physician after examination and relevant research. Under no circumstances should you prescribe treatment to a patient based only on your own conclusions.

Procedures that will help establish the correct diagnosis include the following:

Ultrasound of internal organs;
radiography;
CT scan;
Magnetic resonance imaging;
other required studies.

The entire range of treatment procedures should, first of all, be aimed at relieving the patient’s pain syndrome. For this, the doctor prescribes an appropriate course of treatment with special medications. For pain relief, both tablets and injections of appropriate medications can be used.

After the pain has been relieved, a course of physiotherapy may be prescribed, this could include magnetic therapy, acupuncture, iontophoresis and others. In addition, massage can help as maintenance therapy.

To relax muscles, your doctor may recommend the use of muscle relaxants or topical agents (ointments or creams). Muscle relaxants will help relax muscles and improve blood circulation.

Therapeutic exercises for intercostal neuralgia

Only a doctor can prescribe therapeutic exercises for intercostal neuralgia. The patient is prohibited from performing any exercises on his own. The reason for this may be a deterioration in the patient's condition.

Therapeutic gymnastics will be effective for the patient only if it is used individually and is prescribed based on the patient’s main indicators: general well-being, stage of the disease and symptoms of ongoing neuralgia.

Before performing therapeutic exercises, be sure to warm up. Include the following: bending, shaking your limbs, and turning your head.

Exercises for intercostal neuralgia:

Starting position – lying on your back. Do some stretching. Stretch your toes and arms in different directions (arms up, toes down). Next, stretch your legs in the opposite direction (towards you).
Twisting. Lying on your back, bend your knees, spread your arms to the sides. Move your knees to one side, head to the other. Hands are pressed to the floor at the same level (in the middle).
Raising the pelvis. Lying on your back, bend your knees, arms lie along your body. Raise your pelvis slightly upward and stay in this position for a few seconds. Lower yourself to the starting position and repeat the exercise at least four times.
Lying on your back, knees bent. As you rise up, try to grab your knees with both hands. Stay in this position for a few seconds and return to the starting position.
Sitting position. The legs are extended forward, the arms are raised up and clasped. Legs should be relaxed.

Features of nutrition for intercostal neuralgia

During the course of the disease, the patient must have in his diet all the useful and nutritious substances that will help the patient recover quickly.

Eliminate sweets from your diet during illness: chocolate, sweet buns and sugar. The attending physician will also recommend that you give up excessively fatty foods of animal origin, which will only inhibit blood circulation and contribute to the inflammatory process in the body.

All patients suffering from intercostal neuralgia will be shown the following products:

foods rich in carbohydrates (chicken, legumes, cheese, milk, fish);
products containing vitamin C (citrus fruits, parsley, cabbage, bell pepper);
foods containing vegetable fats (liver, eggs, fish oil, olive oil);
foods high in vitamins and minerals (vegetables, fruits).

Among other things, the patient must remember that while undergoing treatment for intercostal neuralgia, it is necessary to completely eliminate the use of alcohol and reduce the dosage of salt in all dishes.

Consequences and complications of intercostal neuralgia

Any delay in contacting specialists can directly harm the patient. The pain syndrome that appears in most cases of intercostal neuralgia will simply intensify and cause the patient even more trouble and discomfort. As a result, life will become unbearable and very difficult.

Acute pain syndrome, in addition to unpleasant sensations, can provoke the development of other diseases, such as hypertensive crisis, angina pectoris or myocardial infarction.

With increased pain, it becomes harder for the patient to breathe. A decrease in oxygen in the body can lead to hypoxia (oxygen starvation).

As a result of stiffness of movement, it will be very difficult for a patient suffering from intercostal neuralgia to perform absolutely any work, even the smallest and most insignificant.

The result of all of the above will be advisory measures related, first of all, to maintaining an active lifestyle, eating only healthy foods, taking preventive measures to identify primary signs of the disease, and completing a full course of treatment. A properly conducted course of gymnastic procedures will also help the patient recover quickly and maintain an active lifestyle.

Sharp piercing pain in the sternum area can be caused by intercostal neuralgia. The disease is secondary and occurs as a result of compression, inflammation, and irritation of the nerves running along the ribs. “Nerve pain” is the literal translation of the term neuralgia. The intensity of pain in pathology is so great that it is impossible to relieve the pain syndrome and eliminate the symptoms without drug treatment of intercostal neuralgia.

Intercostal neuralgia is not an independent disease, but appears as complications of completely other diseases.

The most common cause of nerve inflammation is called radicular syndrome, which occurs as a result of spinal pathologies. Dystrophic changes cannot directly cause such exacerbations. Complications of osteochondrosis, manifested in the form of vertebral hernias, protrusions, can pinch nerves and are the most common cause of intercostal neuralgia.

Any structural abnormalities of the spine can impinge on the nerve roots in the thoracic region:

spondylolysis – the process of destruction of disc arches;
spondylosis – the appearance of bone growths;
spondyloarthritis;
spondylolisthesis - confusion of the location of the vertebrae;
curvature of the spine.

The causes of these pathologies can be natural processes of wear and tear, congenital conditions, the consequences of certain diseases (trauma, ankylosing spondylitis, tuberculosis, syphilis, spinal tumors).

In addition to problems with the spine, intercostal neuralgia can provoke disruptions in metabolic processes:

disturbances in the digestive process deprive the nerves of proper nutrition;
a sick stomach, liver, intestines can irritate the diaphragm and, as a result, the nerves;
vascular damage, diabetes, hypertension indirectly affect the condition of nerve tissues, disrupt oxygen circulation, and do not deliver necessary microelements and vitamins;
endocrine pathologies can provoke the occurrence of intercostal neuralgia.

How does intercostal neuralgia manifest?

The main symptoms are severe pain along the nerve, extending into the chest. The pain can be aching, constant or sharp, causing an attack.

The pain may radiate to the sternum, under the shoulder blade. Neuralgia on the left causes pain in the heart area. Symptoms of nerve disease are often confused with manifestations of pathologies of the heart, stomach, and lungs. False diagnosis delays the treatment process.

Note! With intercostal neuralgia, the symptoms intensify during increased load, during inspiration, and with pressure.

The symptoms appear too pronounced, the attack may be accompanied by psycho-emotional disorders, stress, and as a result, increased blood pressure and angina. Since pain symptoms increase during inspiration, patients begin to breathe shallowly. Impaired ventilation of the lungs provokes congestion and cough. Sneezing and coughing cause a new attack, the symptoms become much worse.

Increased back muscle tone and inflammation are typical symptoms of radicular syndrome, which causes an attack of neuralgia. Along the course of the inflamed nerve, a burning sensation, coldness of the skin, and numbness may be felt. Redness of the tissues is observed.

In search of a cure for neuralgia, patients try to take an unnatural position in order to reduce the attack. Staying in a static position for too long increases the pain.

How to relieve an attack?

Pain in the chest area can be signs of various pathologies, including confirming a heart attack. It is almost impossible to make a diagnosis on your own. Even experienced doctors can go down the wrong path without additional examinations. If symptoms of neuralgia appear, you should consult an experienced physician. It takes quite a long time to treat pathologies; an integrated approach and diverse influences are required.

But an attack can appear suddenly, and it is simply impossible to wait to visit the hospital. Any medicine for intercostal neuralgia does not act very quickly. To relieve an attack and alleviate the patient’s condition, the following measures can be taken:

Create favorable conditions for the patient, ensuring peace.
Apply dry heat to the source of pain. To do this, you can use pepper plasters, mustard plasters, ointments that contain bee and snake venom.
You can wrap the patient in a woolen scarf.
Warming baths with herbs can relieve an attack of neuralgia.

If the attack is very severe and simple measures do not give the desired result, you can use medications before consulting a doctor.

Analgesics (Analgin) will help reduce pain; non-steroidal anti-inflammatory drugs (Diclofenac) have a stronger effect; spasms can be relieved with antispasmodics (No-spa).

Drug treatment

Treatment of pathology begins with the elimination of pain and other pronounced symptoms.

Anesthesia

Non-steroidal anti-inflammatory drugs will help to anesthetize and reduce the inflammatory process that inevitably accompanies neuralgia: Ketoprofen, Ibuprofen, Diclofenac, Nice, Naproxan, Celebrex. These drugs are a modern and practically safe medicine for intercostal neuralgia. But taking these drugs for a long time is not recommended due to side effects.
You can take analgesics to relieve pain. Taking Sedalgin, Panadol, Tylenon, Pentalgin tablets helps prevent the occurrence of new attacks.

Some drugs can be taken in tablet form; injections or droppers are prescribed to enhance the effect.

For sufficiently severe pain, paravertebral blockades are effective. They are carried out only in medical institutions. Lidocaine, Diclofenac, Hydrocortisone, Novocaine show good results.
Ointments containing bee or snake venoms cope quite well with pain. These drugs have a number of contraindications; people who are intolerant to poisons especially need to be careful.

Relieving muscle spasm

During the disease, the muscles located next to the damaged nerve spasm and are in good shape. Without eliminating this pathology, it is impossible to reduce inflammation and completely get rid of pain. The following groups of medications cope with this task:

The muscle relaxants Tizanidine, Clonazepam, Mydocalm quickly solve this problem. Since this group of drugs affects the nervous system, Mydocalm can only be taken under medical supervision.
Antispasmodics are safer. Besalol, Halidor, No-shpa, Papazol can be taken without fear of severe complications. Both tablets and injections are effective.

Complex and related drugs

In addition to eliminating pronounced symptoms, treatment aims to restore nutrition to nerve receptors, ensure motor activity, and eliminate the cause of the disease.

Vitamin therapy

B vitamins have a good effect on nerve fibers. Most often they are taken as injections (Milgama). Medicines work comprehensively: they relieve pain, relieve spasms, and restore the penetrating ability of nerve fibers. Eliminate numbness and restore sensitivity.

Sedatives

Severe painful attacks with intercostal neuralgia are often accompanied by nervous breakdowns, emotional disturbances, insomnia, and unmotivated anxiety. To restore psycho-emotional balance, you can take sedatives.

Ointments

The disease can be treated with various ointments:

analgesics are contained in Fastum gel, Voltaren, Ketonal, Finalgon, Traumeel;
improve regeneration and blood circulation with the help of Capsicam, Fenalgon, Apizatron, Viproxal;
The chondroprotector Chondroxil restores the mobility of the spine.

All ointments are applied to the painful area and rubbed in gently.

Non-drug treatment

After relieving attacks with medications, it is recommended to use physiotherapy and various types of massage in complex therapy. Non-traditional methods such as acupuncture, hirudotherapy, and apitherapy are very popular. Various baths with herbs, salt, turpentine, and extracts of various plants are used in home and spa treatment.

Massage

The procedure should be carried out by experienced specialists who know how to influence muscles and joints. A properly performed massage relaxes muscles, increases blood flow and tissue nutrition, releases pinched nerves, and has an analgesic and relaxation effect. Classic, acupressure, cupping hardware massage is used. At home, minor rubbing of tissues is allowed, without affecting the spine.

Physiotherapy

They are carried out during the period of remission. Contraindicated for people with heart problems, who have had a heart attack, diabetes and tuberculosis. Intercostal neuralgia can be treated using electrical muscle stimulation, electrophoresis, phonoresis, magnetic therapy, and darsonvalization. Many procedures are enhanced by the use of medications.

Treatment of intercostal neuralgia is a rather lengthy process. Without eliminating the causes of the pathology, it is impossible to guarantee stable remission. Therefore, further treatment combines preventive measures to prevent exacerbations and an impact on the underlying disease.

The disease is caused by a pinched nerve. A burning sensation, tingling or numbness in the place where the nerve roots were pinched - these symptoms of neuralgia are often mistaken for disturbances in the functioning of the heart. When you inhale or exhale deeply, with a sudden change in body position, or when you feel the ribs, the pain intensifies, radiating in the chest, in the lower back, under the shoulder blade.

Causes of illness

Intercostal neuralgia is not an independent disease. It usually develops as a result of various lesions of the spinal column - osteochondrosis, spinal hernia, scoliosis, vertebral displacement. Sometimes the cause is syphilis, tuberculosis, atherosclerosis, hypertension, myocardial infarction.

Trophic changes in muscles also contribute to the disease. These processes, in turn, can be caused by problems with the thyroid gland, pathologies of the adrenal glands and ovaries, and menopause. At risk are people who abuse alcohol and experience other toxic effects - for example, salts of heavy metals; constantly taking certain medications. Improper load on the back, muscle fatigue, spinal injuries, and chest deformation can also cause neuralgia. Other factors include diseases of internal organs, anemia, decreased immunity, all kinds of infections, growing tumors that can compress nerve endings.

The diagnosis is made by excluding other pathologies, so additional examination is required in the form of CT, MRI.

Symptoms

The main signal is pain, varying in strength and character. It can be acute, occurring periodically, or continuous and aching, localized, as a rule, in the region of the heart, sternum, under the shoulder blades.

A person may develop hypertension and increase intracranial pressure. Irregularities in the heart rhythm, tachycardia and angina pectoris often occur. Unpleasant sensations intensify with intense physical activity, hypothermia, poor nutrition, prolonged stay in one position, or a sharp increase in temperature. A person instinctively begins to breathe superficially, shallowly, which leads to congestion in the lungs, a decrease in their vital volume and a decrease in ventilation. The combination of neuralgia with cough can cause great harm to health.

Men feel pain in the lower ribs, women - in the heart area. When the disease affects pregnant women, not only the mother, but also the unborn baby experiences severe discomfort. This pathology does not occur in children.

Treatment

Treatment will depend on the underlying cause. If a spinal nerve is pinched, getting rid of osteochondrosis or a herniated disc can help. If you have problems with the stomach or intestines, the tablets are contraindicated. It is better to take medications in the form of injections, suppositories, ointments.

Ointments based on snake or bee venom relax muscles, improve muscle elasticity. For greater effectiveness, it is better to bandage the treated area with a scarf or towel. The pepper patch also has a beneficial effect, as it warms up and relaxes the muscles, relieves pain and inflammation. The skin must first be degreased with alcohol and wiped dry. As soon as pleasant warmth begins to spread, the patch needs to be removed.

Externally prescribed "Ketonal", "Voltaren", "Finalgon", "Diclofenac". Such drugs relieve muscle spasms, stop the inflammatory process in soft tissues, and reduce pain. In addition, the listed ointments improve the regeneration of muscle tissue cells and normalize blood circulation. Nonsteroidal anti-inflammatory drugs (NSAIDs) are used as medications, which include Diclofenac, Ketoprofen, and Indomethacin. Various dosage forms are used - tablets, injections, ointments, gels.

If the pain is prolonged and severe, blockades are necessary - injection of anesthetic agents under the skin. Injections are prescribed in quantities of at least 5, depending on the severity of the disease. Paravertebral blockades with novocaine and lidocaine are used, the drugs are administered intramuscularly from the side of the spinal column. To saturate tissues with oxygen, Trental and Pentoxifeline are prescribed. Neuroprotectors Actovegin and Mexidol normalize metabolism in peripheral nerves and brain tissue. Depending on the reasons that caused intercostal neuralgia, enzymes to improve digestion, antibiotics, vitamins, and drugs to maintain immunity may be prescribed.

Doctors advise taking Naproxan, Celebrex, Ketoprofen, Pentalgin, Sedalgin, Baralgetas internally. They reduce temperature and have a pronounced anti-inflammatory effect.

The muscle relaxants “Mydocalm”, “Clonazepam”, “Tizanidine” will not only relieve pain, but will also further help relieve muscle tension, which in turn will relieve pressure on the pinched nerve. To restore mobility to the spine, Chondroxide is effective, which restores cartilage tissue and promotes its replenishment in the joints.

Additional treatment methods

To get rid of the disease, an integrated approach is required - drug treatment must be combined with physiotherapeutic procedures: ultraviolet heating, laser and magnetotherapy, special gymnastics, ultrasound. Gradually, over the course of 8 procedures, massage - classic, acupressure or vacuum - can help restore the mobility of the spine and relax the muscles. It should only be carried out by a specialist after examining the patient's x-rays. You can warm up using woolen items. All this is permissible only during the period of remission.

Priority is given to special physical therapy. Exercises are selected strictly individually and depend on how severe the symptoms are, the severity of the disease and the general condition of the person. The main rule is to gradually increase the load so as not to provoke a new attack. The main emphasis should be on strengthening the muscles of the back and abdominals.

Traditional medicine recipes can also be used. Rubbing with alcohol tincture of valerian, fresh juice of black radish or horseradish root helps best. It is recommended to take decoctions of peppermint and chamomile internally. They help relieve pain and inflammation.

Similar questions are often written on forums dedicated to health and treatment of various diseases. Sometimes the questions “which ointment is better” bother me? Some people are interested in whether it is possible to lubricate the lower back in case of kidney disease and a simultaneous attack of osteochondrosis. Therefore, we consider it important to provide the main indications and contraindications for the use of local remedies for neuralgia, pain of various etiologies in the practice of a neurologist and indicate the features of their use.

Modern ointments from neuralgia

In neurology, ointments are used that have both a warming and a cooling effect. They are equally suitable for the treatment of dislocations, bruises, and sprains. Cooling ointments and gels often contain heparin, which prevents the formation of blood clots and helps to “dissolve” bruises a little. In addition, they may contain non-steroidal anti-inflammatory drugs.

Also in the treatment of intercostal neuralgia in, often used -.

Products that have a warming effect often contain local irritants that increase blood flow to the surface of the skin. One such remedy is Capsicam ointment, which contains the effect of cayenne pepper.

In the photo - capsics. The packaging shows what is included in the ointment

Warming ointments also enhance their effect if some non-steroidal anti-inflammatory component is present in the prescription.

P contraindications for use ointments

General contraindications to the use of ointments, creams and gels are as follows:

An unclear clinical situation (perhaps the source of pain is not the musculoskeletal system, ligaments, muscles), but the heart, thoracic and abdominal organs. In this case, an urgent consultation with a doctor is needed so as not to miss a myocardial infarction, an attack of acute appendicitis or intestinal obstruction;

Severe liver and kidney failure. The fact is that the absorbed ointments enter the bloodstream, and then (albeit in small quantities) into the liver. Finally, excretion from the body is mainly carried out by the kidneys. Therefore, in case of chronic glomerulonephritis, high urea levels, jaundice, chronic active hepatitis of viral and alcoholic etiology, cirrhosis, any ointments that contain are contraindicated;

Exhaustion and cachexia, as well as very old and senile age, a state of deep encephalopathy, dementia in the stage of personality disintegration;

Pustular, fungal skin diseases, eczema, psoriasis, atopic dermatitis. In the presence of these diseases, there are special ointments and creams that are intended for application to the damaged surface of the epidermis.

Rules for the use of drugs

For ointments containing non-steroidal anti-inflammatory drugs (Fastum-gel, Finalgon and others) the following rules exist:

They are applied to intact skin;
At first, preference is given to cooling ointments, and only then resort to warming ones;
If you have a stomach ulcer or erosive gastritis, it is not recommended to use such local remedies for more than 2-3 days; in order to avoid systemic effects, it is better to combine the application of ointments with the use of proton pump blockers (omeprazole);
Ointments with a pronounced burning effect (Finalgon) are prohibited from being applied to the projection of the heart, as well as in patients with hypertension, since copious application of the ointment can provoke a hypertensive crisis;

The photo shows finalgon ointment for external use. Under no circumstances apply finalgon to the heart area!

Burning ointments are not recommended to be applied at night; a long period of resorption and insomnia may occur;
Also, ointments with a pronounced burning effect can only be applied to “rough skin” - the outer surface of the thigh, knees, buttock, lower back, shoulder. If Finalgon gets into the delicate skin of the popliteal fossa, in the groin, or on the skin of the external genital organs, you will have to endure several painful minutes, or even hours, sitting under running cold water.

Massage and ointment application

Of course, it increases blood flow to the area, so applying any ointment after a massage will have a faster healing effect for both. The main thing you need to remember is that you cannot massage “dry”, and also use the same ointment that you want to apply for massage. Another common mistake is massage with oil (for example, olive oil).

In this case, a protective hydrophobic shell is formed on the skin, which can prevent water-based gels from penetrating inside. After a massage with vegetable oil, you can apply fat-based ointments that will easily penetrate the skin.

Therefore, for massage you need to use special massage creams, or a regular “Ballet” type cream for massage. It is good to use Nicoflex massage cream, which itself has a tonic and slight warming effect, and is indicated in sports medicine.

Local irritant - Nicoflex ointment is well suited for massage

A few words should be said about ointments based on poisons. They can have a good anti-inflammatory effect if the patient is not allergic to these substances.

Most often used:

Snake venom (viper venom) is ointments Viprosal, Viprotox, Nayatox;
Bee venom (apizartron).

In addition to the treatment of neuralgia, these ointments are good for long-term treatment of joint pathologies such as rheumatism, osteoarthritis and other diseases.

In conclusion, it is worth saying that the shelf life of such local products must be strictly observed: if the ointment base has lost its properties in cosmetology, this is not so bad, but if the active substance has lost its medicinal properties, it can even cause harm.

Therefore, you need to carefully monitor the expiration date.