How to test intercostal neuralgia. Signs of intercostal neuralgia in men, women and children. Vitamin preparations prescribed for intercostal neuralgia

Occurs due to irritation nerve root in the thoracic region, accordingly, neurotic pain will correspond to the root that is involved in the process. The diagnosis should be taken extremely seriously, since it is possible to miss quite serious diseases hiding behind similar symptoms, such as myocardial infarction, pneumonia and some others.

Pathology occurs in at a young age, and in the elderly, it is extremely rare that a diagnosis can be made in children, since they rarely have factors contributing to the development of the disease. Often there is a provoking factor that triggers chain reaction symptoms, for some it is physical activity, for others it is hypothermia, for women it is carrying a child in their arms or pregnancy.

The nature of pain in neuralgia of the intercostal nerves

In order to distinguish a symptom and find out which part of the body is experiencing pain, it is enough to conduct several tests. Since intercostal neuralgia affects the nerve roots coming from the spine, one should remember their main function.

The spine performs the main function of movement in this area, therefore, with the next attack, the pain will intensify with movements in the chest. Usually occurs unbearable pain, sharply limiting movements in the body. When you try to straighten up, the pain intensifies, forcing you to remain in a half-bent position.

Since the ribs are attached to the spine, any movement of them also causes pain. This is especially noticeable when deep breath. Additionally, some patients notice that they have my back hurt in the area of ​​the shoulder blades the day before the attack.

Pain occurs more often on one side left or right, above/below chest lasts a short time, but residual symptoms remain for a long time. In the case of this disease, it does not have special significance, since nerve root entrapment can occur on any side and height of the ribs. It is extremely rare that symptoms occur in the upper chest, more often at the level of the heart, which causes additional concern in patients. Pain in the heart or abdomen quite often accompanies neuralgia; this localization only indicates the affected nerve.

Photo of the area where intercostal neuralgia hurts

It should be understood that if there is pain in the chest area, it is necessary to exclude diseases of the organs that are located in this region, namely the lungs and heart.

If the pain comes from the heart, it will not increase with movement, but rather with some kind of physical activity. Let's say that while walking, when the pulse and blood pressure increase, it comes to the heart. more blood, its work increases and signs of problems with the cardiovascular system will appear.

If the problem is in the lungs, the pain will not change in any way when changing position, and much more often it occurs when exhaling.

Intercostal neuralgia is also not characterized by skin rashes, itching, etc. If, a couple of days after an attack of pain, characteristic pimples appear on one side of the body, this may indicate shingles.

Pain in the mammary gland in women may also indicate a disease, but to rule out other problems, a consultation with a mammologist may be recommended.

Classic picture. What kind of pain occurs with intercostal neuralgia:

How to relieve an attack of pain

It should be understood that during an attack the patient will not be able to take any fast-acting medicine. Pills or even injections will not have time to act on the nervous system so quickly. Various ointments, are not able to eliminate such intense symptoms, even if used regularly. There is a factor that causes nerve pinching and it needs to be addressed immediately.

To alleviate the condition, it is better to lie down on a flat surface, it could be a bed, a bench or the floor. The patient should be reassured and given some time to rest. After lying flat without moving, the symptoms usually begin to go away, but this does not last long.

IN emergency situations, pain can be relieved with strong analgesics or non-steroidal anti-inflammatory drugs.

To get rid of intercostal neuralgia, you should consult a vertebrologist, who will send you for examinations and find out the cause of the infringement.

Further, a course of spinal correction may be recommended to completely eliminate the problem. Special exercises should not be performed to relieve pain until the cause is clear, as you can harm yourself. To eliminate severe pain in the ribs, you need to eliminate various displacements in the costovertebral joints, and then monitor the optimal loads on the back.

Intercostal neuralgia(Neuralgia intercostale - lat.) - this is, if we say in simple words, compression and pinching (and sometimes irritation) of nerves and nerve ganglia located in the intercostal area (see figure below).

Definition and meaning of types of neuralgic pain

The treatment of this disease should be treated with particular care - first of all (before treatment, and this is IMPORTANT), it is necessary to determine whether this is really intercostal neuralgia?

Intercostal neuralgia is a difficult disease, given the large number of nerve nodes and their location

Among the most “popular” neurological diseases(neuralgia), the main symptom of which is acute pain, This neuralgia also exists. That is why is a reason to contact not only a neurologist, but also other doctors who deal with problems of acute pain: a therapist, a surgeon, and sometimes a traumatologist, especially if this neuralgia has been present for a long time.

Sometimes, with this neuralgia, chest and side pain are so strong that often not only the linear ambulance team goes to such patients, especially on the first day medical care, but also a specialized cardiology team. By the way, young mothers often experience intercostal neuralgia while breastfeeding.

In this article we will talk about the most common causes of intercostal neuralgia, its key symptoms that will distinguish it from acute and emergency conditions, as well as treatment on the first day of development of intercostal neuralgia, that is, before the first visit to a neurologist, or before calling a local therapist at home.

Symptoms of the disease

Intercostal neuralgia is a multifaceted disease and symptoms such as most likely also relate to neuralgia of the intercostal nerves. Let us list the most striking and understandable symptoms that most likely indicate intercostal neuralgia:

• The main symptom of the disease is This strong pain in the chest. If you show it with your hand, then, most likely, the hand will describe an arc from the spine to the front surface, along the ribs (in other words, the right or left side, under the hand);
• Pain has a clear connection with movement– strengthening occurs when turning, raising the arm;
• Pain especially intensifying with a deep breath, due to incomplete breathing is possible;
• Also the pain “responds” to any sudden shock. This is coughing, sneezing, straining, laughing. Therefore, it is worth coughing, or asking others to lightly tap the edge of your palm on your back or side. A sharp increase in pain will indicate neuralgia.
• This nature of pain is called “radicular”. Pain strikes like lightning like a blow electric current. Sometimes the patient “freezes” without completing the movement. The popular apt “term” – lumbago – becomes clear.

In women, intercostal neuralgia can radiate to.

Uncharacteristic signs of an attack of intercostal neuralgia

To make it clearer, these are signs the presence of which shows that the patient most likely has such a person, and such a person should be treated especially carefully, because the disease may turn out to be much more serious than banal neuralgia.

• The patient's condition is calm. He tries to find a comfortable position, but there is never any obvious suffering on his face, restless eyes. The patient does not experience anxiety, and even more so, there is no fear of death, anxiety and tossing, which often occurs during a heart attack;
• No pallor, sticky cold sweat, decreased blood pressure, acrocyanosis (blueness of the lips, tip of the nose, ears, fingertips);
• There is no retrosternal localization of pain, which rather radiates to the jaw, left hand, has a pressing and burning character;
• There is no feeling as if “a stake was stuck in the middle” (as with intercostal neuralgia), and there is no desire to lie down, bent “in half”, as during an attack acute pancreatitis.

BE CAREFUL! If there is a suspicion of a cardiac cause of pain, as well as acute pancreatitis, or a stomach ulcer, then you must first call an ambulance and give validol or nitroglycerin under the tongue. In the event that you are mistaken, then in case of intercostal neuralgia there will be no harm from the drug, but in case of an attack coronary disease heart this drug can save lives.

Reasons for development

Intercostal neuralgia is a multifactorial disease. Anything that can cause compression of the intercostal nerve, or inflammation, can ultimately result in severe pain:

• Sudden hypothermia of the back and chest (including driving with the side window open in a car, even in summer), after sweating during winter work such as clearing snow;
• Sudden movement, injury, falling on your side or back, slipping on ice, as well as carrying heavy objects and especially the moment of putting them on your back;
• Compromised intervertebral discs, which can compress the intercostal nerves at typical points of exit from the spine in osteochondrosis thoracic spine;
• In women, the cause of attacks of intercostal neuralgia may be the systematic wearing of tight underwear - incorrect selection of a bra, especially with “underwires” and in subjects of “graceful proportions”.
• An important cause, finally, is the herpes simplex virus. Only in this case viral disease along the intercostal nerves, a vesicular rash appears above them. The blisters are similar to those with chickenpox; they dry out, forming crusts that then fall off. Their formation is accompanied by burning and discomfort. Provoking factors for the development of this type of nerve inflammation are decreased immunity, frequent colds, and sore throats. In addition, this type of neuralgia develops only in people who previously (usually in childhood) had chickenpox. They are the vast majority.

Most importantly, the illusion of improvement after the rash disappears is futile. Therefore this type intercostal neuralgia and is called "", that is, arising after herpes.

This painful burning pain, which can deprive a person of sleep for many years, is caused by a neuropathic effect, a specific degeneration of the nerves. It occurs under the influence of the neurotropic herpes virus, which does not disappear from the body, but remains in the nervous system, passing into a “dormant state.”

Therefore, looking ahead, we must immediately say that everything is decided by the day, and even the hours. It is at the first signs of the formation of a vesicular rash that it is immediately necessary to prescribe modern antiviral drugs - acyclovir, Zovirax, both topically, in the form of ointments and creams, and orally. Any delay and attempt to prescribe another type of therapy will be ineffective, which will ultimately lead to persistent, burning pain.

Intercostal neuralgia can also be a sign - be careful.

Treatment of intercostal neuralgia

Before treatment, you must first get it by first visiting a therapist, then go to a neurologist in the direction.

Treat intercostal neuralgia It’s simply necessary, read what will happen and what to expect. When intercostal neuralgia occurs, first of all, you need to make it a rule: never take it before visiting a doctor. This can lead to “blurring” and “smearing” of the picture of acute pancreatic necrosis, perforated ulcer stomach and other disasters in abdominal cavity, and time for emergency surgery will be lost. Of the ways first aid suitable:

• Rubbing into intercostal spaces essential oil peppermint in a ratio of 1 drop of essential oil to 5 drops vegetable oil. Has a distracting effect;
• We recommend the “Kuznetsov applicator” (other names: needle applicator, Kuznetsov applicator, yoga mat). People call this remedy “lie on pins and needles.” It is recommended to apply for 20 - 30 minutes, and then rub in the oil; (generally a great thing and not only for intercostal neuralgia)

• In addition to essential oil, you can topically use gels containing anti-inflammatory substances, for example, Fastum - gel, Dolobene. These drugs have a cooling effect;

After examination by a doctor and confirmation of the diagnosis, medications can be used orally and parenterally (intramuscularly). These include:

• Muscle relaxants central action(Mydocalm, Sirdalud). Allows you to reduce pain, affecting the reduction muscle spasm and reducing muscle swelling, therefore reducing compression on the nerve;
• Non-steroidal anti-inflammatory drugs: Movalis, Celebrex, Nalgesin. Better to appoint intramuscular injection ampoule of the drug 1 time per day for 3 to 5 days, no more. Then - switch to taking pills. In those patients who have gastritis, peptic ulcer stomach, or heartburn - you need to take omeprazole (20 mg twice a day) along with these drugs.
• Concentrated multivitamin preparations, such as Milgamma Compositum. It is rational to prescribe intramuscularly for 10-14 days.
• As a local anesthetic therapy, you can use patches that release lidocaine slowly, such as Versatis. This patch can be compared to a “soft blockade” without. For example, if you attach it to a painful place at night, you can ensure a restful sleep.

The big advantage of local therapy is the absence system effect: drugs do not pass through the liver, so their concentration does not decrease.

If intercostal neuralgia “has arrived,” then an important component in therapy, especially in the first day or two, is to prevent swelling in the area of ​​inflammation. This can be achieved by limiting fluid intake, or in cases of severe pain, prescribing potassium-sparing diuretics can be used. Such “soft” drugs include Veroshpiron.

It is also important to comply with the protective regime: avoid drafts, do not wrap yourself up, especially in the first day. When edema is severe, stimulation of blood flow is not required. A good solution would be to use it for sleeping.

Physiotherapeutic techniques, massage, manual therapy can be used only when a severe exacerbation has been eliminated and the pain syndrome has been relieved - no earlier than 5 - 7 days.

Pain relief for severe intercostal neuralgia and emergency care

In the first two or three days, a sharp attack of intercostal neuralgia can deprive a person of rest and sleep, because the pain can be very strong and for an indefinite period of time. Such pain, in addition to insomnia, can provoke deterioration in health. For example, the back may aggravate the following conditions:

• provocation of increased blood pressure, the development of a hypertensive crisis, the appearance of thrombotic complications - for example, transient ischemic attack or the development of stroke;
• exacerbation of gastrointestinal diseases: chronic constipation, exacerbation of hemorrhoids (since the slightest straining provokes increased pain and also forces a person to avoid bowel movements);
• transition of an acute pain state to a chronic pain syndrome, development of depression.

From the above it follows that acute pain due to intercostal neuralgia must be urgently relieved, but this should be done only after excluding another cause of the disease: myocardial infarction, an attack of acute pancreatitis, atypical renal colic. If this necessary stage completed, then anesthesia is carried out by the following means:

• use of local anesthetic patches. Currently, cutaneous applications with lidocaine have become the drug of choice for the treatment of intercostal neuralgia on the first day of the disease. One of these patches is Versatis.

The use of skin patches for severe neurological pain (especially when there is intercostal neuralgia) has long been tested in the West, Europe and the USA. Sometimes even patches containing narcotic analgesics, such as the opiate fentanyl, are used. Indications also include neurological pain in herpes zoster.

IN Russian Federation Such patches are a “luxury” even for cancer patients.

• intramuscular injections of NSAIDs (), such as Ketonal, Baralgin, which have a pronounced anti-inflammatory effect. Then, on days 2-3, they are replaced with NSAIDs, which most affect the inflammatory response: meloxicam, celecoxib.

• Performing a blockade. It is carried out in a neurological hospital, a treatment room of a polyclinic, in as a last resort, blockade if other methods are ineffective, can be carried out at home. Novocaine, adrenaline, and B vitamins are administered. The result is pain relief, elimination of blood flow due to the vasoconstrictor effect of adrenaline, which reduces inflammation, and vitamins will enhance trophism nerve tissue;

• have a good analgesic effect local remedies: ointments with bee and snake venom - Apizartron, Viprosal. The poison components they contain improve local blood circulation, promote the removal of metabolic products from the source of inflammation, and reduce pain impulses;

• It is worth cautioning against the use of ointments with a pronounced warming effect, such as Finalgon, Capsicum. (Due to numerous requests, our neurologist wrote an article - “ “) These ointments should be applied to the lumbar region, knees, ankles, elbow joints. And rubbing into the chest area and intense burning can contribute to a reflex increase in blood pressure, which can lead to hypertensive crisis. Preference should be given to ointments and gels with a cooling effect, such as Dolobene;

• combinations can also be used aromatic oils based on menthol, which has a distracting effect;
• Physiotherapeutic pain-relieving techniques that work on the basis of reflex regulation are justified: acupuncture (acupuncture), acupressure.

The use of massage with warming techniques, rubbing, and manual techniques is prohibited until severe inflammation and constant pain subside.

Also, during the first few days, with severe pain, it is possible to prescribe sleeping pills and sedatives. Over-the-counter products include:

• Glycine (dissolve at night, 2 tablets);
• drugs based on plant components: Novo - Passit, Persen - Forte.
• It is not recommended to take herbal soothing decoctions in large volumes - a glass or more - since excess fluid intake at night can lead to increased swelling.

After removal acute attack pain, it is necessary to remember the principles of preventing intercostal neuralgia. They consist of preventing overloads, sudden movements, injuries, hypothermia, maintaining a motor regimen, and engaging in physical education and sports for health purposes.

The methods described here for relieving pain during the most acute period of intercostal neuralgia, despite the insignificant list of drugs, cover almost all classes of compounds and techniques. Only highly specialized issues remained unexamined, for example, the treatment of neuropathic pain during the development of postherpetic neuralgia, which remains one of the most difficult problems in neurology. These methods will definitely be discussed in future articles.

Video from a popular show. It clearly explains what intercostal neuralgia is, how to detect it and how to treat it. Under the title “When you don’t need to go to the doctor or intercostal neuralgia”:

Intercostal neuralgia is a dangerous disease that mandatory needs to qualified treatment. Delaying treatment can have dire consequences. Let's figure out what intercostal neuralgia is and all the subtleties of its course and treatment.

Intercostal neuralgia (thoracalgia) is a process characterized by compression of the intercostal nerve endings. Accompanied nagging pain in the region of the ribs, passing into the region of the heart. This is why intercostal neuralgia can be confused with heart disease. This pathological process is more common in older people.

Causes of the disease

Thoracalgia is a non-independent disease, that is, it is a complication that resulted from the underlying disease or processes that are pathological in nature. Most often they are associated with pathologies and diseases of the spine. That is, pain caused by MN may be associated with osteochondrosis. For example, a complication of osteochondrosis (disc hernia) can cause the development of MN and associated pain.

Also, one of the main causes is pathological processes in the spine, accompanied by inflammation, swelling or pinching of the nerve roots of the sternum. In addition to disc hernias, the cause of progression of intercostal neuralgia can be:

• vertebral displacement;
• scoliosis;
• sponditis Definition. This is the destruction of the arches of individual vertebrae;
• growth of bone formations;
• immobile areas in the spinal column;

Often reasons similar diseases are syphilis, tuberculosis, etc. From these statistics it is clear that intercostal neuralgia can begin to develop not only due to diseases and injuries associated with the spine. The above diseases cause irreversible changes that, during development, violate the integrity of organs, tissues and nerve endings.

Intercostal neuralgia can develop due to disruptions in the nutrition of nerve endings. Diseases such as myocardial infarction, atherosclerosis, hypertension, diabetes mellitus can affect the development of neuralgia.

Another reason is trophic changes in the muscles between the ribs. They may be due to: problems at work thyroid gland, diseases of the adrenal glands and ovaries, menopause in women. Constant stress, fatigue, strain on the back muscles, spinal injuries, age, alcohol consumption and sternum deformities can play a significant factor.

Signs of thoracalgia

The main and very first symptom is pain. Moreover, the pain may differ in both strength and type. With intercostal neuralgia, it can be periodic and acute, or it can be continuous and aching. In addition to the main location, pain can be observed in the area of ​​the heart, sternum or in the area of ​​the shoulder blades. Due to this fact, there is a possibility of making an erroneous diagnosis, such as myocardial infarction or angina. Unlike the above diseases, with MN the pain increases significantly when inhaling, with changes in body position or with load on the chest.

Due to pain syndromes that directly affect the psycho-emotional state, arterial and intracranial pressure, may lead to failures in heart rate or angina. There are a number of factors that can increase pain:

Given the increased pain upon entry, in order to relieve the pain, the patient begins to breathe shallowly, without taking deep breaths. Shallow breathing may cause the formation of congestion in the lungs and decreased ventilation. If intercostal neuralgia is in symbiosis with a cough, then the circle of shallow breathing can become firmly entrenched and cause harm to health.

Another symptom is constant pressure muscles in the back area vertebral segments. In this area there are often such unpleasant phenomena like burning, sudden coldness, numbness.

Types of illness

Intercostal neuralgia can be classified according to gender. In men, the disease occurs with pain in the lower part of the ribs, and in women, MN is accompanied by pain in the heart area. Among children this pathology practically never occurs.

Intercostal neuralgia often occurs in pregnant women, which can subsequently complicate pregnancy. This happens due to severe, unbearable pain, which causes discomfort not only to the mother, but also to the child himself.

Treatment of intercostal neuralgia

Mandatory components in the treatment of MN are massage and physiotherapeutic procedures, which help relieve inflammatory processes, release pinched nerves, dull pain, improve tissue nutrition and improve self-awareness. Such procedures can only be carried out during remission.

Physiotherapy. The greatest effectiveness is shown by the use of currents, needles, lasers, irradiation with UV rays, phonoresis with the use of painkillers, electrophoresis, and magnetic therapy.

Massage. Apply different types massage, such as acupressure, classic, using a vacuum or special cans. Advice. Treatment vacuum jars can be done at home.

Warming up. It is also quite effective in the treatment of MN. Important! Warming is done by placing a woolen item or scarf on the sore spot, and not using direct heat (applying eggs, etc.).

Drugs and medications

Medicines are prescribed to relieve pain and inflammation. Nonsteroidal anti-inflammatory drugs known as NSAIDs are used as pain relievers. This broad group includes: Diclofenac, Ibuprofen, Ketoprofen, Indomethacin. They are used in tablets, ointments, gels and injections. The most popular Diclak gel, Indomethacin ointment, Emulgel and other drugs that have similar effects.

Paravertebral blockades are used as painkillers, such as Novocaine or Lidocaine. They are injected intramuscularly on the side of the spine. Action similar drugs fast, but short-lived. Among other things, paravertebral blockade drugs do not affect the etiology.

To enhance the circulation of oxygen throughout tissues and organs, use Trental and Pnthoxifylline. To improve metabolism (metabolism) in the brain and peripheral nerves use neuroprotectors such as Mexidol or Actovegin.

Depending on the root cause of MN, your doctor may prescribe antibiotics, enzymes that improve digestion, drugs that build and support the immune system, as well as vitamins.

Folk remedies

Any of the listed folk methods must be checked for the presence of allergic reactions.

• Squeeze the juice from black radish and rub it on the nerves.
• Pour 2 tablespoons of sandy immortelle into 0.6 liters of boiling water. Strain through a sieve and drink within 20 hours.
• Pour 4 tablespoons of chamomile flowers into 0.3 liters of boiling water. Boil (10 minutes) and strain. Drink 0.1 liter 3 times. in a day.
• 1 table/l peppermint pour 0.2 liters of boiling water. Cook for 10 minutes. Strain through a sieve and drink 0.1 liters in the morning and evening.
• Dissolve 2 tablespoons of salt in 0.5 liters hot water. Dip natural fabric and apply to the sore spot for 2 hours.
• Brew flax seeds with boiling water and let steep for 10 minutes. When finished, wrap the seeds in gauze and apply to the chest area.
• In the summer, you can apply freshly cut burdock to sore spots at night, insulating the area.
• Pour 0.5 liters of vodka over birch buds. Leave for 10 days in a dark place. When finished, rub the sore areas with the tincture.
• Mix lemon balm leaves with orange zest equal parts. Pour 1 table/l of dry mixture into 0.2 liters of boiling water and leave for 10 minutes. After time, add 1 teaspoon/l of valerian and honey (to taste). Drink 0.2 liters 2 times. in a day.
• Pour 4 tbsp of sage into 0.25 liters of water at room temperature and leave for 1 hour. Strain the broth through a sieve and add while taking a bath. The water should be no more than 38°. You can add a little sea ​​salt no flavorings. Take a bath for no more than 12 minutes. A course of up to 10 procedures.
• Grate the potatoes and onions. Place the mixture on a piece of cloth/bandage and apply to the sore spot until it dries.
• Soak a napkin made from natural raw materials in valerian tincture and apply to the sore spot overnight.
• Pour 2 tablespoons of rue (herb) into 0.2 liters of vodka. Leave for about 7 days in a dark room. Apply lotions to sore areas until warm.
• If severe pain occurs, you can apply pepper patch, having previously treated the sore spot with alcohol.
• Add 4 drops of eucalyptus, fir or lavender essential oil to a bathtub with a temperature of up to 38°, after mixing the essential oil with honey or milk. You should take a similar bath every other day.

Prevention

The prevention of intercostal neuralgia includes a set of measures that require strict control and implementation.
If the disease has managed to “catch”, then competent treatment is necessary. This is the main point that will help avoid the recurrence of intercostal neuralgia, as well as complications.
If your medical history indicates diseases that are at risk, then treatment for them must be started immediately.

• To ensure that diseases such as scoliosis do not cause complications, constantly monitor your posture.
• For proper blood circulation throughout the body and replenishment of the necessary physical activity on the back muscles and abdominal area exercise regularly.
• Avoid heavy objects.

  If it is not possible to exclude this factor, then lift a heavy thing according to the rules. Place your feet shoulder-width apart and squat with your back straight. Take the object in your hands and slowly return to the starting position with a straight back. It is advisable to distribute the load on both hands.

• Avoid temperature changes. This is especially true for drafts and wind. Any hypothermia can give impetus to the development of an existing chronic disease.
• Proper nutrition. Enrich your diet with proteins, vitamins B and C. Drink more clean water.

The treatment of such a serious disease should be carried out by a qualified doctor who will competently formulate a course of medication, write out appropriate recommendations and, possibly, send for further research and clarification of the root cause of intercostal neuralgia.

Many people, especially older people, experience symptoms of intercostal neuralgia. This disease is the most common pathology of the nervous system. As a rule, neuralgia of this kind is caused by diseases of the spine, but it can also appear as a result of other pathological processes in the body. Doctors consider the disease not too dangerous for human health, but it provokes severe pain, which interferes with leading a normal, quiet life. To cure neuralgia, you need symptomatic treatment and therapy that eliminates the cause of the disease.

What is intercostal neuralgia

Intercostal neuralgia (another name is thoracalgia) is pinching, irritation or compression of the spinal nerve. Due to the nature of the pain (on the left, in the heart area or under the heart), during the first attacks, many patients confuse the disease with cardiovascular pathologies, for example, a heart attack. It is also important to differentiate intercostal neuralgia from stomach pain, renal colic. From heart attack The pathology is different in that it does not change blood pressure or pulse, and nitroglycerin does not help relieve symptoms. The pain intensifies with movement.

Pain with intercostal neuralgia can occur in different parts of the patient’s body near the spine: throughout the chest, on the right or left side of the back, under the shoulder blades. Often the painful sensations are girdling in nature. As a rule, intercostal neuralgia develops due to the course of other diseases of the spine: osteochondrosis, scoliosis, tumors and incorrect position vertebrae In addition, the disease can be caused by the following factors:

• Long-term exposure to low temperatures.
• Inflammatory diseases.
• Injuries to the ribs, chest, spine.
• Tumors localized in spinal cord.
• Poisoning of the body.
• Nerve damage.
• Spondylitis, kyphosis, other diseases of the spine.
• Diabetes.
• Age-related changes.
• Severe strain in the back muscles.
• Fatigue, stress.
• Herpes.
• Pleurisy.
• Pathological changes chest.
• Rib diseases.
• Aortic aneurysm.
• Hormonal changes.
• Fast growth(in children).
• Climacteric, post-menopausal period (in women).

You should not independently diagnose intercostal neuralgia when similar symptoms appear and begin treatment, because there may be something hidden behind it: serious illness, which requires urgent medical intervention. Methods for diagnosing the disease include examination of the patient, tests and examination with special devices. How to determine the presence of intercostal neuralgia:

• Ultrasound. Not the main method of examination for intercostal neuralgia (due to high density bone tissue).
• X-ray. Helps to see abnormalities in the structure of a person’s bones.
• CT scan. The tomogram will show bone and soft fabric.
• Myelography. During the examination, a contrast agent is injected into the spinal canal, with which you can see changes in soft tissues due to the disease.
• Contrasting discography. Contrast agent is introduced into the area intervertebral disc.
• MRI. Allows you to fully examine the structure of damaged tissue or bone structures.
• Electrospondylography. Helps identify pathology initial stage occurrence.

Women who are pregnant and breastfeeding require a particularly careful approach to therapy after diagnosis of the disease, because many medications are contraindicated for them. Intercostal neuralgia can occur due to severe stress on the back. If the pain is tolerable, women should be prescribed physical therapy, yoga or other exercises to relieve acute symptoms of the disease.

Symptoms and signs of the disease

The nerves of the spine have large branches, so when they are damaged, the pain often mimics cardiovascular diseases. For example, there may be unpleasant sensations in the thoracic region on the left, radiating to the scapula. In the treatment of left intercostal neuralgia, in contrast to heart diseases, they help sedatives, such as corvalol, validol. The frequency of pain attacks is significantly reduced when taking them. Painful sensations may become stronger during turns, inhalations, changes in body position, and sudden movements.

The pain associated with intercostal neuralgia can be dull, sharp, burning, or paroxysmal. Can last from several minutes to several days, often disappears after sleep comfortable position. In addition, the disease is accompanied by: numbness of the affected areas, muscle tension, convulsions, increased sweating, a feeling of “crawling goosebumps” on the skin, sleep disturbance, tearfulness. Intercostal neuralgia increases after physical exercise or loads.

Methods for treating the disease at home

Treatment of intercostal neuralgia at home is carried out using different methods. The main task in acute period diseases - to relieve pain, which can be extremely painful for the patient. Along with taking painkillers, it is necessary to influence the cause of the pathology and carry out appropriate therapy.

Modern treatment back pain has long gone away easy fix discomfort. It is important to treat not the manifestations, but their cause. An example of this integrated approach NSAIDs can be supplemented with neurotropic vitamins (B1, B6, B12). B vitamins not only help eliminate pain faster than when taking NSAIDs alone (for example, sodium diclofenac), but also have a beneficial effect on physiological processes in the nerve fiber, stimulate nutrition and restoration of the structure of nervous tissue. Thus, the optimal addition to NSAIDs is the drug Neuromultivit in injections, which includes three vitamins B1, B6, B12 in therapeutic dosages. The use of neurotropic vitamins in high therapeutic doses allows you to consolidate the analgesic effect, promotes recovery nerve fiber, thanks to which it is possible to achieve long-term remission of pain. Treatment with the drug begins with daily injections for 5-10 days, then switches to maintenance administration, 2-3 injections per week for two to three weeks.

To reduce painful sensations, doctors recommend wearing a corset that supports the spine and relieves stress on the nerves. In addition, it helps cope with pain dry heat which does not harm the body - this method is suitable for pregnant women who do not resort to pill treatment. To prevent attacks, doctors advise patients to sit less and not take awkward positions, sleep on a flat surface, avoid heavy physical exercise, but moderate strength exercises, on the contrary, should be made part of the daily routine.

Drug treatment

Drug treatment will help the patient quickly relieve excruciating pain. To get rid of intercostal neuralgia using medicines, they approach therapy comprehensively: prescribe analgesics, anti-inflammatory, muscle relaxing medications. How to treat intercostal neuralgia with medications:

• Relieve pain. Drugs such as ibuprofen, diclofenac, and ketoprofen help with this. These are non-steroidal anti-inflammatory drugs that quickly eliminate the symptom of intercostal neuralgia, but they should not be taken by people who have problems with gastrointestinal tract. In this case, the tablets Movalis, Sedalgin, Panadol, Pentalgin, Baralgetas will help. It is advisable to take the pill immediately after the symptoms of the disease appear - this will make the attack go away faster.
• Make a blockade. This is necessary when the patient has severe pain from a disease for which conventional pills do not help. Then they give injections of novocaine, lidocaine, hydrocortisone or diclofenac.
• Use pepper patch. It will help relieve pain from intercostal neuralgia for several days.
• Eliminate back muscle spasm. Drugs from the group of muscle relaxants will help with this: Tizanidine, Mydocalm, Clonazepam.
• Get rid of numbness. B vitamins often help restore the structure of nerves.
• Apply ointment. There are drugs with a pronounced analgesic effect, for example, Finalgon, Fastum-gel. Products such as Apizatron and Viproxal will help improve blood circulation and metabolic processes of the skin. Chondroxide ointment will help correct the mobility of the spine with intercostal neuralgia.

Treatment of neuralgia with cupping

Cupping massage is effective procedure, which helps get rid of intercostal neuralgia together with medications. This method improves lymphatic drainage, blood circulation, and promotes tissue regeneration. Before performing a massage, a person must thoroughly clean the areas of the skin where the cups will be placed. Next, its surface is lubricated with heated oil - eucalyptus or olive. When attaching the cans, the method of igniting the cotton wool inside, and then placing them on the back, or the mechanical method of removing air (in modern cans) can be used.

Doing cupping massage at home for intercostal neuralgia, you need to remember that the devices should only slightly absorb the skin, lifting it no more than one and a half centimeters. After attaching the can, begin the massage: to influence the back, you need to move the device from bottom to top, as you go lymphatic vessels. You should not place jars on the spine itself. At correct execution the procedure will not cause pain to the patient, and the effect of treating the disease will not take long to arrive.

Physiotherapy and exercise therapy

Physiotherapeutic methods are no less effective than treatment medications. To get rid of neuralgia, doctors prescribe dynamic current to the patient, along with which they introduce into the body medicinal products. Intercostal neuralgia is also treated with ultrasound, which provides micromassage to the affected areas. So that the patient can painlessly cope with the disease, treatment with paraffin, mud, and ozokerite is prescribed. Medical Physical Culture will help the patient strengthen the back muscles, thereby relieving the load on the spine and coping with the pressure on the affected nerve.

Acupuncture

Acupuncture (acupuncture) is an ancient method of treating diseases, including neuralgia. During it biologically active points are pierced with special thinnest needles. Impact on certain areas with the help of these devices improves blood flow, metabolic processes, relieves pain, and eliminates muscle imbalance during exacerbation. For neuralgia, doctors usually prescribe two or three courses of acupuncture (one course is about ten procedures, but depends on the severity of the disease). To achieve the desired effect, take a break of two months.

Acupressure

Acupressure is a method of treatment from alternative medicine, which, however, has been proving its effectiveness in the treatment of intercostal neuralgia for many years. The essence of the method is to influence biologically active points associated with certain organs. The methods of influence are different: light stroking or touching points, pressure with a finger or palm, strong deep pressure (can be done either with a finger or with special devices, grains, matches).

Pressing and stroking should be carried out perpendicular to the surface of the skin. If this is stroking, it should be continuous and performed at the same pace from the beginning to the end of the procedure. For intercostal neuralgia, as a rule, about 10-15 procedures are needed to significantly reduce pain. The patient can do the massage independently after consultation with a professional. Diagram of the location of some points from intercostal neuralgia in the photo:

Folk remedies for pain relief

1. Indoor geranium. Tear off a leaf from the plant, rub it on the areas affected by pain, wrap yourself in a woolen blanket or scarf - this will help reduce pain in the area of ​​intercostal neuralgia.
2. Product with beeswax, honey, onion. To prepare the ointment, mix the juice onions, juice from a white lily bulb, a little honey and beeswax. Apply the mixture to the sore area, wrap yourself well to provide warmth, and go to bed.
3. Mumiyo with propolis. These remedies have long been known for the treatment of intercostal neuralgia. Their joint use ensures restoration of affected tissues and relief of inflammatory processes. To enhance the effect, the mixture is used not only externally, but also taken internally.
4. Yarrow. To prepare an infusion with this plant, pour a glass of boiling water over a large spoon of the herb and leave for an hour, wrapped in a towel or blanket. Strain the resulting solution. When it cools down, take a tablespoon three times a day to relieve pain from intercostal neuralgia.
5. Turpentine with Vaseline. Mix the products in a ratio of one to two, rub into the affected areas. Over time, intercostal neuralgia will subside.

Video: how to recognize and treat intercostal neuralgia

It is extremely important to correctly recognize intercostal neuralgia so as not to confuse it with heart disease, stomach disease, kidney disease, or a heart attack. When the nerve is first damaged, people may panic, not understanding what is happening. The leading cardiologist talks in detail about the signs of intercostal neuralgia, which is characterized by a specific area of ​​pain, its aching or stabbing nature, shortness of breath, worsening with inspiration, and helps to understand how it differs from heart disease. Watch the video, which will help you recognize pathologies and tell you how to treat neuralgia.

– a disease caused by pinching, inflammation of the nerve processes in the intercostal space. The main symptom is sudden or gradually increasing pain, which is constant or manifests itself in the form of attacks. The pain is girdling and pronounced, concentrated along the inflamed nerve.

Patients with intercostal neuralgia may feel:

• Burning;
• Tingling;
• Acute pain;
• Drawing pain;
• Throbbing pain.

Sometimes the pain syndrome due to neuralgia does not have a clear localization and can move to other parts of the body: lower back, shoulder blades, shoulders and arms. Intercostal neuralgia can act as an independent disorder or secondary symptom dangerous diseases. For accurate diagnosis You need to consult a neurologist.

Types of intercostal neuralgia:

• Essential (primary)– develops independently, without associated diseases. It occurs most often. This type is characterized by dull, It's a dull pain, which persists for a long time.
• Symptomatic (secondary)– occurs when exposed to other pathological processes in the body. Sharp and unbearable pain manifests itself in paroxysms, has a clear localization, and is short-lived.

Neuralgia is a direct signal of health problems; it is worth conducting an examination immediately. After determining the diagnosis, you need to select effective treatment. Without health measures, the disease can become chronic.

What is right intercostal neuralgia?

Neuralgia on the right develops when the damaged nerve is located with right side. This is where characteristic painful sensations appear. It is less common than left intercostal neuralgia.

What is left intercostal neuralgia?

A pinched nerve on the left side is called left intercostal neuralgia. May be mistaken for a symptom of heart disease and vice versa. Requires urgent medical examination. Read about it here.

Causes of the disease

The causes of neuralgia can be different. The disease is most often caused by:

• Emotional stress;
• Excessive physical activity;
• Injuries - even minor bruises can cause illness;
• Hypothermia;
• Hormonal disorders;
• Intoxication of the body with medications, heavy metals or alcohol;
• Osteochondrosis, osteoporosis, vertebral displacement and other diseases of the spine;
• Oncological pathologies;
• Nervous system lesions ( multiple sclerosis, polyradiculoneuritis);
• Diabetes;
• Allergic diseases;
• Bacterial infections;
• Herpes virus type 3 (herpes zoster);
• Cardiovascular diseases.

A deficiency of B vitamins in the body can also cause the development of neuralgia. The root cause of vitamin deficiency often lies in gastrointestinal diseases.

Read about it here.

Symptoms of intercostal neuralgia

Clinical manifestations of intercostal neuralgia, which are mainly expressed in the form of pain.

Painful attacks are characterized by a number of signs:

• High intensity;
• Suddenness;
• Stitching, burning, pulling character;
• Intensifies with deep breathing, coughing, turning the body; Read about it here.
• Increases when pressed with fingers;
• Durability.

In addition to the pronounced pain syndrome, there are several other important features.

Symptoms in adults

When a nerve is pinched (inflamed), the following symptoms are observed:

• Severe pain,
• Muscle tension;
• Forced body position to reduce pain;
• Numbness;
• Paleness/redness of the skin;
• Edema;
• Increased temperature of the inflamed skin area;
• Sweating;
• Decreased sensitivity;
• Changes in blood pressure;
• Respiratory disorders
• The appearance of blisters with clear liquid (herpes).

Read about it here.

Symptoms in pregnant women

During pregnancy, the female body is weakened and exposed to various diseases, including intercostal neuralgia. She occurs in the second or third trimester of pregnancy and is conditioned physiological processes in a woman's body. Including due to incorrect posture, spinal pathologies, osteochondrosis, lack of B vitamins, hypothermia, and past infections.

Symptoms of the disease are:

• Pain in the chest, shoulder blades, lower back, upper abdomen;
• When moving, turning, taking a deep breath, coughing, the pain intensifies;
• Numbness;
• Cramps and muscle twitching;
• When pressing, the pain increases;
• The pain syndrome goes away after childbirth.

Symptoms in children

IN childhood intercostal neuralgia is rare. However, sometimes this disease occurs in newborns due to improper carrying of the child in the arms, hypothermia, and diseases of the spine.

Symptoms of intercostal neuralgia in children:

• Muscle twitching;
• Sweating;
• Decreased appetite
• Pale/redness of the skin in the area of ​​inflammation;
• The child pulls his hands to the sore spot;
• In newborns it is accompanied by a cry;
• The child cries when accidentally touching the source of pain.

If a child has signs of intercostal neuralgia, a careful diagnosis by a doctor is required; it can easily be confused with heart disease.

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Diagnosis of intercostal neuralgia

Diagnosis of neuralgia is carried out based on complaints of pain in the chest area and an external examination of the patient. By palpating the intercostal spaces, a primary conclusion can be made about the presence/absence of intercostal neuralgia.

IN in some cases To confirm the diagnosis, instrumental diagnostic methods are used:

1. X-ray of the spine.
2. ECG and ultrasound of the heart for pain on the left side.
3. Electroneurography (for nerve damage).
4. CT, MRI of the spine (if a hernia or cancer is suspected).
5. Blood test for antibodies to the herpes virus.
6. Myelography.
7. Contrasting discography.

Answer to the question: read here.

The difference between intercostal neuralgia and heart disease

The signs of heart pain and intercostal neuralgia are very similar, but there are also differences. Diseases of the heart and blood vessels with symptoms similar to neuralgia: angina pectoris, myocardial infarction, hypertonic disease, cardiomyopathy. Wondering how to distinguish intercostal neuralgia on the left from heart diseases, it is necessary to analyze the symptoms, data from the patient’s medical history and instrumental studies.

Intercostal neuralgia is characterized by prolonged pain, while heart diseases are short-term in nature. Neuralgia pain does not go away after taking nitroglycerin and intensifies with body movement. It disappears after taking painkillers.

Heart attacks are characterized by abnormal heart rate and pressure surges, which is not observed with intercostal neuralgia.

Pain and crunching in the back over time can lead to dire consequences- local or complete restriction of movements, up to disability.

People, taught by bitter experience, use natural remedies recommended by orthopedists to cure their backs and joints...

How to treat intercostal neuralgia?

Treatment of neuralgia begins at the first manifestations of the disease. The main emphasis is on reducing and stopping the pain syndrome.

On initial stages The disease is easily treatable, a set of measures is carried out:

• Physiotherapy;
• Acupuncture;
• Taking vitamins B1, B6 and B12.

Intercostal neuralgia at the acute stage requires more thorough treatment:

• Bed rest;
• Firm and level bed;
• Taking painkillers and anti-inflammatory drugs;
• to relieve muscle spasms;
• Sedatives;
• Sollux and UHF.

Treatment of intercostal neuralgia at home

If it is not possible to see a doctor right away, pain due to neuralgia can be relieved by reducing motor activity, keeping to bed, taking painkillers. Therapeutic massages will reduce tension and pain in places where the disease is localized. The use of anti-inflammatory ointments and muscle relaxants will quickly cure the disease.

This treatment requires bed rest. Useful physiotherapy, massage. For wellness massage You can use a warming ointment, which will enhance the relaxing effect. The procedure is performed while sitting.

You need to carefully rub the intercostal spaces and stretch your back muscles. After several sessions muscle clamps weaken and the pain stops. Compresses that have a slight warming effect are useful.

Treatment of intercostal neuralgia with tablets

For intercostal neuralgia, the following is usually prescribed:

• Pain relievers– analgin, spazgan, sedalgin, tramadol.
• Anti-inflammatory– diclofenac, piroxicam, ibuprofen, indomethacin, movalis.
• Muscle relaxants– , clonazepam, baclofen.
• Vitamins B1, B2, B6 and B12.
• Sedatives.

Treatment of intercostal neuralgia with other medications

In addition to oral administration, ointments for external use are effective: apirsartron, vipratox, viperalgin, virapin. They contain bee and snake venom, which has healing properties with a pinched nerve.

To relieve severe pain, it is administered intramuscularly. and novocaine as an anesthetic.