Can intercostal neuralgia be chronic? Intercostal neuralgia: symptoms and causes. Treatment of intercostal neuralgia: new drugs. Infusion of lemon balm and orange peels

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

They are 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 such patients, especially on the first day, are visited not only by a linear emergency medical team, but also by 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:

• Main sign diseases – this is severe chest pain. 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 at deep breath , due to incomplete breathing is possible;
• Also the pain “responds” to any sudden shock. This is coughing, sneezing, straining, laughing. Therefore, you should cough, or ask those around you 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's trying to find comfortable position, but there is never obvious suffering on the 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 “ 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 snow removal;
• 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 with this viral disease along the intercostal nerves does a vesicular rash appear 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, sore throat. 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 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 formation blistering rash it is necessary to immediately appoint modern antiviral drugs– acyclovir, Zovirax, both topically, in the form of ointment and cream, 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. acute pancreatic necrosis, perforated ulcer stomach and other disasters in abdominal cavity, and time for emergency surgery will be missed. Of the ways first aid suitable:

• Rubbing peppermint essential oil into the intercostal spaces 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, you can use medications orally and parenterally (intramuscularly). These include:

• Muscle relaxants central action(Mydocalm, Sirdalud). Allows you to reduce pain by influencing the reduction of 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.

A big plus 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 pronounced exacerbation is eliminated and the pain syndrome is 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 diseases gastrointestinal tract: 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:

• application of patches with local anesthetics. 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;

• Local remedies have a good analgesic effect: 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 blood pressure, which can lead to a 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 relieving an acute attack of pain, it is necessary to remember the principles of preventing intercostal neuralgia. They consist in preventing overloads, sudden movements, injuries, hypothermia, compliance with the motor regime, physical education and sports for recreational purposes.

The methods described here for pain relief the most acute period 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 complex problems 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”:

Painful sensations of a reflex nature that occur due to inflammation, compression or irritation of the intercostal nerves are called intercostal neuralgia (thoracalgia). This syndrome is accompanied by pronounced pain.

Symptoms

Intercostal neuralgia characters various symptoms – painful sensations and numbness of the affected area, convulsions, excessive sweating and tearing of the eyes, a sensation of “goosebumps” on the skin, sleep disturbance. Pain can be localized in the intercostal space on the left under the scapula in the heart area or on the right side.

On the left in the heart area or under the shoulder blade

Often with neuralgia, pain appears on the left side and resembles pain in the heart. In this regard, it is possible to confuse thoracalgia and heart pain. If symptoms appear in the heart area, you should not self-medicate with cardiac medications. In such cases, it is necessary to contact a specialist who will accurately diagnose and prescribe adequate treatment.

At the same time, neuralgia is inherent specific symptoms, which manifest themselves independently or complexly.

Right under the ribs

Pain in the right intercostal space is the main symptom of neuralgia. Depending on the individual characteristics body pain can be different intensity– bright or moderately expressed, sharp or sharp, constant or shooting. At physical activity, coughing, and sometimes when breathing, the patient’s pain intensifies.

To minimize pain, the patient can lean to the right or left, depending on which side is affected. Under tension abdominal muscles(for example, when sneezing, coughing, laughing, etc.) the patient can press his palm to the affected area.

Causes

Intercostal neuralgia occurs due to compression or irritation nerve endings, which are caused by inflammatory and degenerative processes in the spinal column. In most cases, thoracalgia occurs against the background of other pathologies.

Doctors have identified the main reasons leading to the development of neuralgia:

• injury and damage to the spine and ribs;
• hypothermia of the chest;
• deformities and lesions spinal column(scoliosis, osteochondrosis, intervertebral hernia);
• intoxication of the body caused by diseases internal organs, reception medicines or the influence of heavy metals;
• some infectious diseases, such as tuberculosis;
• oncological diseases of the respiratory system;
• diseases of the nervous system;
• weakened immune system;
• allergic reaction.

The main cause of intercostal neuralgia is osteochondrosis, which destroys cartilaginous structures, and this causes compression of the nerve endings and acute sharp pain. Spinal pathologies and impaired muscle tone cause serious complications.

Treatment at home

At the first signs of intercostal neuralgia, it is important to promptly seek help from a qualified doctor, since self-medication and wasting time will only aggravate the problem and cause a number of serious complications.

Intense pain will not allow the patient to ignore the disease and will force him to begin treatment. Therapy for intercostal neuralgia is as follows:

• elimination pain syndrome and other symptoms with the help of medications;
• relieving the inflammatory process or eliminating pinched nerve endings;
• eliminating the causes of neuralgia.

Pills

As drug therapy the patient is prescribed analgesics and non-steroidal anti-inflammatory drugs. To increase the effectiveness of medication treatment and improve immunity, the doctor adds vitamins to the treatment complex.

Important! For thoracalgia, doctors prescribe Ketoprofen, Sedalgin, Naproxan and other drugs.

Ointments

When treating at home, you can use anti-inflammatory and analgesic ointments that have local action. They activate blood circulation and relax muscle tissue, which leads to relief of the patient's condition.

You can use ointments with the addition of bee or snake venom. Also good effect provide such ointments as “Diclofenac”, “Voltaren”, “Finalgon”

The area treated with ointment is bandaged with a warm scarf or towel.

Injections

In some cases, the patient is prescribed painkillers and blockade agents in the form of injections. They relieve inflammation, eliminate spasms and reduce pain. Among the injections, the doctor may prescribe Indomethacin, Ketaprofen, Diclofenac.

Massage

With massage in muscle tissue intercostal spaces improve blood circulation and become more active metabolic processes. Thanks to this, the transmission is normalized nerve impulses and muscles relax. After just a couple of massage sessions, the patient will feel the analgesic effect. The duration of treatment is at least 10 sessions.

To consolidate the effect of the massage, specialists prescribe manual therapy to the patient. Chiropractor returns the vertebrae to correct position and release pinched nerve endings. At the same time, it is important to find qualified specialist, because wrong influence on the spine can lead to irreparable complications.
Physiotherapy

Physiotherapy and exercises have a good effect in the treatment of neuralgia. physical therapy. Among the physiotherapeutic methods, doctors use ultrasound on the affected area, electromagnetic field, ultraviolet radiation, electrophoresis.

Popular questions

What is an ICD 10 code?

ICD 10 is an abbreviated form of the document name “ International classification diseases”, which is revised once every ten years. Intercostal neuralgia has code M79.2 and is designated in the list of diseases as “Neuralgia and neuritis.”

Can there be a temperature with intercostal neuralgia? How is it dangerous?

Thoracalgia is not characterized by attacks of fever and high body temperature. However, during acute attacks of extensive inflammation of the nerves, the temperature can rise to 37.5 degrees. It does not stay constant and decreases on its own.

Note! If the body temperature rises to 38 degrees and above, then perhaps this is hidden under neuralgia viral disease like shingles. The symptoms of this disease are similar to the symptoms of inflammation of the nerves in the intercostal space. Therefore, it is important to correctly diagnose the disease before starting treatment.

First aid for an attack

At acute attack intercostal neuralgia, it is necessary to relieve pain and eliminate spasm. To relieve a spasm, you can pinch, apply something cold, or inject the patient with something in the affected area. In most cases, the pain disappears as the spasm goes away. If this does not happen, then it is necessary to apply an anesthetic in the form of an ointment or gel to the skin.

During pregnancy or after childbirth

Thoracalgia in pregnant women is treated with local therapy, as it has minimal impact on the health of the fetus. A woman is prescribed physiotherapy and selected exercises special gymnastics. Of the drugs prescribed multivitamin complexes. Patients are also advised to wear a prenatal bandage and follow bed rest.

Important! IN postpartum period For the treatment of intercostal neuralgia, drugs that are compatible with lactation are selected.

How to distinguish heart pain from intercostal neuralgia?

Since the symptoms of neuralgia are very similar to the symptoms of heart disease (angina pectoris, myocardial infarction, etc.), when diagnosing damage to the intercostal nerves, it is necessary to monitor changes in pulse and blood pressure. When the nerves in the intercostal space are diseased, they do not change.

Unlike neuralgia, with heart pain, changing body position does not reduce the intensity discomfort. With thoracalgia, any movement increases the pain syndrome.

The difference between damage to the intercostal nerves and other diseases prevents the development of serious complications that can even cause death.

How long does it take to treat?

The duration of treatment for neuralgia of the intercostal nerves depends on the individual characteristics of the patient’s body and ranges from a month to six months.

Thoracalgia worsens the patient’s quality of life, but does not pose a threat to his life. Timely diagnosis neuralgia and its treatment allows you to quickly get rid of unpleasant symptoms.

Intercostal neuralgia is a symptom of compression or irritation of the spinal nerve.

The pain from this is very strong and excruciating.

Due to its symptoms, this disease can be confused with other diseases of the spine and heart.

Most often, neuralgia occurs in young people over 30 years of age and in the elderly, very rarely in children.

Irritation or compression of the nerves running from the spine to the intercostal space

Intercostal neuralgia occurs when the nerves running from the spine along the intercostal space are irritated or compressed.

The nature of the pain caused can be different: aching, dull, sharp and burning. It may be constant, or it may appear from time to time.

• Increased pain from physical activity.
• A painful point between the ribs can be felt during examination.
• The pain is not relieved by nitroglycerin and can last for hours or days.

Causes of intercostal neuralgia

• Wearing tight underwear.
• Shingles (herpes stuck).
• Performing physical activity without special training.

These are only the most common causes that lead to neurological disease. But they all have one thing in common: pain is caused by pinching the spinal nerve root in the thoracic spine or pinching or irritation of the intercostal nerves in the intercostal space.

It should be noted that the cause of spasms can be stress, poisoning, consumption large quantity alcohol, diabetes and lack of vitamins B. In women, the disease occurs during menopause, due to changes in the spine, against the background of hormonal disorders.

Osteochondrosis - as a cause of neurology

A very rare occurrence. This department is inactive and the load on it is very small.

The development of osteochondrosis of the thoracic region, as well as other parts of the spine, can be a metabolic disorder, lack of necessary vitamins and microelements, lack of physical activity.

For these reasons, a hernia forms on the spine intervertebral disc or osteophytes, in turn, they compress the nerve endings of the spine.

Neuralgia, which developed against the background of osteochondrosis, is not an independent disease, but only a symptom of osteochondrosis.

When a nerve is pinched, the pain goes along the entire nerve and gradually surrounds the person, although it does not have a clear localization.

Sensitivity disturbances may appear - numbness or burning along the affected nerve. Due to unclear localization of pain and the inability to understand exactly where it hurts, doctors may make an incorrect diagnosis.

A person may undergo a course of treatment that is completely unnecessary for him, only because of an incorrect diagnosis. For example, pain may occur in the heart area and radiate under the shoulder blade. Such symptoms can be mistaken for angina pectoris.

It is not the symptom that needs to be treated, i.e. intercostal neuralgia, and the cause itself is osteochondrosis. First of all, you need to remove the pain, and only then begin to treat the disease.

The patient is recommended to spend several days at rest and take a course of non-steroidal anti-inflammatory drugs. Also, the drugs quickly relieve pain and, due to their anti-inflammatory effect, reduce swelling. After the pain stops, I proceed directly to the treatment of osteochondrosis.

Symptoms of muscular-tonic syndrome may include the presence of muscle tightness.

They arise as a result of innervation and contraction of individual muscle fibers.

These are the places where pain is most concentrated - trigger points.

Muscular-tonic syndrome can occur due to prolonged exposure to static tension and irritation of the nerve roots. All this entails the activation of a protective mechanism that limits the pathological zone.

With prolonged spasm, it forms venous stasis and swelling develops, which stretches the fibrous capsule and irritates the receptors.

The first stage of treating the syndrome is identifying and treating the cause of the pain itself.

The second stage is the elimination of trigger points existing in the muscles. And the third stage, changing the lifestyle, so that the static load changes to dynamic.

Hypothermia is a condition that occurs after a decrease in body temperature below 36.6 degrees.

Due to hypothermia, inflammation of the intercostal nerves is possible.

Pain during inflammation of a pulling nature near the affected nerve, which can radiate to nearby tissues in the form of attacks.

Atrophy may sometimes occur muscle nerve, several cases of paralysis have been recorded.

Mild nerve inflammation may go away on its own within a few weeks. With pronounced inflammatory process use hormonal drugs- prednidazole.

Wearing tight underwear for women

In women, there is a risk factor for intercostal neuralgia such as wearing tight underwear.

Thin girls are especially susceptible to this disease, because due to their thinness they have a small subcutaneous fat layer and for this reason the nerves are located quite close to the skin.

The pain occurs due to mechanical compression of the nerve by the hard underwires of the bra.

If the cause of intercostal neuralgia is inflammation of the tissues surrounding the nerve or the nerve itself, caused, for example, by the herpes simplex virus, then the pain will be of a constant burning nature and rashes will appear on the skin at the site of pain.

After treatment, the virus does not disappear from the human body, but continues to reside in the spinal nodes.

During a decrease in immunity and other factors that can trigger the activity of the virus, a vesicular rash may occur, or as it is otherwise called herpes zoster.

Pain can occur both before and after the rash occurs. Sometimes a rash may not appear at all.

Intercostal neuralgia can occur even after infectious diseases have been cured.

First of all, a course of immunosuppressive therapy, a course of painkillers and antiviral drugs.

A correct and timely diagnosis greatly facilitates and shortens the course of treatment of the disease.

The first stage is pain relief

First of all, the patient needs painkillers. Doctors usually prescribe non-steroidal anti-inflammatory drugs for these purposes. The choice of such drugs in pharmacies is huge; you should not take anything on your own. Only a doctor can prescribe correct and correct treatment.

At severe pain injections of drugs such as ketonal, ketorol and others are prescribed. The course of treatment with painkillers lasts from 5 to 10 days.

The second stage is the use of ointments and injections (non-steroidal anti-inflammatory drugs)

The use of non-steroidal anti-inflammatory drugs in the form of ointments or injections. Prescribed drugs such as ibuprofen, diclofenac, indomethacin, piroxicam and others. These drugs are taken systematically by the hour, without waiting for the next manifestation of pain. This group of drugs is prescribed with special precautions and is strictly prohibited for people with gastrointestinal diseases. People with such diseases successfully use a drug such as Flexen. The drug is available in the form of capsules and injections. The capsules are made in such a way as to completely eliminate contact with the gastric mucosa. Injections, in turn, are prepared right before injection into the muscle, which eliminates the need for stabilizers and preservatives.

The third stage of treatment is vitamin therapy

B vitamins (B1, B6 and B12) are prescribed. Experienced doctors intramuscular administration of vitamins is prescribed according to the following scheme: B1 - according to even numbers, and B6 - according to odd numbers. Sometimes doctors prescribe multivitamins. To relieve muscle spasms, muscle relaxants (sirdalud, clonezepam and tizanidine) are prescribed. Practice prescribing sedatives if necessary.

At very acute pain blockades are made using novocaine or lidocaine. The pain relief effect is very fast, but this procedure Not suitable for everyone. It all depends on the individual tolerance of the administered substances.

The fourth stage - physiotherapeutic methods

Most often prescribed: currents, electropheresis and phonopharesis of drugs, ultraviolet irradiation. Good impact Intercostal neuralgia is treated with acupuncture, cauterization and laser therapy.

Prevention

An essential method of preventing neuralgia is.

Focus your exercises on developing and increasing the mobility of the spine. Avoid drafts and hypothermia. Don't stay in uncomfortable positions for a long time. Strong physical activity is contraindicated for older people.

Watch your posture, do not lift or carry heavy objects. Avoid mono-diets and fasting.

Take multivitamins, and in particular vitamin B. You should also treat diseases that can provoke neuralgia: diabetes, atherosclerosis and vascular disease. Timely diagnosis and treatment of spinal pathologies.

In poor working conditions (sedentary work or heavy load on the spine), a work-rest regime should be observed. Try to avoid colds and infectious diseases.

Intercostal neuralgia (or thoracic radiculitis, thoracalgia) is neurological disease, characterized by damage to the intercostal nerves, the main symptom of which is severe pain (on the pain scale it ranks third after pain during labor and renal colic). Most often it affects people aged 25 to 65 years; children practically do not suffer from this pathology. Men and women can equally suffer from intercostal neuralgia.

In humans, there are 12 pairs of intercostal nerves. They are moving away from spinal cord and pass in the space between the ribs. Each such nerve bundle contains sensory, motor and autonomic nerve fibers. Any damage (compression, inflammation, irritation, etc.) can cause symptoms of neuralgia.

Causes

There are many reasons that can cause the development of intercostal neuralgia:

Symptoms of intercostal neuralgia

Signs and symptoms of intercostal neuralgia are quite typical for this disease:

Often, the symptoms of thoracalgia are in some way similar to other diseases: myocardial infarction, stomach ulcer or gastritis, pancreatitis, pneumonia (pneumonia), pleurisy and angina. However, each of them is characterized additional signs, including those identified on instrumental or laboratory research, which distinguish these pathologies from thoracic radiculitis.

Diagnostics

After the doctor has collected the patient’s complaints and anamnesis of the development of the disease, to confirm the diagnosis it is necessary to conduct additional examinations. The most informative and used of them:

Treatment of intercostal neuralgia

Treatment of intercostal neuralgia can be divided into medications and physiotherapy. When these treatment methods are combined, the duration of the disease and recovery processes are reduced several times.

Drug treatment of intercostal neuralgia

Physiotherapeutic treatment of intercostal neuralgia

• Osteopathy. Eliminates the cause of deformation of the intercostal nerve, restores blood circulation and metabolism, relaxes muscles. Treatment duration is 5-15 sessions.
• Exercise therapy. It is performed after the acute pain syndrome has been eliminated, strengthens the spine and muscular frame of the back, and normalizes all metabolic processes.

Surgical methods of treatment for intercostal neuralgia are not used. The exception is spinal pathologies, which cause neuralgia and require surgical intervention.

Complications

The only complication of intercostal neuralgia may be pain shock that occurs due to severe pain. It manifests itself as severe motor restlessness, the patient cannot sit, often changes positions, and walks. Screams or groans are also possible. After some time, blood pressure decreases, even to the point of fainting.

As treatment, the patient should be immediately given an anesthetic intramuscularly or intravenously, placed on a bed, and provided with access to fresh air.

Prevention

To prevent the development of intercostal neuralgia, you should pay attention to following simple and simple rules:

• Avoid hypothermia;
• At long work in static and uncomfortable position take breaks of 5 minutes every 30-60 minutes;
• If any pathology of the spine and other organs and organ systems occurs, contact medical care to a specialist;
• Maintain correct posture;
• Monitor proper and balanced nutrition;
• Class physical exercise to strengthen the muscular frame of the back and chest (gymnastics, exercises, exercise equipment);
• Avoid injury.

Neuralgia is usually called pain caused not by an organ or part of the body, but directly by the nerve itself. In the case of intercostal neuralgia, pain is caused by damage or compression of the nerves passing between the ribs.

What is intercostal neuralgia

Intercostal neuralgia is a syndrome characterized by intense pain in the chest area, or more precisely, in the intercostal space. The disease occurs mainly in old age, but its occurrence in children is also possible. The incidence of the disease in men and women is approximately the same.

The intercostal nerves come from the thoracic spine and contain fibers for various purposes - sensory, motor and sympathetic. There are a total of 12 pairs of intercostal nerves. Passing between the ribs, they innervate the muscles and skin of the chest, abdomen and peritoneum.

It is customary to distinguish two main types of intercostal neuralgia - radicular, caused by pinching of the roots of nerve fibers in the spine, and reflex, caused by muscle spasm in the intercostal space.

Also, depending on whether the pain is felt on one side of the chest or on both, intercostal neuralgia can be unilateral or bilateral. The disease is of a bilateral type, most often caused by herpes. It is worth keeping in mind that damage to the intercostal nerve on one side can lead to pain on both sides of the body - due to the fact that the nerve fibers are partially intertwined.

The disease does not pose an immediate threat to life, although it does cause the patient a lot of discomfort. However, in some cases, the cause of neuralgia may be hidden serious illnesses, for example, tumors. In addition, pain may worsen general state patient, lead to insomnia, hypertensive crises, etc. It should also be borne in mind that dysfunction of the intercostal nerve can negatively affect the process of supplying blood to tissues.

Intercostal neuralgia: symptoms

The area where pain occurs is the intercostal space. The pain is shooting or burning in nature. The intensity and duration of pain may vary from patient to patient. Sometimes the patient may feel only a slight burning sensation, and sometimes - severe pain, intensifying with each breath. Often, the patient can feel a wave of pain spreading along the intercostal nerve. When pressing on the place where the nerve goes, the pain can intensify many times. At night, the pain usually does not decrease, which can lead to insomnia.

But with intercostal neuralgia, the symptoms may not be entirely typical. For example, pain may also radiate to the scapula, epigastric region, lower back, collarbone, in women - into the mammary glands.

Symptoms of intercostal neuralgia also include some indirect signs: increased sweating, muscle twitching, loss of skin sensitivity in the area where the damaged intercostal nerve is located, paleness or redness of the skin, swelling. The symptoms of neuralgia may also be similar in appearance to pain caused by other diseases. For example, when a nerve running in the area of ​​the lower rib is irritated, pain occurs that resembles renal colic.

But first of all, the symptoms and nature of pain in neuralgia should be separated from the signs cardiovascular diseases, in particular, ischemic disease. Left-sided neuralgia is especially often disguised as angina.

Features that distinguish neuralgia and its symptoms from heart disease

Here are the typical characteristics and symptoms that are characteristic of intercostal neuralgia pain (as opposed to angina pain):

• The intensity of pain changes with changes in body position - bending, turning. When taking a deep breath, coughing or sneezing, the pain intensifies.
• The pain can be partially or completely relieved by taking sedatives and sedatives - Corvalol, valerian.
• The pain lasts for hours and even days.
• The pain is not relieved by taking vasodilators.
• The nature of the pain has nothing to do with physical activity(this refers to loads not associated with changes in the position of the body, for example, walking).
• The pain is not accompanied by heart rhythm disturbances.

It is worth noting that angina pectoris and neuralgia can have a number of similar symptoms, for example, changes in blood pressure or shortness of breath, although the mechanism of their occurrence is different in both cases.

Lichen alba is treated on an outpatient basis. Photo: Andrei_R/Shutterstock.com

Causes of neuralgia

The most common cause of the disease is osteochondrosis. This disease causes compression of the nerve roots in the intervertebral discs.

Hypothermia, working in an uncomfortable position, draft, cold, neurological diseases, diseases of internal organs, intoxication - all this can also provoke the appearance of intercostal neuralgia. The causes of the syndrome may also lie in damage to the nerve sheaths (demyelination). It is possible that intercostal neuralgia may occur as a result of rib fractures and spinal injuries. In children, neuralgia may be associated with birth injuries or disturbances in the formation of the skeleton.

Among infectious causes intercostal neuralgia, herpes zoster should be put in first place in terms of prevalence. Neuralgia can also be caused by diseases such as tuberculosis and influenza.

Factors contributing to neuralgia:

• diabetes
• age-related vascular diseases
• lack of immunity
• deficiency of vitamins, primarily group B
• hypertension
• hormonal changes

In most cases, the immediate cause of intercostal neuralgia is muscle spasm which leads to compression of the nerves.

Diagnostics

When making a diagnosis, neuralgia must be differentiated from pain caused by diseases of the spine not associated with osteochondrosis or trauma (for example, spondylitis or ankylosing spondylitis), pleurisy, diseases of the gastrointestinal tract, kidneys, oncological diseases, as well as from diseases of the cardiovascular system.

To clarify the diagnosis, first of all, analysis of symptoms and visual inspection patient, listening to the heart, lungs and palpating the rib area. However, in some cases it can be difficult to set accurate diagnosis, based on these data, can therefore be assigned additional research. Clinical researches may include a cardiogram, radiography, X-ray and magnetic tomography, electroneurography, myelography, ultrasound, blood and urine tests.

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Treatment of intercostal neuralgia

Intercostal neuralgia - what to do if you have pain in the chest area? First of all, it is necessary to figure out whether this is really intercostal neuralgia or something more dangerous disease. Indeed, with intercostal neuralgia, the symptoms often copy the symptoms of diseases of the internal organs. AND self-treatment, in the event that the diagnosis was made incorrectly by the patient himself, can lead to dire consequences. In addition, neuralgia different people may differ in causes and intensity, and effective treatment each time may have its own characteristics. Therefore, if there are characteristic features, indicating intercostal neuralgia, you should consult a therapist. Only a doctor can correctly recognize the symptoms and prescribe treatment.

The treatment strategy consists of three stages:

1. Relief of pain using painkillers
2. Elimination immediate cause pinched or damaged nerve
3. Treatment of those pathologies that caused nerve irritation

Traditional medicine

In traditional medicine they are usually used following methods treatment of intercostal neuralgia:

• Therapy medications(analgesics, anti-inflammatory drugs, vitamins)
• Physiotherapy
• Limitation of spinal mobility (for example, with the help of corsets)
• Manual and reflex therapy
• Massage
• Physiotherapy

Treatment in most cases is conservative, although in case of advanced disease and ineffectiveness of other methods, it can also be used. surgery. Treatment methods for right-sided and left-sided intercostal neuralgia are not fundamentally different. During exacerbation of the disease, bed rest is usually indicated, but the patient is recommended to lie on a hard surface.

Drugs

Relief of severe pain is usually done with injections of painkillers - novocaine blockades. If the pain is moderate, it is preferable to take oral analgesics. Also, for intercostal neuralgia, muscle relaxants are prescribed to help relax muscles, diuretics to relieve swelling, sedatives and antidepressants - to relieve stress state. Ointments or patches with anti-inflammatory and analgesic substances can be used locally. In case of intercostal neuralgia caused by herpes, drugs that fight viruses are prescribed.

Treatment methods for intercostal neuralgia caused by osteochondrosis

If the root cause of the disease is osteochondrosis, then the fight against neuralgia should be aimed primarily at its treatment. In this case, methods such as physiotherapy, massage and manual therapy provide great help.

Physiotherapeutic procedures are one of the most effective methods in the treatment of the consequences of osteochondrosis. These may include the use of ultrasound, magnetic fields, electric current, laser, UV and IR radiation.

The massage is designed to strengthen and relax muscles, as well as improve blood flow in tissues. Manual therapy is aimed, first of all, at restoring the configuration of the spine and eliminating displacements of individual vertebrae.

Folk remedies

Neuralgia is by no means a modern phenomenon. Our great-grandfathers knew very well what kind of scourge this was, but they also knew how to treat it. ethnoscience has developed a lot effective methods, which can be successfully used today. After all, it is not always possible to see a doctor if an attack of illness occurs suddenly.

Rubbing the affected area has a good effect. alcohol tincture birch buds or valerian. General warming of the body with warm clothes or a woolen scarf also helps. Local heating of the painful area using heating pads is ineffective and can only worsen the condition.

From funds for internal reception It is worth mentioning peppermint decoction. It is prepared like this: 1 tablespoon of dry leaves is infused in 200 g of boiling water. You should drink 100 g of the decoction in the morning and evening.

Prevention

It is well known that any disease is easier to prevent than to treat. This is also true for neuralgia.

• Monitor your diet and lifestyle
• Avoid hypothermia and drafts
• Avoid strenuous physical work
• Avoid injury to the ribs and spine
• Monitor correct posture and do strengthening exercises, especially if your job is sedentary
• Treat in a timely manner infectious diseases and diseases of the musculoskeletal system