How to treat the intercostal nerve. Intercostal neuralgia: symptoms on the right and left and methods of treatment. How to treat severe neuralgia

Severe pain in the ribs prompts a person to go to the doctor to find out how to treat intercostal neuralgia and what medications to suppress the symptoms of the disease.

Intercostal neuralgia does not belong to the category of dangerous diseases. But it develops against the background serious pathologies and develops into severe complications. Neuralgia is caused intervertebral protrusions and hernias, tuberculosis, diabetes, multiple sclerosis, tumors.

The symptoms of neuralgia are such that they can easily be confused with signs renal colic, cholecystitis, angina pectoris. Put correct diagnosis and only a doctor can prescribe treatment based on diagnostic studies.

Usage medicines – main way treatment of intercostal neuralgia. To treat the disease and the cause that caused it, the following is prescribed:

pills;
injections for intramuscular and intravenous administration;
ointments, gels or creams.

The form of medication for intercostal neuralgia is chosen by the doctor. Medicines are prescribed taking into account the severity of the disease, the patient’s well-being and contraindications.

Tablets are considered an ineffective treatment for intercostal neuralgia. In addition, they irritate the mucous membranes gastrointestinal tract, cause adverse reactions. Erosive gastritis and stomach ulcer - possible harm from uncontrolled use of tablets.

Pain relievers

Primary task drug therapy: relieve pain – the main symptom of the disease. Pills and injections help get rid of prolonged debilitating pain. For pain relief the following is usually prescribed:

Spazgan;
Analgin;
Baralgin;
I took it.

To relieve unbearable pain that occurs with swelling of nerve fibers and root compression syndrome, the following is used:

Ketoprofen;
Ibuprofen;
Celebrex;

Analgesics are used to relieve pain and prevent new attacks:

Panadol;
Tylenone;
Pentalgin.

These drugs are available in tablets, injection solutions, ointments and gels. They are taken in tablets. To quickly relieve pain, injections are given and IVs are placed.

The course of treatment with anesthetics is short, it does not exceed 4-5 days. They disrupt the normal functioning of the gastrointestinal tract.

Local painkillers

Local anesthetics relieve swelling and pain of a neuralgic nature. They are prescribed for temporary relief of acute pain syndrome. Reduce painful sensations and eliminate muscle tension ointments, gels, solutions for injections.

The drugs are applied or injected directly into the lesion. They are used to make blockades. Pain is suppressed with injections of Lidocaine, Novocaine or Xylocaine. Application local anesthetics limited in time. They are highly toxic agents that can cause great harm body. Unbearable pain removed with one-time blockades.

Anti-inflammatory medications

Inflammatory processes occurring in nerve fibers lead to swelling and pain. The swollen tissue puts pressure on the nerves. Pinched nerve roots are accompanied by pain. Relieving inflammation, eliminating pain.

Inflammatory processes are suppressed with non-steroidal anti-inflammatory drugs:

Ortofen;
Nimesulide;
Ketoprofen;
Voltaren;
Movalis.

The products effectively relieve inflammation. If you use them correctly, according to the regimen given by the doctor, you can get a long-term stable remission. To eliminate inflammation, take a tablet 2 times a day, give an injection, or use rectal suppositories.

The body's susceptibility to drugs is almost the same. But they are best absorbed through the mucous membranes. Long-term treatment anti-inflammatory drugs cause exacerbation of certain ailments (for example, gastritis or ulcers). They should not be used without a doctor's prescription.

Muscle relaxants

IN drug treatment intercostal neuralgia include muscle relaxants - drugs with a sedative effect. They eliminate pain, relax muscles, and improve the patient’s well-being. Which of them can be used for treatment:

Tizanidine;
Tolperisone.

The taken muscle relaxant eliminates congestion in the muscle tissue, swelling. For treatment, use a drug prescribed by a doctor.

Vitamin therapy

To suppress inflammatory processes, replenish vitamins and minerals, and strengthen the immune system, it is necessary to take special complexes. Medicines with B vitamins are involved in blocking acute inflammatory processes that erupt in nerve tissues. Vitamin complexes relieve muscle spasms, neutralize negative impact medications used.

Sedatives

Painful sensations worsen the well-being of patients, plunge them into a state of prolonged stress, create a feeling of discomfort, and reduce the quality of life. Taking sedatives for intercostal neuralgia helps relieve nervous tension, relax skeletal muscles, normalize the condition of a sick person.

For this purpose, medication with a sedative extract can be included in drug therapy. medicinal plant. Suitable for treatment:

Chamomile;
Mint;
Motherwort.

Herbs with sedative effect Use separately or prepare collections from them. It is worth drinking infusions and decoctions from them. Have an effective impact pharmaceutical drugs: syrups, tinctures.

They drink a sedative at night. It promotes good sleep, good rest, relieves nervous and muscle tension. Have an excellent relaxing effect essential oils: lavender and mint.

Medicines with bee and snake venom

Eliminate intercostal neuralgia with medicines based on snake oil and bee venom. The effectiveness of ointments and gels with these poisons is quite high. They're warming up skin, accelerate blood circulation, remove metabolic products, and saturate tissues with bioactive substances. The drugs regenerate damaged nerve tissue.

The product with poison is used externally, it is rubbed into the lesions with soft massaging movements, bypassing the heart area. For treatment use:

Apisatron. Ointment with bee venom suppresses pain and inflammation, restores blood flow.
Viprosal. Ointment with viper venom eliminates pain and improves blood circulation. Camphor and fir, which it contains medicinal product, have an analgesic effect.

These ointments are used as prescribed by a doctor. They are not always used for treatment of:

lactation;
pregnancy;
allergies;
heart diseases.

Antiviral agents

Problem: how to treat intercostal neuralgia viral in nature, is easily solved. Antiviral medications are used to suppress it. Effectively fight pathology:

Amiksin;
Remantadine.

Ointments and gels

Remedies for neuralgia in the form of ointments and gels quickly relieve pain. They instantly penetrate through the skin pores into the deep tissues, to the lesion, reduce the severity of the pain syndrome and eliminate swelling.

External agents stimulate blood circulation, distract from pain, and remove nervous tension. Thanks to them, blood supply to the sore spot improves, nutrition of damaged tissues, and pain goes away.

To treat intercostal neuralgia use:

Fastum-gel. The product relieves pain, stimulates blood flow, and eliminates swelling.
Capsicam. The ointment, due to its effective warming effect, accelerates the supply of blood to tissues. It restores tissue trophism and helps replenish nutrients.
Finalgon. The ointment warms up. Thanks to her blood vessels are expanding. Blood flow increases. Oxygen and nutrients enter the tissues.
Indomethacin, Ortofen, Naklofen, Ibuprofen. Ointments fight inflammation, swelling and pain.
Menovazin. The ointment has a pronounced analgesic effect.
Chondroxyl. The chondroprotector restores mobility to the spine.

Preference is given to ointments. Their rate of penetration into tissue is higher than that of gels. On early stages and for severe pain, use ointments that can relieve muscle spasms and relax muscles.

For patients suffering from severe pain, try not to prescribe ointments with a burning effect. By increasing stimulation at the site of the lesion, it is possible to provoke the development of an ischemic crisis or heart attack due to excessive outflow of blood from the coronary vessels.

Antispasmodics

With neuralgia, the muscle tissue surrounding the damaged nerve fibers, spasm, their tone is excessively high. Without eliminating muscle spasms, you cannot get rid of pain. Increased tone relieved with antispasmodics:

Besalol;
Halidor;
No-spy;
Papazol.

To eliminate spasms, they take pills and give injections.

Intercostal neuralgia requires comprehensive therapeutic treatment. Thanks to it, pain is quickly relieved, the patient’s well-being is improved, and the inflammatory processes that cause the disease are blocked. Prescription of treatment by the doctor - required condition. Prescribed medications will give maximum healing effect, will not allow complications to develop.

Neuralgia is a disease that occurs when there is irritation, as well as pinching of the intercostal nerve. Its main feature is sharp pain. Most often, the pathology occurs in older people, but can also be observed in young people (usually those who lead a sedentary lifestyle), less often in children (during the period of active growth).

Acute pain with intercostal neuralgia occurs in the area of the heart and ribs. Pain may radiate to the lower back and shoulder blades. Therefore, sometimes doctors have difficulty making a diagnosis. The disease occurs with the left and with right side. Symptoms vary depending on the location of the pathology.

Often these characteristic pains are the cause of other diseases. And in order to eliminate this confusion, you should know the signs associated with pathology.

The cause of spasms and pinching may be heavy physical exertion or sudden incorrect movements.

Many people think that intercostal neuralgia is caused by osteochondrosis. However, this is not always the case. There are other disorders that cause pinching.

A pinched nerve often leads to the following factors:

joint dysfunction – spinal-motor sections are damaged, muscle function is disrupted;
bias intervertebral discs- this process leads to severe pain in back;
reflex effects - formed when the vertebrae are displaced;
scoliosis is an organ that, when the spine is curved, begins to work incorrectly, which is why problems arise;
neoplasms internal organs capable of moving discs and spine.

The cause of spasms and pinching may be heavy physical exertion or sudden incorrect movements. You should not lift weights, because... a hernia will also appear. To avoid any violations with musculoskeletal system, should be carried out active image life, move more, exercise moderately.

Less commonly, neuralgia can be caused by:

diabetes;
pathologies of the digestive system (colitis, gastritis, stomach ulcer, etc.);
acute gastroenteritis;
allergic diseases;
multiple sclerosis.

Muscle spasms often appear during traumatic disorders or psycho-emotional stress. Hypothermia provokes neuralgia, which can develop into pneumonia. It is possible that neuralgia occurs as a symptom of another disease.

Symptoms

The main complaint of patients with the disease spinal column is pain.

Pain syndrome. The pain can be pulling, stabbing, shooting, forming in the area of the affected area and often deepens under the shoulder blade, between the ribs, in the upper abdomen. At first, only discomfort, fatigue, and tightness in the spine are possible. The pain is felt and increases when turning, bending the body, as well as when coughing, deep breath.

Vertebral syndrome. Thoracic radiculopathy has the same symptoms. First, the roots begin to rot spinal cord, and if this is not prevented, then signs of loss of function subsequently appear. Then the sensory and motor fibers are damaged and are expressed by other symptoms:

tingling sensation, skin becomes numb, goosebumps appear;
muscle weakness;
suppression of tendon reflexes;
dry skin or increased sweating;
sensitivity is lost.

Pressing on the spine or chest causes pain in the intercostal spaces and paravertebral points. The back muscles are very tense and are unable to protect the thoracic region from sharp shocks that cause pain. In this regard, the mobility of the spine is reduced.

Problems with the functions of internal organs. When a nerve is damaged, symptoms include organ dysfunction. This occurs due to a disorder of autonomic fibers. At first, the changes are not very noticeable, but later functional, organic damage occurs. Then the following symptoms are possible:

cough, shortness of breath;
unstable pressure;
accelerated pulse.

Symptoms and treatment must be addressed of this disease, because if you neglect them, unpleasant consequences will arise.

Possible consequences

Because of this, neurological deficits appear in the human body, also muscle weakness legs If the disease is severe, temporary paralysis may occur.

Diagnostics

A specialist will be able to determine the diagnosis of intercostal neuralgia without much difficulty. The doctor will ask the patient about his complaints and conduct some examinations:

upon examination, you may notice redness or pallor of the skin over the pathological nerve;
When you feel the damaged intercostal space, pain will appear.

In addition to discomfort, a pinched nerve leads to serious damage to the functions of certain internal organs and systems. As a result, brain signals cannot reach the peripheral nervous system.

If the doctor still has doubts about making a diagnosis, he will need additional ways research:

radiography;
CT scan;
myelography.

If necessary, an ultrasound may be required abdominal cavity, ECG.

Treatment

Therapeutic actions are carried out to eliminate pain symptom, as well as the treatment of that disease, as a result of which neuralgia occurred.

Treatment is mainly carried out on an outpatient basis. It is better for the patient to rest for the first week. The bed should be flat, preferably with an orthopedic mattress.

Drug therapy

The following medications are most often prescribed to a patient with intercostal neuralgia:

Nonsteroidal anti-inflammatory drugs (Diclofenac, Rofecoxib, Meloxicam) are available in the form of injections, tablets, and suppositories. These medications eliminate painful sensations, relieve the inflammatory process.
Drugs that improve nervous system(Novo-passit, Persen, Sedasen, etc.), they contain plant components.
Muscle relaxants (Tolperil, Mydocalm) reduce spasms of striated muscles.
Vitamin B (Milgamma, Neurobion, etc.) normalizes damaged nerve structures.

At acute form development of the disease will require injection treatment, and subsequent home treatment- taking pills.

Local therapy

It happens that conservative methods could not cope with the disease, in this case they resort to surgical treatment.

The affected area should always be kept warm; you can wear a knitted sweater or woolen scarf.

If the nerve is damaged, treatment is possible various ointments, gels:

non-steroidal anti-inflammatory ointments and gels (Fastum-gel, Dolobene);
anesthetics (Menovazin, Finalgon, Capsicam, etc.) have an analgesic effect;
transdermal patches (Voltaren, Nanoplast forte) are saturated with painkillers, anti-inflammatory substances, they have a positive effect on the affected nerve.

Non-drug treatment

If acute signs intercostal neuralgia have been eliminated, non-drug therapy methods can more quickly restore the functioning of the affected areas:

physical therapy – the doctor individually selects exercises for each patient to strengthen the muscular corset of the spine;
therapeutic massage – normalizes metabolic processes, relieves pain and swelling;
acupuncture;
manual therapy – restores connections between the vertebrae, and also removes pinched nerves;
physiotherapy (UHF, magnetic therapy, electrophoresis, mud and hydrotherapy, laser therapy, etc.)

Massage

It is very good to treat the disease with the help of massage. This method has a relaxing effect on the muscular system, normalizes blood flow in the tissues, and prepares them for physical exercise and manual procedures.

The massage technique should be performed with rubbing, stroking, kneading movements. It is necessary to complete the entire course of massage, which will be prescribed by a specialist. Massage is not only pleasant, but also beneficial for the spinal column.

Surgery

It happens that conservative methods could not cope with the disease, in which case surgical treatment is resorted to. An operation is performed to decompress the compressed nerve process (removal of tumors, osteophytes, hernias). If displacement of the spinal discs or their instability is noticed, it is necessary to perform spinal fusion (fixation of some segments).

After the operation, rehabilitation will be required, which can last from several weeks to several months.

Folk recipes

Help alleviate the patient's condition folk recipes, but only as an adjuvant therapy.

The most effective and well-known recipes are:

Freshly squeezed horseradish and radish juice can eliminate pain. It must be applied to the affected area.
Pick aspen buds and chop them, add Vaseline in a ratio of 1:4, i.e. 1 part Vaseline and 4 parts kidneys. Everything is thoroughly mixed and applied to the painful area 3-4 times a day.
Rue tincture will have an analgesic effect. You will need 2 tbsp. l. raw materials, then pour 250 ml hot water, after which it is infused for about 2 weeks. During periods of intense pain, apply lotions to the affected area.
You can take a warm bath with sage and sea salt.
At home, you can prepare an ointment from the venom of snakes and bees. Rub thoroughly into the desired area, then wrap warmly.

Prevention

Pinched nerves often occur when sedentary life. Intercostal neuralgia often results from osteochondrosis, lordosis, and radiculitis.

In order not to pinch a nerve and cause painful neuropathy, you should keep your posture as straight as possible, do not hunch over, and do not overwork the muscles of the lower back and back.

And yet, when sudden attack pain, you need to switch to a lighter mode of activity, do not overcool and avoid intense physical strain.

Damage to the intercostal nerves, accompanied by acute pain. Characterized by paroxysmal shooting or burning pain in one or more intercostal spaces, running from the spinal column to the sternum. Diagnosis is based on complaints and an objective examination of the patient; to exclude/detect pathology of the spine and internal organs, additional examination is carried out using radiography, CT, and endoscopy of the gastrointestinal tract. The main directions of therapy are etiotropic, anti-inflammatory, neuroprotective and physiotherapeutic treatment.

General information

Intercostal neuralgia is a pain syndrome associated with damage to the intercostal nerves of any etiology (due to pinching, irritation, infection, intoxication, hypothermia, etc.). Intercostal neuralgia can occur in people of different ages, including in children. Most often it is observed in adults. The most common is intercostal neuralgia, caused by osteochondrosis of the spine with radicular syndrome or intervertebral hernia of the thoracic region, and also caused by herpes zoster. In some cases, intercostal neuralgia acts as a “signaling signal” serious illnesses structures that form the chest or organs located within it (for example, pleurisy, tumors of the spinal cord, chest and mediastinum). In addition, left-sided intercostal neuralgia can mimic cardiac pathology. Due to the variety of etiologies of neuralgia of the intercostal nerves, patient management is not limited to clinical neurology, but often requires the participation of related specialists - vertebrologists, cardiologists, oncologists, pulmonologists.

Anatomy of intercostal nerves

Intercostal nerves are mixed, containing motor, sensory (sensitive) and sympathetic fibers. They originate from the anterior branches of the spinal roots thoracic segments spinal cord. There are a total of 12 pairs of intercostal nerves. Each nerve passes in the intercostal space below the edge of its corresponding rib. The nerves of the last pair (Th12) pass under the 12th ribs and are called subcostal. In the area from the exit from the spinal canal to the costal angles, the intercostal nerves are covered by the parietal pleura.

The intercostal nerves innervate the muscles and skin of the chest, the anterior wall of the abdomen, the mammary gland, the costophrenic part of the pleura, and the peritoneum lining the anterolateral surface of the abdominal cavity. The sensory branches of adjacent intercostal nerves branch and connect with each other, providing cross-innervation, in which an area of skin is innervated by one main intercostal nerve and partially by the superior and inferior lying nerve.

Causes of intercostal neuralgia

Damage to the intercostal nerves may be inflammatory nature and be associated with previous hypothermia or infectious disease. The most common neuralgia of infectious etiology is intercostal neuralgia due to herpetic infection, the so-called. herpes zoster. In some cases, damage to the nerves is associated with their injury due to bruises and fractures of the ribs, other injuries to the chest, and spinal injuries. Neuralgia can occur due to compression of the nerves by the intercostal muscles or back muscles with the development of muscular-tonic syndromes associated with excessive physical activity, work with uncomfortable position, reflex impulses in the presence of pleurisy, chronic vertebrogenic pain syndrome.

Various diseases of the spine (thoracic spondylosis, osteochondrosis, intervertebral hernia) often cause irritation or compression of the intercostal nerves at the point of their exit from the spinal canal. In addition, the pathology of the intercostal nerves is associated with dysfunction of the costovertebral joints due to arthrosis or post-traumatic changes in the latter. Factors predisposing to the development of neuralgia of the intercostal nerves are deformations of the chest and curvature of the spine.

IN in some cases intercostal neuralgia occurs as a result of compression of the nerves by a growing benign pleural tumor, a neoplasm chest wall(chondroma, osteoma, rhabdomyoma, lipoma, chondrosarcoma), aneurysm of the descending thoracic aorta. Like other nerve trunks, intercostal nerves can be affected when the body is exposed to toxic substances, hypovitaminosis with B vitamin deficiency.

Symptoms of intercostal neuralgia

The main symptom is sudden unilateral piercing pain in the chest(thoracalgia), running along the intercostal space and surrounding the patient’s torso. Patients often describe it as “lumbago” or “passing electric current" Moreover, they clearly indicate the spread of pain along the intercostal space from the spine to the sternum. At the beginning of the disease, thoracalgia may be less intense in the form of tingling, then the pain usually intensifies and becomes unbearable. Depending on the location of the affected nerve, pain may radiate to the scapula, heart, epigastric region. The pain syndrome is often accompanied by other symptoms (hyperemia or pallor of the skin, local hyperhidrosis) caused by damage to the sympathetic fibers that make up the intercostal nerve.

Characterized by repeated painful paroxysms, lasting from a few seconds to 2-3 minutes. During an attack, the patient freezes and holds his breath while inhaling, since any movements, including respiratory excursion of the chest, cause increased pain. For fear of provoking a new painful paroxysm, during the interictal period patients try to avoid sharp turns of the body, deep sighs, laughter, coughing, etc. During the period between painful paroxysms along the intercostal space, paresthesia may be noted - subjective sensory sensations in the form of tickling, crawling.

At herpetic infection intercostal neuralgia is accompanied skin rashes appearing on the 2-4th day of thoracalgia. The rash is localized on the skin of the intercostal space. It represents small pink spots, which are then transformed into vesicles that dry out to form crusts. Itching is typical, occurring even before the first elements of the rash appear. After the disease resolves, temporary hyperpigmentation remains at the site of the rash.

Diagnosis of intercostal neuralgia

A neurologist can determine the presence of neuralgia of the intercostal nerves based on characteristic complaints and examination data. The patient's antalgic posture is noteworthy: in an effort to reduce pressure on the affected intercostal nerve, he tilts his torso to the healthy side. Palpation in the affected intercostal space provokes the appearance of a typical painful paroxysm; trigger points. If several intercostal nerves are affected, during a neurological examination an area of decreased or loss of sensitivity in the corresponding area of the skin of the body can be determined.

Clinical differentiation of pain syndrome is important. Thus, when pain is localized in the cardiac region, it is necessary to differentiate them from pain syndrome with cardiovascular diseases, primarily from angina pectoris. Unlike the latter, intercostal neuralgia is not relieved by taking nitroglycerin, but is provoked by movements in the chest and palpation of the intercostal spaces. With angina, a painful attack is of a compressive nature, provoked by physical activity and is not associated with turning the body, sneezing, etc. In order to clearly exclude coronary heart disease, the patient is given an ECG, and if necessary, a consultation with a cardiologist is indicated.

When the lower intercostal nerves are damaged, the pain syndrome can mimic diseases of the stomach (gastritis, gastric ulcer) and pancreas (acute pancreatitis). Stomach pathology is characterized by a longer and less intense pain paroxysm, usually associated with food intake. With pancreatitis, girdle pain is also observed, but they are usually bilateral in nature and associated with food. In order to exclude pathologies of the gastrointestinal tract organs, they may be prescribed additional examinations: determination of pancreatic enzymes in the blood, gastroscopy, etc. If intercostal neuralgia occurs as a symptom of thoracic radiculitis, then painful paroxysms occur against the background of constant dull pain in the back, decreasing when the spine is unloaded in horizontal position. To analyze the condition of the spine, a chest X-ray is performed, if a intervertebral hernia- MRI of the spine.

Intercostal neuralgia can be observed in some lung diseases (atypical pneumonia, pleurisy, lung cancer). To exclude/identify similar pathology A chest x-ray is performed, and if indicated, a computed tomography is performed.

Treatment of intercostal neuralgia

Implemented complex therapy aimed at eliminating causal pathology, relief of thoracalgia, restoration of the affected nerve. One of the main components is anti-inflammatory therapy (piroxicam, ibuprofen, diclofenac, nimesulide). In case of severe pain, drugs are administered intramuscularly, therapy is supplemented by therapeutic intercostal blockades with the administration of local anesthetics and glucocorticosteroids. Auxiliary in the relief of pain syndrome is the appointment sedatives, allowing to reduce pain by increasing the threshold of excitability of the nervous system.

Etiotropic therapy depends on the genesis of neuralgia. So, for herpes zoster, antivirals(famciclovir, acyclovir, etc.), antihistamines and local application antiherpetic ointments. In the presence of muscular-tonic syndrome, muscle relaxants (tizanidine, tolperisone hydrochloride) are recommended. If there is compression of the intercostal nerve at the exit of the spinal canal due to osteochondrosis and displacement of the vertebrae, gentle manual therapy or spinal traction can be performed to relieve the compression. If nerve compression is caused by a tumor, surgical treatment is considered.

In parallel with etiotropic and anti-inflammatory therapy, neurotropic treatment is carried out. To improve the functioning of the affected nerve, it is prescribed intramuscular injection B vitamins and ascorbic acid. Drug therapy is successfully complemented by physiotherapeutic procedures: ultraphonophoresis, magnetotherapy, UHF, reflexology. For herpes zoster, local UV irradiation on the area of the rash is effective.

Forecast and prevention of intercostal neuralgia

In general, with adequate treatment neuralgia of the intercostal nerves has favorable prognosis. Most patients experience complete recovery. In the case of herpetic etiology of neuralgia, relapses are possible. If intercostal neuralgia is persistent and cannot be treated, you should carefully reconsider its etiology and examine the patient for the presence of a hernia intervertebral disc or tumor process.

Prevention measures include timely treatment diseases of the spine, prevention of its curvature, adequate treatment of chest injuries. The best protection from herpetic infection is high level immunity, which is achieved in a healthy way life, hardening, moderate physical activity, active recreation in nature.

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– pain and numbness of the affected area, convulsions, high sweating and tearing of the eyes, a feeling 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. When the abdominal muscles are tense (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 of 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;
deformations and lesions of the spinal column (scoliosis, osteochondrosis, intervertebral hernia);
intoxication of the body caused by diseases of internal organs, taking medications 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 of pain 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 the help of massage in the muscle tissues of the intercostal space, blood circulation improves and activates 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 massage, specialists prescribe to the patient manual therapy. Chiropractor returns the vertebrae to correct position and release the 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.

Intercostal nerves

The intercostal nerves are a continuation of the thoracic nerves spinal nerves. The latter exit the spinal canal through the intervertebral foramina. Intercostal nerves lie in the intercostal spaces.

These nerves innervate the muscles and skin of the chest and abdominal walls, parietal layers of pleura and peritoneum, mammary glands.

Causes of neuralgia

Intercostal neuralgia is the appearance of pain in the direction of the intercostal nerves. This disease develops as a result of irritation, compression or inflammation of the intercostal nerves. Neuralgia can be triggered by compression of the roots of the thoracic spinal nerves at the site of their exit from the spine or pinching (inflammation) of nerves already in the intercostal space. That is, the source of pain must be sought in thoracic region spine or in the intercostal space.

Causes of intercostal neuralgia:

Symptoms of intercostal neuralgia

Most characteristic feature intercostal neuralgia is the occurrence. It's interesting what pain can take on different characteristics. Someone complains about stupid and aching pain, and some for sharp and burning ones. In addition, pain can occur either in the form of attacks or bother a person constantly. Often patients describe neuralgic pain as an electric current passing through the chest. One thing can be said absolutely for sure: these pains are quite intense and bring real suffering to a person.

Often pain occurs on one half of the chest, spreading along the direction of the intercostal nerve. It can radiate to the arm, heart, stomach, lower back. The pain noticeably intensifies when sneezing, coughing, or trying to take a deep breath. Movement also causes increased pain. Therefore, patients with intercostal neuralgia often try to take the most comfortable position, usually by tilting the torso in the healthy direction.

The occurrence of intense chest pain requires careful differential diagnosis with heart, respiratory, digestive systems. Most dangerous condition is myocardial infarction, which also occurs with intense pain in the chest.

How can we understand what exactly a person is suffering from?

With intercostal neuralgia, the pain is localized in the chest and side, and in case of pain - behind the sternum and radiates to the arm, shoulder blade, lower jaw. Neuralgic pain intensifies with deep inspiration, sneezing and coughing; this does not happen during a heart attack. In addition, with intercostal neuralgia, local pain can be determined when pressing at specific points:

Near the spine in the area where the affected nerve exits;
At the edge of the sternum in the area where the nerve ends;
In the direction of the nerve in the intercostal space.

You should also pay attention to other symptoms. During myocardial infarction, changes in heart rhythm, heart rate, blood pressure are observed, and cold sweat, fear of death. To confirm or refute cardiac pathology, it is necessary to do.

It is worth noting that pain is not the only symptom of intercostal neuralgia. The following signs also support the disease:

Numbness of the skin at the site where the affected nerve exits the spinal column;
Twitching of intercostal muscles;
Local pallor or redness of the skin;
Local increased sweating;
Local cooling of the skin.

Treatment of intercostal neuralgia

Treatment of the disease must be comprehensive. To eliminate pain, non-steroidal anti-inflammatory drugs (Diclofenac, Nimid, Piroxicam) are used. The doctor may prescribe medications in the form of tablets or injections. With moderate pain there may be useful ointments(Ketonal Gel, Finalgon). Ointments have a warming and analgesic effect. In case of severe pain, therapeutic blockades are performed - the injection of painkillers into the nerve plexus.

Since intercostal neuralgia often develops against the background muscle spasm, use muscle relaxants (Mydocalm, Sirdalud). To improve trophism nerve tissue prescribed (Neurovitan).

How to treat the intercostal nerve. Intercostal neuralgia: symptoms on the right and left and methods of treatment. How to treat severe neuralgia

Pain relievers

Local painkillers

Anti-inflammatory medications

Muscle relaxants

Vitamin therapy

Sedatives

Medicines with bee and snake venom

Antiviral agents

Ointments and gels

Antispasmodics

Symptoms

Possible consequences

Diagnostics

Treatment

Drug therapy

Local therapy

Non-drug treatment

Massage

Surgery

Folk recipes

Prevention

General information

Anatomy of intercostal nerves

Causes of intercostal neuralgia

Symptoms of intercostal neuralgia

Diagnosis of intercostal neuralgia

Treatment of intercostal neuralgia

Forecast and prevention of intercostal neuralgia

Symptoms

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

Right under the ribs

Causes

Treatment at home

Pills

Ointments

Injections

Massage

Popular questions

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First aid for an attack

During pregnancy or after childbirth

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How long does it take to treat?

Intercostal nerves

Causes of neuralgia

Symptoms of intercostal neuralgia

How can we understand what exactly a person is suffering from?

Treatment of intercostal neuralgia