Treatment of body and soul from physical and energetic diseases. Intercostal neuralgia on the left side: symptoms, causes and treatment methods How massage affects the back and body

Intercostal neuralgia causes acute, severe pain in the rib area.

It can be burning or dull in nature.

Although this pathology does not pose any particular danger, treatment still cannot be postponed until later.

When treating this disease special attention is paid to massage.

After all, the main cause of pain is muscle spasm.

A well-executed massage can reduce muscle tightness. As a result, the intensity of pain decreases.

What is intercostal neuralgia?

Intercostal neuralgia is a syndrome characterized by the appearance of severe pain in the space between the ribs. The pain occurs due to compression of the nerve endings that pass between the ribs.

Neuralgia may be:

• radicular, in which the nerve fibers passing in the spine are pinched;
• reflexive, it is caused by muscle spasm in the space between the ribs.

The disease is not life-threatening, but significantly worsens its quality. After all, due to the pain syndrome, the patient sleeps poorly, his irritability increases, and hypertensive crises may occur.

What are the main methods of treating intercostal neuralgia?

If pain occurs in the intercostal space, you should contact a neurologist as soon as possible. The doctor will assess the condition and select the most appropriate treatment tactics. Most often, drug treatment is prescribed.

Before prescribing a massage, the patient must be examined. If the cause of pain is a tumor, then massage procedures are contraindicated. Due to increased blood flow, the tumor may begin to grow faster.

What are the benefits and how massage can help with intercostal neuralgia

With massage you can:

• strengthen the muscle corset;
• eliminate muscle tightness;
• improve blood flow in tissues;
• stimulate local metabolic processes.

Basic the cause of severe pain is muscle spasm, because of it, pain goes from acute to chronic. Massage helps relieve spasms, due to this, the severity of pain is reduced.

When can you have a massage?

Massage procedures are prescribed only after the acute stage of the disease has passed. The patient should not complain of severe pain that interferes with speaking, inhaling deeply, or emptying the bowels.

If you consult a doctor in a timely manner and prescribe adequate treatment, 4-5 days pass from the moment severe pain appears until the acute stage subsides. After this, the doctor can give a referral to a massage therapist to consolidate the effect obtained from drug therapy. Often, drug treatment continues and can be combined with medication.

Contraindications to the use of massage for intercostal neuralgia

Before prescribing treatment and massage, the patient is sent for a comprehensive diagnosis. The doctor needs to find out the reason why the nerve roots are pinched. In some pathologies, massage is prohibited.

Massage is not prescribed in such cases:

• acute infectious and inflammatory processes, due to increased blood flow, the infection spreads throughout the body;
• purulent skin lesions, dermatological diseases;
• severe exhaustion of the body;
• high blood pressure, hypertension;
• oncological diseases;
• mental illness;
• epilepsy;
• hereditary blood diseases in which there is an increased tendency to thrombosis and bleeding (thrombophlebitis, severe atherosclerosis, hemophilia, hemorrhagic vasculitis);
• disruption of intestinal function (dysbacteriosis, diarrhea).

In such situations, massage can worsen the patient's condition.

Video: "How to treat intercostal neuralgia at home?"

Massage for sciatica

Types of massage used for intercostal neuralgia

After severe pain subsides, the patient can go to the massage therapist. To alleviate the condition and reduce pain, the specialist will knead the back and chest. Patients are prescribed therapeutic or acupressure massage.

Classic therapeutic massage procedures allow:

• stimulate blood flow in small arteries and capillaries;
• warm up the skin and tissues that are under it;
• strengthen metabolic processes;
• improve the functioning of the nervous system, the conduction of nerve impulses;
• speed up the process of removing toxins and other substances that are involved in the inflammatory process.

When performing acupressure, a specialist acts on biologically active points. Finger piercing, pressure, kneading, and nail pricking are used. To reduce the severity of pain, use strong and medium-duration exposure from 2 to 5 minutes.

Technique and features of implementation for intercostal neuralgia

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Next fact

Massage is done in the back and chest area. Before starting it, the massage therapist must clarify on which side and at what level the painful sensations are concentrated.

Begin the massage on the opposite side from the place where the pain is concentrated. The specialist gradually moves from healthy areas to problematic areas. The massage therapist begins to work on the affected area after the 3rd session.

If intercostal neuralgia provokes the appearance of pain on both sides, then the treatment begins from those places where the discomfort is less pronounced. The massage is done as carefully as possible the first time. Over time, the intensity and strength of the impact can be increased.

For massage The patient is first placed on the massage table on his stomach. A special pillow is placed under the chest. After complete treatment of the back, the patient turns over, the specialist continues to massage, working on the muscles of the chest.

Most people experiencing intercostal neuralgia 10-15 sessions are prescribed. The duration of the first of them should not be more than 15 minutes. Over time it increases.

In the absence of contraindications, warming ointments are used. Pain-relieving ointments and gels can be applied to problem areas after the massage is completed.

To carry out the massage, the patient is placed on his stomach, and his arms are asked to be extended along the body. First, the back is stroked with both hands on both sides. The movement is repeated 7–9 times.

Then they begin squeezing on the healthy part of the back. Make it with the edge of the palm. The movement occurs in the direction from the long dorsi muscle down towards the couch.

Having completed this combined stroking, the massage therapist can proceed to kneading. The procedure begins with the long muscles of the back.

• kneading with 4 fingertips (repeat 3-4 times);
• stroking with 2 hands (2–3 times);
• impact with the finger phalanges, while the palms are clenched into a fist (3–4 times).

The kneading ends with stroking to soothe the sore muscles.

After treating the long back muscle, they move on to the latissimus.

To warm it up and warm up, use the following techniques::

• ordinary kneading (3-4 times);
• shaking, carried out in the direction from the iliac crests to the armpits (2-3 repetitions);
• double ring kneading (3-4 times);
• shaking (2–3 times);
• stroking (3 times).

The complex on the healthy side is repeated 2-3 times, then the massage therapist can move to the sore side. The impact on it should be less intense. You should focus on the patient’s well-being.

The techniques described are the preparatory stage of massage. After it is carried out, they proceed to rubbing the spaces between the ribs where pain is felt. It should be carried out in the direction from the spinous vertebral processes along the spaces between the ribs, through the long back muscle. The massage therapist should use his fingertips to get into the grooves between the ribs to the maximum depth. Treatment begins from below the waist.

After completion, the patient is asked to turn over on his back. The development of the pectoral muscles begins with stroking and squeezing movements (3-4 repetitions).

Then the following complex is performed:

• shaking (2-3 repetitions);
• kneading (4–6 times);
• alternating stroking and shaking (3 times).

After completing the warm-up of the pectoral muscles, begin intercostal. The massage therapist rubs in a circular, zigzag, straight line direction from the sternum to the pectoralis major muscle (up to the breast gland in women), then he moves down to the back. Each technique is repeated 3-4 times.

Afterwards the massage therapist should rub the subcostal angle. When performing a massage, the fingers are positioned so that 4 of them go deep under the hypochondrium, and the thumb remains on top. Rub them from the center of the sternum down to the couch. After 3-4 repetitions, stroking, squeezing, rubbing, kneading movements are performed on the treated area. Repeat them 2-3 times.

The anterior and lateral parts of the chest are massaged separately. The specialist should work by stroking and squeezing the pectoralis major muscles, the movements are repeated 3-4 times. Then he rubs the intercostal spaces in the direction from the sternum to the back. You need to move your hands as far as possible.

Straight, spiral, circular, zigzag rubbing, which is done with the pads of 4 fingers, is repeated 3-4 times. After rubbing, begin squeezing with the heel of your palm along the ribs. Then alternate stroking and squeezing movements.

After completion, carry out ordinary kneading (4 times), kneading with the finger phalanges, while the palms are clenched into a fist (3 times). These movements alternate with stroking and shaking (2 times each).

After completing the specified complex begin to rub the spaces between the ribs. To do this, the hand on the treated side is placed behind the head, and the massage therapist performs the following movements:

• zigzag stroking along the ribs towards the iliac fossa, along the torso (3-4 repetitions);
• squeezing with the bases of the palms (5 repetitions), movements are directed along the ribs;
• straight, zigzag rubbing (each 3-4 repetitions);
• squeezing (3 times).

After this, the patient should take a deep breath several times, leaning to the healthy side, clasp his hands, raise his arms up and lower them to his hips. To complete the procedure, the patient turns on his stomach, and the massage therapist strokes, squeezes, shakes, and kneads the latissimus dorsi muscle.

During the massage or after its completion, you can use warming ointments and creams..

Video: "Massage for intercostal neuralgia: technique"

Conclusion

• If severe pain in the intercostal space is diagnosed intercostal neuralgia.
• For treatment, medications, exercise therapy, physiotherapy, and massage are prescribed.
• Classical therapeutic massage is most often recommended.. But for intercostal neuralgia, acupressure is also allowed.
• To reduce pain, the back, pectoral muscles and intercostal space are treated.

Intercostal neuralgia is one of the most common neurological diseases, for which all treatment methods are used: from etiotropic (antiviral therapy for postherpetic neuralgia), to pathogenetic (non-steroidal anti-inflammatory drugs), symptomatic (painkillers). Great importance is attached, among which all types of massage occupy an important place.

How can a back massage help with intercostal neuralgia?

The formation of a stable pain syndrome depends on several factors in which key importance is played:

• swelling with the development of a focus of inflammation;
• pronounced muscle spasm.

There may be other mechanisms for the development of intercostal neuralgia: spondylolisthesis (shift of a vertebra relative to another, higher or lower); infringement of the nerve root by disc herniation, disc protrusion, fracture of the vertebral body and many other reasons.

In the picture, spondylolisthesis is a shift of the vertebrae, clearly visible at the break in the drawn line

But, since muscle spasm is the main mechanism that forms not only an acute pain attack, but transforms it into a chronic form in the vast majority of cases, massage for intercostal neuralgia helps reduce the intensity of pain and speed up recovery.

To do this, a back massage must be performed under the following conditions:

• You can perform a massage (like other physiotherapy) only after the acute pain has subsided. This means that the pain no longer interferes with talking, breathing, or emptying the intestines. As a rule, after the onset of the disease, 4-5 days should pass, subject to adequate treatment and proper pain relief with the use of medications;
• The diagnosis must be correct and fully inform the doctor about the cause of the pain. This means that not all intercostal neuralgia is affected by massage. If it is a symptom of a more serious disease, massage can be not only useless, but also very harmful.

First of all, massage should not be used for malignant neoplasms, which can manifest as intercostal neuralgia (read the article -). This often happens with metastases to the spine. After destruction of the vertebra, compression of the nerve occurs, or with infiltrative tumor growth, the tumor grows into the nerve itself, causing pain. Massage in such a situation can accelerate the spread of metastases throughout the body.

Therefore, you need to be very careful if you have the following signs:

• presence of persistent night pain;
• loss of connection between pain and breathing and movement, localization in the vertebra;
• fever and rise in temperature.

If the diagnosis is clear, then a classic therapeutic and preventive back massage will bring relief, since:

• the massage therapist’s actions increase blood flow in the muscle, carrying away waste products;
• as a result, muscle tone decreases;
• Finally, local products are rubbed into the skin, which are absorbed much better after the massage. In addition, the massage itself can be carried out using a product that causes heating and blood flow. The main thing is that the cream or ointment for massage is not absorbed for a long time (10-15) minutes. Often used, for example, "Nicoflex".
• Compositions of aromatic oils can be added to the massage (base) oil or cream, which can act both tonic and soothing.

• the massage should begin and end with blood pressure measurement, especially at the beginning of the course;
• The duration of the back massage should not exceed 15–20 minutes, and the operating time can be increased gradually;
• The massage should begin with stroking. There should be no unjustified, sudden movements; the body should not “shudder” and shrink in anticipation of the massage therapist’s hands;
• competent massage, when carrying out the most powerful manipulations, causes a pleasant languor, and upon completion causes a feeling of warmth, pleasant relaxation, and drowsiness;
• After the massage, it should be possible to cover the patient and leave him to take a nap in a relaxed state for 20-30 minutes. It would be wrong to immediately “drive” him out into the corridor, so that then he would walk home in the winter wind for half an hour. Such a massage will do more harm than good.

Contraindications for massage for intercostal neuralgia

In conclusion, it is worth recalling the general contraindications for massage with intercostal neuralgia, even if the pain has subsided:

• hereditary blood diseases in which there is a tendency to bleeding and thrombosis (hemophilia, hemorrhagic vasculitis, severe atherosclerosis, thrombophlebitis);
• purulent skin lesions;
• epilepsy, mental illness;
• severe exhaustion, up to cachexia;
• oncological diseases;
• fever, infectious diseases, tuberculosis;
• functional intestinal disorders (diarrhea, dysbacteriosis),
• hypertensive crisis and high blood pressure (the most common cause);

A good course of back massage, on average, is carried out at least every other day, for 10 to 15 sessions. A more lasting effect is achieved by combining massage with acupuncture and laser therapy. See articles on the topic of treatment of neuralgia:

It is best to carry out massage on a special massage table, with bilateral access, at the patient’s home. If all the recommendations given here are followed, the massage will only be beneficial and will serve to improve the health of the body to achieve a feeling of “muscular joy”.

How to massage with intercostal neuralgia - video

Intercostal neuralgia pain in this disease is localized in the intercostal space, but often it radiates along the pinched nerve

Intercostal neuralgia is one of the most common causes of pain in the chest. This is a disease characterized by inflammation of the nerves located between the ribs.

This disease mainly occurs in middle-aged and elderly people. Children practically do not suffer from intercostal neuralgia.

Intercostal neuralgia is:

• pinching, irritation or inflammation of nerve endings in the intercostal space;
• or pinching of the roots of the thoracic spinal nerves in the spinal column.

Symptoms of intercostal neuralgia on the left

The pain in this disease is localized mainly in the intercostal space, but often it radiates along the path of the pinched nerve - in the back, lower back or under the shoulder blade. The pain with intercostal neuralgia is very strong and burning, it is constant, but without attacks.

In addition to pain, patients experience:

• spastic muscle contractions;
• paleness or redness of the skin;
• in the area of ​​the affected nerve, skin sensitivity is lost.

Intercostal neuralgia is often confused with heart pain. Meanwhile, they are quite easy to distinguish.

Pain with intercostal neuralgia tends to intensify with deep inhalation or exhalation, as well as with any movement of the body, for example, when sneezing or coughing, during physical activity, often radiating to the left, but sometimes to the right. It is often painful to even take a deep breath - a burning pain occurs along the intercostal spaces. Moreover, the patient feels it only on one side of the chest.

In the case of angina, heart pain does not change with inhalation and exhalation, as well as with changes in body position or movement in the chest. The pain may be accompanied by irregular pulse rhythms, an increase or decrease in blood pressure. The sensations are usually relieved with ordinary nitroglycerin.

It is important to differentiate between the manifestations of intercostal neuralgia and myocardial infarction, which can cause severe pain. It is for this reason that in case of sudden pain in the heart area, you should immediately call an ambulance and do an electrocardiogram - remember that in case of a heart attack, the patient requires urgent medical care.

Causes of left-sided intercostal neuralgia

There are many factors that provoke the development of intercostal neuralgia, however, pain, in fact, is caused either by pinching of the spinal nerve root in the thoracic region, or pinching (irritation) of the nerves located in the intercostal space.

As a rule, pinched roots are caused by various manifestations of osteochondrosis, but such factors as ankylosing spondylitis, spondylitis and others are also possible. However, more often attacks occur due to irritation of the nerve when it is pinched by the intercostal muscles due to muscle spasm or inflammation.

The causes of spasms and, consequently, attacks of neuralgia may be the following:

• hypothermia;
• lung diseases;
• mental stress;
• traumatic effects;
• past infectious diseases;

In addition, intercostal neuralgia develops due to poisoning and changes in the spine, which are caused by hormonal disorders in women during menopause. Various allergic reactions and diseases of the nervous system, in particular, such as polyradiculoneuritis and multiple sclerosis, also lead to this disease.

Intercostal neuralgia tends to occur with aortic aneurysms and certain diseases of the internal organs. The disease also develops after a herpetic infection.

With systematic physical stress, for example, when lifting heavy objects, microtraumas often lead to neuralgia, especially if they are combined with hypothermia.

Intercostal neuralgia is provoked by alcohol, since it has a toxic effect on the human nervous system. Diabetes mellitus and a lack of B vitamins (with stomach ulcers, hepatitis, gastritis and colitis) also lead to the disease, since metabolic disorders occur in the nervous tissues.

Symptoms similar to those of intercostal neuralgia are also possible due to spasms (excessive tone) of one or more back muscles. When the affected muscle is stretched (bending forward, moving the shoulder blade, right or left shoulder), this case is characterized by an increase in pain.

Treatment of intercostal neuralgia

Therapy for this disease usually consists of two stages. First of all, the pain is relieved, and then the direct treatment of the disease that caused the nerve injury begins.

In the first week, patients diagnosed with intercostal neuralgia are recommended to remain in bed, and they need a hard surface - it is better to place a shield under the mattress.

To relieve pain, the doctor prescribes painkillers, usually from the NSAID group. They also have an anti-inflammatory effect. Patients are also prescribed muscle relaxants to help relieve muscle spasms. Taking sedatives is appropriate. Vitamins B1, B6 and B12 are recommended - they help restore damaged nerve structures. During exacerbations of neuralgia, dry, light heat helps.

After acute symptoms have been eliminated, diagnostics are carried out to identify the cause that caused the development of intercostal neuralgia. And if it becomes clear that we are talking about some general disease (colds, infections, allergies, depression or diabetes), then therapy begins with it.

If intercostal neuralgia is of a vertebrogenic nature, that is, caused by a disease of the spine, its comprehensive treatment is recommended.

To restore the correct physiological position of the cervical and thoracic spine, courses of therapeutic massage, as well as physical therapy and manual therapy are prescribed.

Acupuncture and laser therapy provide excellent results for intercostal neuralgia.

To prevent intercostal neuralgia from developing into a chronic form with frequent attacks, the patient should significantly reduce physical activity and give up alcohol, and if possible, he should avoid stressful situations.

If conservative treatment of intercostal neuralgia does not help, then the question of surgical intervention is raised. For example, treatment is carried out for a disc herniation or osteochondrosis, which provoked attacks of the disease.

Massage for intercostal neuralgia

Therapeutic massage for neuralgia allows you to work out the paravertebral muscles well, thereby improving metabolic processes in them. As a result, swelling and pain decrease, and the muscles come into physiological tone.

Thus, the main purpose of massage for intercostal neuralgia is to relieve pain and relax the muscles of the affected areas. Massage is carried out on the front side of the chest, as well as on the back.

For one-sided pain, massage on the back is done first on the healthy side, and only then on the half that hurts. In the case when the pain syndrome has already spread to both sides, the less affected one is determined and massaged first.

The procedure begins with stroking along parallel lines - from the sacrum to the shoulder girdle. Squeezing is also done, after which they move on to kneading the large muscles of the intercostal spaces and back.

After the back massage, begin massaging the pectoralis major muscles, the intercostal spaces of the anterior surface of the chest and the intercostal angle.

During the massage, it is necessary to observe the patient’s increased sensitivity, in no case exceeding the pain threshold.

Intercostal neuralgia on the left: treatment with folk remedies

Treatment of neuralgia using traditional medicine recipes is a rather lengthy process; you should not expect the desired effect instantly.

So, the treatment methods are as follows:

• steam the flax seeds, put them in a linen bag and periodically apply to the sore spot;
• Horseradish or radish juice helps relieve painful sensations - they lubricate the place where the pain is localized;
• mix the gruel from steamed or fresh wormwood with sea buckthorn or olive oil and apply this mixture to the sore spot;
• help with intercostal neuralgia baths with sage: 4 tbsp. spoons of herbs are poured into a glass of warm water, infused for about an hour and filtered. The infusion should be poured into a bath of water (temperature 37 degrees), and 4 tbsp should be added there. spoons of sea salt;
• 3-4 leaves of indoor geranium are wrapped in a linen scarf and applied to the sore spot. All this needs to be bandaged and tied with a woolen scarf. Leaves need to be changed 3 times in 2 hours;
• ointment from aspen buds. It is done simply: the buds should be dried and ground, then rubbed with butter or petroleum jelly in a ratio of 1:4. The finished ointment is thoroughly rubbed into painful areas;
• a mixture of iodine and glycerin. Both components must be mixed well in equal proportions in a dark container. Painful areas are lubricated with a tampon soaked in this composition. Just avoid the area around the spine! And keep in mind: this mixture should not be rubbed into your back, but rather lubricated. Then the patient should put on cotton underwear. The procedures are done at night, and there is no need to wrap yourself up afterwards. In a month, manipulations must be done 15 times.

To quickly get rid of intercostal neuralgia, its causes and symptoms, the patient should be at rest; treatment involves bed rest. The cause of increased pain during neuralgia can be bright sunlight or intense lighting.

Intercostal neuralgia is a serious disease characterized by severe painful attacks. The pathology is associated with damage to peripheral nerve endings, which can be caused by a variety of reasons. As a rule, it is treated with conservative methods, including massage. What does massage do for intercostal neuralgia, and can it be done at home?

Massage for intercostal neuralgia

Intercostal neuralgia is pain in the area of ​​the ribs and chest that occurs when the nerve endings are compressed at the exit points of the spine. Depending on the force of compression and the number of affected roots, the pain can be dull, pulling, cutting or burning, localized in one area or encircling. They may be accompanied by muscle spasms and sensory disturbances. Attacks of pain occur when moving the body, sneezing, coughing, when affecting the skin along the spine, on the sternum and in the intercostal spaces, that is, where the nerve roots pass.

Painful attacks due to neuralgia can appear at any time of the day and last from a couple of minutes to several hours. If the lesion is extensive, the pain is felt constantly, only with varying intensity. Often it radiates under the shoulder blade, into the collarbone, around the heart, and prevents you from taking a deep breath. In most cases, the disease develops against the background of pathologies of the spine (in the thoracic region), such as osteochondrosis, spondylitis, and ankylosing spondylitis. This is facilitated by degenerative-dystrophic processes in the vertebrae and intervertebral discs, as a result of which pinched nerves occur.

There are other causes of intercostal neuralgia:

• hypothermia of the body;
• excessive stress on the back;
• infectious diseases;
• upper body injuries;
• muscle inflammation;
• tumors of the spine and spinal cord.

Important! Even severe stress or prolonged nervous strain can provoke the appearance of pain, and in some cases, damage to the peripheral nervous system is caused by hormonal imbalances. Provoking factors also include age-related changes in muscle and bone tissue, since most people with this diagnosis are over 40 years old.

The benefits of massage for neuralgia

The main goal of massage for lesions of the nerve roots is to eliminate pain. This is accomplished by relaxing the muscles in the affected area. Tight muscles increase compression of nerve endings and blood vessels, which interferes with normal blood flow and relief of inflammation. With the help of a gentle impact on problem areas, it is possible to relieve muscle tension and reduce pressure on the roots and blood vessels. With the normalization of blood supply, swelling gradually disappears, inflammatory processes in tissues subside, and pain goes away.

What else does therapeutic massage provide:

• improves metabolic processes in tissues;
• helps restore the functions of affected nerves;
• relieves stress;
• improves the general condition of the patient.

But a positive result can only be achieved if the massage procedure is carried out correctly and there are no contraindications, otherwise the risk of complications and increased pain attacks increases.

Indications and contraindications

Therapeutic massage is indicated in cases where intercostal neuralgia is caused by muscle spasms or diseases of the spinal column, and the pain syndrome is moderate. With severe pain, even the lightest touch to the affected areas is painful for the patient, which means there will be no benefit from such a procedure.

As for contraindications, in addition to acute pain, these include:

• inflammatory processes in the body;
• the presence of viral and bacterial infections;
• malignant and benign tumors;
• physical exhaustion;
• dermatological diseases, especially purulent ones;
• injuries to the ribs, chest and spine.

Also, do not massage if you have high blood pressure or general malaise. To accurately determine the cause of the disease and make sure there are no contraindications, you need to undergo a full examination, and based on its results, the doctor will determine whether a massage can be prescribed.

Important! An experienced, qualified massage therapist should carry out the procedure (at least the first few sessions), and only if there is a lasting improvement and after consultation with a doctor, massage is allowed at home.

Rules for massage

For intercostal neuralgia, it is necessary to massage both the back and chest, regardless of where the pain is localized. To achieve a lasting positive result, a minimum of 10 procedures lasting up to 20 minutes are prescribed. Massage is performed daily or every other day, depending on the patient’s condition and the use of other therapeutic techniques. During treatment, experts recommend adhering to certain rules in order to obtain a high therapeutic effect from the procedures.

Important! After completing the session, you should not get up immediately, much less go out into the cold. It is advisable to remain in a lying position for another 5-10 minutes, completely relaxing the muscles. To enhance the therapeutic effect, it is recommended to combine massage with physiotherapy and therapeutic exercises.

Massage technique

To perform a massage at home, it is enough to watch how an experienced specialist does it 1-2 times. The massage technique is quite simple and includes standard techniques - stroking with fingertips, kneading, rubbing painful areas.

Table. Stages of performing a massage

If the patient feels pain in a specific point, it is necessary to work on this area separately. You need to massage carefully, first performing stroking, then rubbing and kneading movements. It is not advisable to use pinches here, so as not to cause suffering to the patient. The duration of such work should not exceed 4-5 minutes. After this, the person should lie quietly for 10 or 20 minutes so that the muscles calm down. Instead of classical massage, cupping and acupressure massage can also be used for intercostal neuralgia.

Video - Massage for intercostal neuralgia

Massage is also effective for other types of neuralgia, for example, facial or sciatica. Depending on which part of the body is affected, the massage technique has certain differences, but the procedure does not present any particular difficulties. You can read about all the intricacies of massage and related methods of treating neuralgia.

Intercostal neuralgia(synonym – “ thoracic radiculitis) is a neurological pathology that occurs as a result of damage or compression of the intercostal nerves, manifested in the form of pain.

The pain experienced by patients with intercostal neuralgia is one of the most severe. On the scale, it ranks third, along with acute kidney pain.

Intercostal neuralgia is often confused with other diseases, especially if the pain occurs on the left (simulates pathologies of the heart, stomach). Often even experienced doctors are misled.

Anatomical features

Anatomy of intercostal nerves:

• Nerve bundles that perform motor functions emerge from the anterior part of the thoracic spinal cord, and sensory bundles emerge from the posterior part.
• Then, inside the spinal canal, the anterior and posterior bundles unite to form the thoracic nerves of the spinal cord. There are a total of 12 pairs of nerves in the thoracic region, corresponding to the number of segments of the spinal cord.
• The spinal nerve exits the spinal canal through the intervertebral foramen.
• Outside the spine, the thoracic nerve is divided into two bundles: anterior and posterior. The posterior one goes to the back muscles. The anterior bundle, in fact, is the intercostal nerve. The first intercostal nerve runs along the edge of the rib. All the rest are located in the thickness of the intercostal muscles, filling the spaces between the ribs.

Types of nerve fibers that make up the intercostal nerve:

• motor– innervate the intercostal muscles, the diaphragm, provide respiratory movements;
• sensitive– provide skin and other types of sensitivity;
• vegetative– control the functions of blood vessels, sweat glands, etc.

Causes of intercostal neuralgia

Causes of intercostal neuralgia:

Cause	Description
Sudden awkward movements.	A sudden movement may cause short-term compression of the intercostal nerve. This leads to pain.
Osteochondrosis of the thoracic spine.	A degenerative disease characterized by the destruction of intervertebral discs. Factors leading to the development of neuralgia: Reducing the height of intervertebral discs. As a result of their destruction, subsidence of the spinal column occurs. The vertebrae move closer to each other, the diameter of the intervertebral foramina decreases, and the spinal nerves passing through them are compressed. Development of the inflammatory process. It often involves the site where the nerve exits the spinal canal. Biologically active substances, leukocytes and antibodies accumulate in the inflammatory focus, causing nerve irritation. Pathological changes in the vertebrae. Bone outgrowths form on the vertebral bodies - osteophytes. They compress the nerves passing through the intervertebral foramina.
Injuries	Types of injuries leading to intercostal neuralgia: bruises of the back and chest; rib fractures; vertebral fractures, especially compression ones, when the vertebra seems to be flattened in height. During an injury, the nerve is irritated. In the long term, pain may be caused by retraction of the nerve into the scar or compression by a bone callus.
Infectious diseases	Infections that most often lead to the development of intercostal neuralgia: cold viral diseases, especially flu; herpes zoster (herpes virus infection). Pathogenic microorganisms, once in the human body, release toxins that can spread through the bloodstream. They can cause damage to intercostal and other nerves.
Hypothermia	Cold causes irritation of the intercostal nerves, leading to attacks of intercostal neuralgia.
Increased physical activity	With excessive physical strain, microtraumas of the intercostal muscles occur.
Radiculopathy (radicular syndrome)	Radiculopathy is compression of the spinal root. In this case, irritation and pain extend to the intercostal nerve.
Herniated disc	A disease characterized by protrusion of the intervertebral disc beyond the vertebra. The prolapsed part of the disc compresses the nerve emerging from the intervertebral foramen. In the thoracic spine, spina bifida are rare, since the vertebrae are connected to the ribs and take part in the formation of the chest; they are securely fixed.
Tumors of the spine, spinal cord, surrounding tissues	Tumors in the area where the nerves pass through the spinal foramen, reaching a fairly large size, cause compression.
Spondylolisthesis	Rarely found in the thoracic spine. It is characterized by the sliding of the overlying vertebra from the underlying one forward. As a result, both the spinal cord and the nerves extending from it are compressed.
Congenital malformations of vertebrae and ribs	wedge-shaped vertebrae: the right part of the vertebra is lower than the left or vice versa, resulting in a distortion of the spine, compression of one or more spinal nerves; absence or duplication of a rib: in this case, the spine takes on an incorrect configuration; spondylolysis: the body and the vertebral arch are located separately, they are not connected, as a result of which the body gradually moves forward, the shape of the intervertebral foramen is disrupted.
Lead poisoning	Lead has a toxic effect on nerve tissue.
Alcohol abuse	Ethyl alcohol has a toxic effect on nerve tissue.
Osteoporosis	A disease characterized by thinning and destruction of bone tissue. This leads to a decrease in the height of the vertebrae, their deformation, and increased fragility.
Hormonal disorders	menopause: hormonal changes during menopause lead to the destruction of bone tissue, osteoporosis; diabetes: the disease leads to disruption of blood circulation in small vessels and the supply of oxygen to the bones.
Hypovitaminosis	With a lack of B vitamins, metabolic processes in the nervous tissue are disrupted. During rickets, – hypovitaminosisD, - bone deformation occurs, which can subsequently lead to compression of the nerves.
Scoliosis and severe postural disorders	With significant curvature of the spinal column, conditions arise for compression of the intervertebral nerves.
Ankylosing spondylitis (ankylosing spondylitis)	Chronic disease of the intervertebral joints, leading to deformities of the spinal column.
Vertebral hemangioma	A rare condition when a benign vascular tumor is located deep in the vertebral body - hemangioma. It makes the vertebra more fragile and susceptible to injury.

Signs of intercostal neuralgia

Symptom (group of symptoms)	Explanation
Pain in the area of ​​the affected nerve	The leading symptom of intercostal neuralgia. The pain is very intense and occupies the third position (severe pain) on the generally accepted scale. May be comparable to hepatic or renal colic. Duration of pain: constant; in the form of attacks. Nature of pain: dull; aching; burning; piercing. Most often, pain occurs on one side, spreads along the affected nerve, as if encircling half of the chest.
Increased pain during movement and physical activity	Factors that can provoke increased pain and pain in intercostal neuralgia: A drug* Description Mode of application** Analgin (syn.: Metamizole Sodium, Baralgin, Spazdolzin). One of the most common medications used for pain of various origins. It has analgesic and, to a lesser extent, anti-inflammatory and antipyretic effects. Release forms: tablets of 0.05, 0.1, 0.15 (for children) and 0.5 g. injection solution 1 – 2 ml 25% - 50%. Use for neuralgia: In tablets: Adults: 0.25 - 0.5 g 2 - 3 times a day. Children: 5 – 10 mg per kilogram of body weight per day. In injections: Adults: 1 - 2 ml of 25% - 50% solution 2 - 3 times a day. Children: 0.1 – 0.2 ml of 50% solution for every 10 kg of body weight. Tempalgin Combined drug. Includes Analgin and Tempidine (a mild tranquilizer). Adults take 1 tablet for pain. Baralgin (synonyms: Bral, Spazgan, Spazmalgon, Spazmalgin) It is a combination drug with a pronounced analgesic effect. Compound: analgin– analgesic and anti-inflammatory agent; pitofenone hydrochloride– a drug that blocks nerve impulses in the autonomic nervous system; fenpiverinium bromide- a drug that blocks nerve impulses in the autonomic nervous system. Release forms: in tablets; in ampoules for injection. Application (adults): in tablets: take 1 tablet for pain 1 – 3 times a day; in injections: administer the solution intramuscularly or intravenously (slowly!) for pain. Ketorolac (syn.: Ketalgin, Ketorol) Strong pain reliever. The most powerful among non-hormonal and narcotic drugs. Release forms: tablets 0.01 g; solution in ampoules of 3% - 1 ml. Application: Intravenous and intramuscular Ketorol is prescribed in a dosage of 0.01 - 0.03 g every 6 - 8 hours. The maximum daily dose is 0.09 g. Ortofen (syn.: Diclofenac, Voltaren, Clofenac, Ultrafen, Etifenac) It has a pronounced anti-inflammatory and analgesic effect. Release forms: tablets 0.015 (for children) and 0.025 (for adults) g; solution for injection 75 mg – 3 ml. *Hereinafter when describing medications: the information is for informational purposes only. Treatment must be prescribed by a doctor. Self-administration of drugs can lead to negative consequences. **Hereinafter when describing medications. Source: Mashkovsky M.D., “Medicines - edition 15, revised. and additional”, Moscow, LLC Publishing House “Novaya Volna”, 2005. What ointments are used in the treatment of intercostal neuralgia? Name of ointment Description Mode of application Voltaren (Ortofen) Anti-inflammatory and analgesic drug Diclofenac in the form of an ointment. Apply directly to the area where the pain is localized. Apply 2-3 grams of ointment to the sore spot 3-4 times a day. Ketonal cream and Ketonal gel Painkiller Ketorol in the form of gel and cream. Apply directly to the area where the pain is located. Apply a small amount of cream or gel 2 times a day to the sore spot. Rub well into the skin. Continue the course of treatment for no more than 7 days. Apizartron German-made ointment based on bee venom. Effects: irritates the nerve endings of the skin; increases blood flow; accelerates the removal of biologically active substances that support the inflammatory process; eliminates pain. Application: squeeze 3–5 cm of ointment onto your finger; apply a 1 mm thick layer of ointment to the sore spot; leave for 2 - 3 minutes, then cleanse the skin. There should be redness and a feeling of warmth at the site where the ointment is applied. Apizartron is used 2-3 times a day. Viprosal B Combined ointment. Compound: viper venom – irritates the nerve endings on the skin, thereby eliminating pain; turpentine ointment – ​​warming effect; camphor - like viper venom, has an irritating effect on the skin nerve endings. Rub the ointment 1 – 2 times a day into the sore spot. The course of treatment is continued depending on the doctor’s prescriptions. Menovazin ointment Compound: 2.5 g of menthol: irritates the nerve endings of the skin, dilates subcutaneous blood vessels, enhances the analgesic effect, creates a feeling of coolness; 1 g of benzocaine: is a local anesthetic, eliminates pain; 1 g of procaine: is a local anesthetic, eliminates pain. Menovazine is applied to the sore spot and thoroughly rubbed into the skin 2 – 3 times a day. The duration of the course of treatment is determined by the doctor. Turpentine ointment Effects: local irritation of the nerve endings of the skin; anesthesia; destruction of pathogenic microorganisms (turpentine is an antiseptic). Rub into the skin at the site of pain 1 – 2 times a day. Finalgon An ointment consisting of 2-butoxyethyl alcohol And vanillylnonamide. Effects: warming due to vasodilation; anti-inflammatory; anesthetic. The drug is available in tubes, the kit includes a special applicator. It is necessary to squeeze 0.5 cm of ointment onto the applicator, apply to the sore spot and rub thoroughly. Wrap yourself in woolen cloth. Finalgon takes effect 20–30 minutes after application. Vitamin preparations prescribed for intercostal neuralgia When a nerve is compressed, its nutrition and functioning are disrupted. Therefore, for intercostal neuralgia, vitamin preparations are prescribed to help improve metabolic processes in the nervous tissue. Drug name Description Methods of application VitaminB1 (Thiamin) One of the most important vitamins for nervous tissue. Takes part in metabolic processes, protects nerve cells from free radicals. The drug is available in ampoules of 1 and 2 ml in the form of a solution of 2.5% and 5%. Administer one ampoule intramuscularly every other day. Calcium pantothenate A substance belonging to the group of vitamins. Participates in education mediators– connections that ensure impulse transmission between nerve cells. Release forms: in tablets of 0.1 g; solution in ampoules 10% - 2, 5 and 10 ml; solution in ampoules 25% - 2 ml. Application: In tablet form: adults: 0.1 – 0.2 g 2 to 4 times a day; children 1 – 3 years old, 0.005 – 0.01 g; children 3 – 14 years old 0.1 – 0.2 g per dose. In the form of injections: adults: 1 – 2 ml of 20% solution or 2 – 4 ml of 10% solution 1 or 2 times a day; children under 3 years of age: 0.5 - 1.0 ml of 10% solution 1 or 2 times a day; children 3 – 14 years old: 1 – 2 ml of 10% solution 1 or 2 times a day. Vitamin B6 (Thiamin) Thiamine is one of the most important vitamins for the functioning of the nervous system. It takes part in the exchange of amino acids and the synthesis of certain mediators (substances that ensure the transmission of nerve impulses between individual nerve cells). Release form: 1.0%, 2.5% and 5% solution in ampoules of 1 ml and 2 ml. Mode of application: adults: 0.05 – 0.1 g per day every other day; children: 0.02 g per day every other day. Typically, administration of vitamin B6 alternates with administration of vitamin B1 - every other day. Pentovit Complex vitamin preparation. Compound: vitamin B1 ( thiamine chloride); vitamin B6 ( pyridoxine hydrochloride); nicotinamide; vitamin B12 (cyanocobalamid). Physiotherapy for intercostal neuralgia Procedure name Mechanism of action for intercostal neuralgia Application Laser (quantum) therapy Impact of a laser beam on the affected area. Effects: anti-inflammatory; antiallergic; increasing protective reactions of tissues; improved regeneration; dilation of blood vessels, improvement of blood flow, acceleration of the elimination of substances involved in the inflammatory reaction. The laser beam is applied in the places where the nerves emerge from the intervertebral foramina: from the back, to the right and left of the spinal column. The duration of the procedure is up to 10 minutes. The general course consists of 10 – 15 procedures. Electrophoresis with drugs Electrophoresis is a method of physiotherapy that involves introducing medications into the human body through the skin using a weak electric current. For intercostal neuralgia, electrophoresis is done with analgin (painkiller), novocaine (anesthetic). Two electrodes are placed on the skin in the affected area: positive and negative. A tissue pad moistened with a solution of the medicinal substance is placed between the electrodes and the skin. The device is adjusted so that the patient feels a slight tingling sensation on the skin. The session lasts about 5 minutes. The total number of sessions is 10. UHF therapy UHF therapy is the effect on the human body of an ultra-high frequency electric field. Therapeutic effects for neuralgia: increased blood and lymph flow; reduction of tissue swelling caused by the inflammatory process; expansion of capillaries, small arteries; reducing the impact on tissue of toxic substances and pathogens. During the procedure, plates are placed on the patient's body that generate ultra-high frequency electrical currents. In this case, the patient should lie on a wooden couch or bed. The device is adjusted so that the patient feels warmth in the area of ​​the plates. The session lasts from 5 to 10 minutes. The total duration of the course is 10 – 15 sessions. Darsonval Electric currents Darsonval, which are used in physical therapy, have four characteristics: high frequency, high voltage, low force, fast attenuation. Therapeutic effects for intercostal neuralgia: local irritation (during the procedure, tingling and redness of the skin are noted); activation of defense mechanisms; increased blood flow in small vessels. The working part of darsonvalization devices is a glass tube. Electrical discharges are created in it, and it is this that is used to massage the affected area for intercostal neuralgia. Sparks jump between the tube and the skin, resulting in a tingling sensation and a characteristic crackling sound. The duration of the procedure is 5 – 10 minutes. The total number of sessions is 10. Is massage effective for intercostal neuralgia? Medical massage is effective for intercostal neuralgia, so it is almost always included in the overall treatment program. Effects of massage for intercostal neuralgia improvement of blood flow in capillaries and small arteries; strengthening metabolic processes in tissues, accelerating the elimination of toxins and substances involved in the development of the inflammatory process; warming up the skin and underlying tissues; improvement of blood supply and activation of recovery processes in muscles; analgesic effect; improving the function of nervous tissue, improving the conduction of nerve impulses; general calming effect. On what areas of the body is massage performed for intercostal neuralgia? on the back; on the chest (front). What conditions must be met? Before the first session, the massage therapist must check with the patient on which side and at what level the pain occurs; the massage should begin on the opposite, healthy side, and then move to the sick one; with bilateral intercostal neuralgia, massage begins from the place where the pain is weakest; The massage therapist's actions must be careful and rough influences must be avoided. How is massage performed? First, the patient lies on his stomach on a massage table, with a special pillow placed under his chest. Do a back massage. Then he turns over on his back and massages the chest. How long is the session? The first massage session lasts 15 minutes. During subsequent sessions, the time is increased. What is the total duration of the course? 10 sessions. Acupuncture for intercostal neuralgia Acupuncture (acupuncture) is a branch of traditional Chinese medicine that practices the insertion of thin metal needles into specific points on the body. Acupuncture effects: anesthetic; anti-inflammatory; calming; increasing defense mechanisms; increased blood flow and metabolism in the affected area. In modern clinics, acupuncture belongs to a separate branch of medicine - reflexology. Many hospitals have rooms where acupuncture is practiced. This method is often used as part of a comprehensive treatment program for intercostal neuralgia. Manual therapy for intercostal neuralgia In most cases, intercostal neuralgia is associated with compression of the nerve exiting through the intervertebral foramen. Thus, this pathological condition falls within the competence of the chiropractor. The effects that a chiropractor seeks to achieve in a patient with intercostal neuralgia: elimination of nerve compression and pain; normalization of posture; improving overall musculoskeletal function. Osteopathy for intercostal neuralgia Osteopathy is a branch of medicine that involves influencing the root cause. An osteopathic doctor, using light movements, pressure, etc., tries to eliminate factors that led to compression of the nerve in the intervertebral foramen: deformations of bone structures(joints between vertebrae, ribs); excessive tension of the intercostal muscles, back muscles; violation of the outflow of blood and lymph; pathological ligament tension. Osteopathy is somewhat reminiscent of massage and manual therapy, but the effect is lighter and more accurate. Physical therapy for intercostal neuralgia With intercostal neuralgia, it is necessary to limit any physical activity. As the attacks subside, the patient begins to engage in physical therapy under the supervision of a specialist. Swimming is beneficial for patients with intercostal neuralgia. How to treat severe neuralgia? If, despite treatment, severe pain persists with intercostal neuralgia, then treatment is carried out in a hospital, stronger drugs are prescribed: blockade– injection of the nerve area with anesthetic solutions (Novocaine, etc.); tranquilizers– medications that eliminate anxiety and excessive nervous tension caused by constant pain; sedatives means of various groups. Indications for surgical treatment of intercostal neuralgia: herniated disc; pronounced osteochondrosis, accompanied by significant changes in the spinal column; various spinal tumors, spinal cord, surrounding tissues; other spinal diseases requiring surgical treatment. How to treat intercostal neuralgia at home? Neuralgia is a disease that is often accompanied by very severe pain and is treated for a long time and with great difficulty. Therefore, it is worth visiting a neurologist in any case. It is necessary to understand the causes and understand how serious the disease is. Can be used at home(after consulting with your doctor!): anti-inflammatory and warming ointments; folk remedies(see below); home physiotherapy devices: Darsonval, devices for magnetic therapy; call a massage therapist to your home; use various massagers yourself. Traditional methods of treating intercostal neuralgia Method Description Wearing a wool shawl Wrap a woolen shawl around the sore spot and walk like this throughout the day. Effects: warming; increased blood flow; reduction of pain. Ginger, turmeric, pepper compress Ingredients: hot chili pepper – 0.5 teaspoon; dried ginger root powder – 2 teaspoons; Turmeric powder – 1 teaspoon. Cooking method: mix all components with a small amount of warm water until a homogeneous paste is obtained; spread the resulting mixture onto a piece of cloth; apply to the sore spot, wrap with a bandage; wear it as long as possible until it starts to burn badly. Effects: warming up; increased blood flow; reduction of pain, acceleration of metabolism and removal of toxic products and inflammatory agents from the lesion. Tincture of aloe, celandine, red pepper Ingredients: one medium-sized red hot pepper; chopped medium-sized aloe leaf; 1 tablespoon of crushed celandine leaves; 0.5 l of vodka. Preparation: pour vodka over ingredients; leave for 10 days in a dark place; subsequently store in the refrigerator. Application: Rub into the sore spot 2-3 times a day until the symptoms stop bothering you. Tincture of calendula and meadowsweet Ingredients: 30 g of dried and crushed meadowsweet root, or 20 g of fresh flowers; 5 g calendula flowers; 0.2 l of vodka. Preparation: pour 200 ml of vodka over the plant material; Place the container with the tincture in hot but not boiling water for 30 minutes; then remove and leave for another 2 hours in a dark place; filter through cheesecloth. Application: Rub the sore spot 2 – 3 times a day. Warming up with a boiled egg Hard boil an egg, remove the shell. Cut in half, cool slightly. Place both halves cut side down on the sore spot and walk until they cool down. This method must be used carefully to avoid burns. Hot bath Take a hot bath for 15 minutes. Then rub the sore spot with an ointment made up of one part ammonia and two parts unrefined vegetable oil. How is intercostal neuralgia treated during pregnancy? The treatment regimen for intercostal neuralgia in pregnant women is not much different from the standard one. Peculiarities: most painkilling injections and tablets are contraindicated during pregnancy; Ointments are mainly used only as prescribed by a doctor; vitamin therapy is carried out; it is necessary to conduct a comprehensive diagnosis in order to clearly distinguish intercostal neuralgia from other diseases; self-medication is unacceptable, as it can cause harm to both the woman and the child.