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Intercostal neuralgia (intercostal neuralgia) can scare - the pain in the chest that accompanies it may suggest a heart attack. So how can it be concluded that the symptoms experienced by the patient are symptoms of intercostal neuralgia and what may be the causes of this pathology?

Intercostal neuralgia(also known asintercostal neuralgia , intercostal neuralgia) belongs to the group of neuropathic pains and develops when some pathological processes will affect the intercostal nerves extending from the spine, running under the ribs. Theoretically, this problem may occur in patients of any age, but in practice intercostal neuralgia is most often found in middle-aged and elderly adults.

Intercostal neuralgia: causes

Various injuries of the intercostal nerves lead to intercostal neuralgia - an individual may occur due to pressure, irritation or inflammation within the mentioned nerve fibers.

Problems that may be the cause of such processes are listed at least a few - examples include injuries to the intercostal nerves (in this case, intercostal neuralgia can be caused by e.g. a fall from a height, but the disease may also develop maybe after some kind of surgery involving the chest or ribs) or shingles.

The cause of intercostal neuralgia is also pregnancy, and in this case, pain occurs due to physiological changes that occur during pregnancy (we are talking about the enlargement of the chest, which may cause pressure on the intercostal nerves and eventually the occurrence of intercostal neuralgia) .

Occasionally, however, intercostal neuralgia develops in a patient for no apparent cause, in which case the condition is referred to as idiopathic intercostal neuralgia.

Read also: Rib pain - causes and treatment

Intercostal neuralgia: symptoms

As you can easily guess, the basic symptom of intercostal neuralgia is pain - it has a different nature, but most often it is dull or squeezing pain.

Usually this pain appears in the form ofshort-term episodes that may provoke activities such as breathing, sneezing and coughing.

Typically pain related to intercostal neuralgia is felt in the chest area, but sometimes it may radiate to the back or shoulder blade.

Apart from pain episodes lasting several seconds to several minutes, symptoms of intercostal neuralgia may also include other sensations, such as numbness or short-term stinging episodes in the chest.

Intercostal neuralgia: diagnosis

Theoretically, intercostal neuralgia can be diagnosed only on the basis of characteristic symptoms reported by the patient. In practice, however, many different tests are often performed on the patient - they are ordered especially when the patient experiences chest pain for the first time in his life.

This necessity is sometimes caused by the fact that the symptoms of intercostal neuralgia should be differentiated from the symptoms of other conditions, such as a heart attack.

In order to perform the differential diagnosis, patients may be ordered to perform tests such as ECG or laboratory tests (in which the level of troponin is usually measured).

It is also valuable to perform a chest X-ray - during it it is possible to find, for example, damage to the ribs (fresh or after a rib fracture in the past), which may confirm that the patient may have developed intercostal neuralgia due to this .

Intercostal neuralgia: treatment

As in the case of other types of neuropathic pain, also in the case of intercostal neuralgia, it is quite often not easy to propose an effective treatment to the patient. The reason for this is that commonly used painkillers (such as non-steroidal anti-inflammatory drugs) are usually not able to soothe the pain of patients.

For this reason, other types of agents are used in the treatment of intercostal neuralgia, e.g.

  • patches containing capsaicin applied to the skin of the chest
  • Drugs that can generally be used to treat neuropathic pain, such as e.g. antidepressants (e.g. amitriptyline, duloxetine, imipramine)
  • anticonvulsants (e.g. gabapentin, carbamazepine, pregabalin)

Sometimes the mere use of painkillers does not bring relief to patients - in such situations, the blockade of nerve fibers may have beneficial effects (in this case, e.g.local anesthetic - relieving pain - along with glucocorticosteroids, which may in turn exert anti-inflammatory effects).

Nerve blocks can be an effective method of treating various neuropathic pains, but they have some limitations - the effects of using them typically last for several months.

In some patients, rehabilitation (which can and should be used together with pharmacological treatment) brings very beneficial effects.

It is worth mentioning that, just as determining the optimal treatment for the patient is quite often difficult, you definitely cannot give up too quickly - persistent, persistent symptoms of intercostal neuralgia can lead to various problems, such as such as insomnia or depression, therefore it is definitely necessary to try to determine the optimal treatment that will lead to the resolution of unpleasant ailments in the patient.

About the authorBow. Tomasz NęckiA graduate of medicine at the Medical University of Poznań. An admirer of the Polish sea (most willingly strolling along its shores with headphones in his ears), cats and books. In working with patients, he focuses on always listening to them and spending as much time as they need.

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Category:

Neurology