What are the main causes of neuropathic pain. How can neuropathic pain be diagnosed and treated effectively. What lifestyle changes can help manage neuropathic pain symptoms. How does neuropathic pain differ from other types of chronic pain. What are the long-term effects of untreated neuropathic pain.

Understanding Neuropathic Pain: A Comprehensive Overview

Neuropathic pain is a complex and often debilitating condition that affects millions of people worldwide. Unlike typical pain that results from tissue damage, neuropathic pain originates from dysfunction or damage to the nervous system itself. This type of pain can be particularly challenging to manage, as it often doesn’t respond well to conventional pain treatments.

Approximately 1 in 3 Americans experience chronic pain, with neuropathic pain affecting about 20% of those individuals. A 2014 study suggested that up to 10% of the US population may suffer from some form of neuropathic pain. These statistics highlight the prevalence and significance of this condition in modern healthcare.

Characteristics of Neuropathic Pain

Neuropathic pain is characterized by several distinct features:

• Shooting, burning, or stabbing sensations
• Tingling and numbness, often described as “pins and needles”
• Spontaneous pain that occurs without an obvious trigger
• Evoked pain from typically non-painful stimuli (e.g., light touch or temperature changes)
• Chronic discomfort or abnormal sensations
• Sleep disturbances and emotional distress

Is neuropathic pain constant. Neuropathic pain can be either constant or intermittent. Some individuals experience persistent discomfort, while others may have periods of relief interspersed with flare-ups. The unpredictable nature of this pain can make it particularly challenging for patients to manage their daily activities and quality of life.

The Diverse Causes of Neuropathic Pain

Neuropathic pain can arise from a wide range of underlying conditions and factors. Understanding these causes is crucial for proper diagnosis and treatment. The primary categories of neuropathic pain causes include diseases, injuries, infections, and limb loss.

Disease-Related Neuropathic Pain

Several medical conditions can lead to neuropathic pain:

• Diabetes (responsible for 30% of neuropathic pain cases)
• Multiple sclerosis
• Multiple myeloma and other cancers
• Trigeminal neuralgia
• Chronic alcohol abuse

How does diabetes cause neuropathic pain. Diabetes can lead to neuropathic pain through a process called diabetic neuropathy. Prolonged high blood sugar levels damage nerve fibers, particularly in the extremities. This damage can result in a range of sensations, from numbness and tingling to burning pain. Proper blood sugar management is crucial in preventing and managing diabetic neuropathy.

Injury-Induced Neuropathic Pain

Physical trauma can sometimes lead to lasting nerve damage and neuropathic pain:

• Spinal cord injuries
• Herniated discs
• Accidents affecting peripheral nerves
• Surgical complications

Can a one-time injury cause chronic neuropathic pain. Yes, a single traumatic event can potentially lead to chronic neuropathic pain. Even after the initial injury heals, damaged nerves may continue to send inappropriate pain signals to the brain. This phenomenon underscores the importance of proper injury management and follow-up care to minimize the risk of developing chronic neuropathic pain.

Infection-Related Neuropathic Pain

Although less common, certain infections can trigger neuropathic pain:

• Shingles (herpes zoster) and postherpetic neuralgia
• HIV/AIDS
• Syphilis
• Lyme disease

How long can neuropathic pain last after shingles. Neuropathic pain following a shingles outbreak, known as postherpetic neuralgia, can persist for weeks, months, or even years in some cases. The duration varies among individuals, with older adults and those with severe initial outbreaks being at higher risk for prolonged pain. Early antiviral treatment during a shingles episode may help reduce the likelihood of developing long-term neuropathic pain.

Limb Loss and Phantom Pain

Amputation can lead to a unique form of neuropathic pain called phantom limb syndrome. In this condition, individuals experience sensations, including pain, in a limb that is no longer present. This phenomenon occurs due to the brain’s continued processing of nerve signals from the area of the amputation.

Diagnosis and Assessment of Neuropathic Pain

Accurately diagnosing neuropathic pain is crucial for effective management. The diagnostic process typically involves a combination of clinical evaluation, patient history, and specialized tests.

Clinical Evaluation and Patient History

A thorough medical history and physical examination are the first steps in diagnosing neuropathic pain. Healthcare providers will inquire about the nature, location, and duration of the pain, as well as any associated symptoms or triggering factors.

Diagnostic Tools and Tests

Several diagnostic tools may be employed to confirm neuropathic pain and identify its underlying cause:

• Quantitative sensory testing (QST)
• Nerve conduction studies
• Electromyography (EMG)
• Magnetic resonance imaging (MRI)
• Skin biopsy to assess small fiber neuropathy

How is neuropathic pain distinguished from other types of chronic pain. Neuropathic pain is differentiated from other forms of chronic pain through its unique characteristics and response to specific diagnostic tests. Unlike nociceptive pain, which results from tissue damage, neuropathic pain often presents with distinct sensory abnormalities such as allodynia (pain from normally non-painful stimuli) and hyperalgesia (increased pain sensitivity). Specialized questionnaires like the DN4 or painDETECT can also help identify neuropathic components in chronic pain conditions.

Treatment Strategies for Neuropathic Pain

Managing neuropathic pain often requires a multifaceted approach, combining pharmacological interventions with non-drug therapies and lifestyle modifications.

Pharmacological Interventions

Several classes of medications are used to treat neuropathic pain:

• Anticonvulsants (e.g., gabapentin, pregabalin)
• Antidepressants (e.g., duloxetine, amitriptyline)
• Topical agents (e.g., lidocaine patches, capsaicin cream)
• Opioids (used cautiously due to potential for dependence)
• NMDA receptor antagonists (e.g., ketamine in severe cases)

What is the most effective medication for neuropathic pain. The most effective medication for neuropathic pain varies among individuals, as response to treatment can be highly personalized. However, anticonvulsants like gabapentin and pregabalin, and certain antidepressants such as duloxetine, are often considered first-line treatments due to their efficacy and relatively favorable side effect profiles. Treatment often involves trial and error to find the most effective medication or combination of medications for each patient.

Non-Pharmacological Approaches

Complementary therapies can play a significant role in managing neuropathic pain:

• Physical therapy and exercise
• Transcutaneous electrical nerve stimulation (TENS)
• Acupuncture
• Cognitive-behavioral therapy
• Mindfulness and meditation techniques

Can lifestyle changes help manage neuropathic pain. Yes, lifestyle modifications can significantly impact neuropathic pain management. Regular exercise, stress reduction techniques, and maintaining a healthy diet can all contribute to better pain control. Additionally, avoiding triggers such as alcohol and smoking, which can exacerbate nerve damage, is crucial. For conditions like diabetic neuropathy, strict blood sugar control through lifestyle changes can help prevent progression and alleviate symptoms.

Advanced Interventions for Refractory Neuropathic Pain

When conventional treatments prove insufficient, more advanced interventions may be considered:

Neurostimulation Techniques

• Spinal cord stimulation
• Peripheral nerve stimulation
• Deep brain stimulation

Interventional Procedures

• Nerve blocks
• Radiofrequency ablation
• Intrathecal drug delivery systems

What is the success rate of spinal cord stimulation for neuropathic pain. Spinal cord stimulation (SCS) has shown promising results in managing refractory neuropathic pain, with success rates varying depending on the specific condition and patient factors. Studies have reported that 50-70% of carefully selected patients experience significant pain relief with SCS. Success is often defined as a 50% or greater reduction in pain intensity. However, it’s important to note that SCS is typically considered after other treatments have failed and requires a thorough evaluation to determine candidacy.

Living with Neuropathic Pain: Coping Strategies and Support

Coping with chronic neuropathic pain extends beyond medical treatments. Developing effective strategies to manage daily life and maintain emotional well-being is crucial for patients.

Psychological Support

The emotional toll of chronic pain can be significant. Psychological support may include:

• Individual counseling
• Support groups
• Stress management techniques
• Depression and anxiety screening and treatment

Adaptive Techniques and Assistive Devices

Adapting daily activities and using assistive devices can help maintain independence and quality of life:

• Ergonomic workplace modifications
• Assistive devices for mobility and daily tasks
• Home safety adaptations to prevent falls

How can patients effectively communicate their neuropathic pain to healthcare providers. Effective communication about neuropathic pain is crucial for optimal treatment. Patients should keep a pain diary documenting the intensity, duration, and nature of their pain, as well as any triggers or alleviating factors. Using descriptive language and pain scales can help convey the experience more accurately. It’s also important to discuss how the pain affects daily activities and quality of life. Preparing a list of questions and concerns before appointments can ensure that all important topics are addressed during limited consultation times.

Research and Future Directions in Neuropathic Pain Management

The field of neuropathic pain research is dynamic, with ongoing efforts to develop more effective treatments and improve understanding of pain mechanisms.

Emerging Therapies

Several promising avenues are being explored in neuropathic pain research:

• Gene therapy approaches
• Stem cell treatments for nerve regeneration
• Novel pharmacological targets (e.g., sodium channel blockers)
• Advanced neuromodulation techniques

Personalized Medicine in Pain Management

The future of neuropathic pain treatment lies in personalized approaches:

• Genetic profiling to predict treatment response
• Biomarker identification for pain subtypes
• Tailored combination therapies based on individual patient characteristics

What role does artificial intelligence play in neuropathic pain research. Artificial intelligence (AI) is increasingly being applied to neuropathic pain research and management. AI algorithms can analyze large datasets to identify patterns in pain experiences, treatment responses, and underlying mechanisms. This can lead to more accurate diagnoses, personalized treatment plans, and the discovery of novel therapeutic targets. AI-powered tools are also being developed to assist in pain assessment, particularly for patients who have difficulty communicating their pain levels. Furthermore, machine learning models are being used to predict treatment outcomes and optimize pain management strategies, potentially improving the efficiency and effectiveness of clinical decision-making in neuropathic pain care.

In conclusion, neuropathic pain represents a significant challenge in modern medicine, affecting millions of individuals worldwide. Its complex nature, diverse causes, and often treatment-resistant characteristics necessitate a comprehensive and multidisciplinary approach to management. As research continues to advance our understanding of neuropathic pain mechanisms and develop innovative therapies, there is hope for improved outcomes and quality of life for those affected by this condition. Patients and healthcare providers must work collaboratively, leveraging both established treatments and emerging strategies to effectively manage neuropathic pain and its impact on daily life.

Neuropathic Pain: Causes, Symptoms, and Treatment

People with neuropathic pain may experience shooting, burning pain. The pain may be constant or occur intermittently. A feeling of tingling, numbness, or a loss of sensation is also common.

Neuropathic is usually caused by a chronic, progressive nerve disease, although it can also occur as the result of injury or infection.

If you have chronic neuropathic pain, it can flare up at any time without an obvious pain-inducing event or factor. Acute neuropathic pain, while uncommon, can occur as well.

Typically, non-neuropathic pain (nociceptive pain) is due to an injury or illness. For example, if you drop a heavy book on your foot, your nervous system sends signals of pain immediately after the book hits.

With neuropathic pain, the pain isn’t typically triggered by an event or injury. Instead, the body just sends pain signals to your brain unprompted. Neuropathic pain tends to get worse over time.

About 1 in 3 Americans experience chronic pain. Of those, 1 in 5 experience neuropathic pain.

A 2014 study estimated that as many as 10 percent of Americans experience some form of neuropathic pain.

Understanding the possible causes can help you find better treatments and ways to prevent the pain from getting worse over time.

The most common causes for neuropathic pain can be divided into four main categories: disease, injury, infection, and loss of limb.

Disease

Neuropathic pain can be a symptom or complication of several diseases and conditions. These include multiple sclerosis, multiple myeloma, and other types of cancer.

Not everyone with these conditions will experience neuropathic pain, but it can be an issue for some.

Diabetes is responsible for 30 percent of neuropathic cases, according to the Cleveland Clinic. Chronic diabetes can impact how your nerves work.

People with diabetes commonly experience loss of feeling and numbness, following by pain, burning, and stinging, in their limbs and digits.

Long-term excessive alcohol intake can cause many complications, including chronic neuropathic pain. Damage to nerves from chronic alcohol use can have long-lasting and painful effects.

Trigeminal neuralgia is a painful condition with severe neuropathic pain of one side of the face. It’s one of the more common types of neuropathic pain and it can occur without a known reason.

Lastly, cancer treatment may cause neuropathic pain. Chemotherapy and radiation can both impact the nervous system and cause unusual pain signals.

Injuries

Injuries to tissue, muscles, or joints are an uncommon cause of neuropathic pain. Likewise, back, leg, and hip problems or injuries can cause lasting damage to nerves.

While the injury may heal, the damage to the nervous system may not. As a result, you may experience persistent pain for many years after the accident.

Accidents or injuries that affect the spine can cause neuropathic pain, too. Herniated discs and spinal cord compression can damage the nerve fibers around your spine.

Infection

Infections rarely cause neuropathic pain.

Shingles, which is caused by reactivation of the chicken pox virus, can trigger several weeks of neuropathic pain along a nerve. Postherpetic neuralgia is a rare complication of shingles, involving persistent neuropathic pain.

A syphilis infection can also lead to the burning, stinging unexplained pain. People with HIV may experience this unexplained pain.

Limb loss

An uncommon form of neuropathic pain called phantom limb syndrome can occur when an arm or leg has been amputated. Despite the loss of that limb, your brain still thinks it’s receiving pain signals from the removed body part.

What’s actually happening, however, is that the nerves near the amputation are misfiring and sending faulty signals to your brain.

In addition to arms or legs, phantom pain may be felt in the fingers, toes, penis, ears, and other body parts.

Other causes

Other causes of neuropathic pain include:

• vitamin B deficiency
• carpal tunnel syndrome
• thyroid problems
• facial nerve problems
• arthritis in the spine

Each person’s symptoms of neuropathic pain may vary slightly, but these symptoms are common:

• shooting, burning, or stabbing pain
• tingling and numbness, or a “pins and needles” feeling
• spontaneous pain, or pain that occurs without a trigger
• evoked pain, or pain that’s caused by events that are typically not painful — such as rubbing against something, being in cold temperatures, or brushing your hair
• a chronic sensation of feeling unpleasant or abnormal
• difficulty sleeping or resting
• emotional problems as a result of chronic pain, loss of sleep, and difficulty expressing how you’re feeling

A goal of neuropathic pain treatment is to identify the underlying disease or condition that’s responsible for the pain, and treat it, if possible.

An important goal is that your doctor will aim to provide pain relief, help you maintain typical capabilities despite the pain, and improve your quality of life.

The most common treatments for neuropathic pain include:

Over-the-counter pain medication

Nonsteroidal anti-inflammatory drugs (NSAIDs), such as Aleve and Motrin, are sometimes used to treat neuropathic pain.

However, many people find these medicines aren’t effective for neuropathic pain because they don’t target the source of the pain.

Prescription medication

Opioid pain medications don’t usually reduce neuropathic pain as well as they reduce other types of pain. Plus, doctors may hesitate to prescribe them for fear that a person may become dependent.

Topical pain relievers can be used, too. These include lidocaine patches, capsaicin patches, and prescription-strength ointments and creams.

Antidepressant drugs

Antidepressant medications have shown great promise in treating symptoms of neuropathic pain.

Two common types of antidepressant drugs are prescribed to people with this condition:

• tricyclic antidepressants
• serotonin-norepinephrine reuptake inhibitors

These may treat both the pain and symptoms of depression or anxiety caused by chronic pain.

Anticonvulsants

Anti-seizure medications and anticonvulsants are often used to treat neuropathic pain. Gabapentinoids are most commonly prescribed for neuropathic pain.

It’s not clear why anti-seizure drugs work for this condition, but researchers believe the medications interfere with pain signals and stop faulty transmissions.

Nerve blocks

Your doctor may inject steroids, local anesthetics, or other pain medications into the nerves that are thought to be responsible for the wayward pain signals. These blocks are temporary, so they must be repeated in order to keep working.

Implantable device

This invasive procedure requires a surgeon to implant a device in your body. Some devices are used in the brain and some are used in the spine.

Once a device is in place, it can send electrical impulses into the brain, spinal cord, or nerves. The impulses may stop the irregular nerve signals and control symptoms.

These devices are typically used only in individuals who haven’t responded well to other treatment options.

Lifestyle treatments

Physical, relaxation, and massage therapies are all used to relieve symptoms of neuropathic pain. These forms of treatment can help ease muscles.

Your healthcare provider can also teach you ways to cope with your pain.

For example, some people with neuropathic pain may experience increased symptoms after sitting for several hours. This might make desk jobs difficult to perform.

A physical therapist or occupational therapist can teach you techniques for sitting, stretching, standing, and moving to prevent pain.

If your doctor is able to identify an underlying cause for the neuropathic pain, treating it may reduce and even eliminate the pain.

For example, diabetes is a common cause of neuropathic pain. Proper diabetes care — which includes a healthy diet and regular exercise — may eliminate or reduce neuropathic pain.

Taking care of blood sugar levels can also prevent worsening pain and numbness.

Multimodal therapy

A multipronged approach can be an effective way to manage the condition.

A combination of medications, physical therapy, psychological treatment, and even surgery or implants may be used to bring about the best results.

Neuropathic pain can negatively impact your life if you don’t take steps to treat it and prevent worsening symptoms.

Over time, this can lead to serious disability and complications, including depression, problems sleeping, anxiety, and more.

Fortunately, researchers are learning more about why this condition develops and what can be done to effectively treat it. That’s leading to better treatment options.

Finding the correct treatment options for you can take time, but you and your doctor can work together to find relief from the symptoms of this painful condition.

Intercostal muscle strain: Signs, treatments, and remedies

We include products we think are useful for our readers. If you buy through links on this page, we may earn a small commission Here’s our process.

Medical News Today only shows you brands and products that we stand behind.

Our team thoroughly researches and evaluates the recommendations we make on our site. To establish that the product manufacturers addressed safety and efficacy standards, we:

• Evaluate ingredients and composition: Do they have the potential to cause harm?
• Fact-check all health claims: Do they align with the current body of scientific evidence?
• Assess the brand: Does it operate with integrity and adhere to industry best practices?

We do the research so you can find trusted products for your health and wellness.

Read more about our vetting process.

Was this helpful?

Intercostal muscle strain is an injury affecting the muscles between two or more ribs. Symptoms include sharp, direct pain, stiffness, and mobility difficulties.

The intercostal muscles have different layers that are attached to the ribs to help build the chest wall and assist in breathing. When an intercostal muscle gets twisted, strained, or stretched too far, it can tear, causing intercostal muscle strain.

In this article, we examine the signs of an intercostal muscle strain, and how to tell one apart from other upper body pains and injuries. We also look at the causes and treatment options for these strains.

Share on PinterestSymptoms of intercostal muscle strain may include sharp upper back pain, tension in muscles, muscle spasms, and severe and sudden pain.

The signs and symptoms of an intercostal muscle strain can differ slightly, depending on their cause. Symptoms may include:

• sharp upper back and rib pain
• severe and sudden pain, particularly if caused by a blow to the chest or back
• gradual worsening pain after repetitive movement, such as rowing, swimming, or other physical exercises
• stiffness and tension in muscles, causing upper back pain
• muscle rigidity when bending or twisting the upper body
• worsening pain when coughing, sneezing, or breathing in deeply
• spasms of the intercostal muscles
• tenderness in the area between the ribs

Intercostal muscle strain vs.

other upper body pains

The upper back is rarely injured because it is relatively immobile. If this area is the cause of pain, it is often due to long-term poor posture. It can also be due to a severe injury that has weakened the sturdiness of the upper spine, such as a car accident.

Pain due to upper back injuries is usually felt as a sharp, burning pain in one spot. The pain can spread to the shoulder, neck, or elsewhere in the upper body, and it may come and go.

Intercostal muscle strain is almost always the result of some event, such as overexertion or injury. In contrast, the initial source of pain from pneumonia or other lung disorders is difficult to pinpoint.

If the specific area of discomfort can be located, such as between the ribs, this indicates the pain is not coming from the lungs or the upper back. Lung pain is usually described as sharp and spreading outward.

When a rib is fractured, the pain is usually much more severe than that of intercostal muscle strain.

The following symptoms may signal a rib fracture:

• feeling breathless
• a protrusion or a sharp stabbing sensation in the rib area
• an area around the ribs that is extremely tender to touch

A fractured rib is a medical emergency requiring immediate attention.

Share on PinterestA direct blow to the ribcage may cause intercostal muscle strain.

Routine activities are not usually the cause of intercostal muscle strain. These strains most often occur as the result of an injury or overexertion of the muscles.

Common causes include:

• a direct blow to the rib cage, such as from a fall or car accident
• an impact blow from contact sports, such as hockey or football
• twisting the torso beyond its normal range of motion
• twisting while lifting weights
• forceful twisting, such as from golf or tennis
• twisting from specific yoga postures or dance positions
• reaching overhead, for example, when painting a ceiling
• lifting any heavy object above shoulder height
• prolonged overhead reaching
• repetitive forceful movements, such as hitting a tennis ball

A sudden increase in physical activity can also lead to an intercostal muscle strain. This is the case particularly when muscles are weakened by a lack of exercise or poor posture.

The time to see the doctor depends on the severity of the injury. A mild injury may result in a low level of pain and stiffness that goes away within a few days.

It is advisable to see a doctor if the pain is severe, lasts for more than a few days, or interferes with sleep or daily activities.

If a traumatic injury, such as a fall or an automobile accident, has occurred, or breathing is difficult, immediate medical attention is needed.

Diagnosing intercostal muscle strain involves a physical exam. The aim is to check for any limitations of movement and assess areas that are tender. The doctor will also ask about any recent injuries or sports involvement.

An X-ray or MRI scan may be ordered if the doctor rules out internal injuries, such as a fractured rib.

Share on PinterestPhysical therapy treatment, such as foam roller stretches, may be recommended for intercostal muscle strain.

Home treatment may be all that is required if the injury that causes an intercostal muscle strain is not severe and symptoms are mild. Home treatment options include the following:

• Applying an ice pack or cold pack, followed by heat therapy. Heat therapy options include a warm bath, heating pads, or adhesive heat wraps. Cold packs and heating pads are available for purchase online.
• Resting and limiting all physical activity for a few days to allow time for the muscle strain to recover.
• Taking pain medications to reduce swelling and pain. Some pain medications can be purchased over the counter or online, including acetaminophen or ibuprofen.
• Splinting the area if breathing is painful by holding a pillow against the injured muscle. However, difficulty breathing means medical attention must be obtained right away.

In addition to the home remedies described above, the doctor may order the following:

• muscle relaxants for severe pain and spasms
• physical therapy (PT)
• injection of lidocaine and corticosteroids to reduce pain and swelling if other treatments fail

Physical therapy

PT may involve various stretches to strengthen intercostal muscles, foam roller stretches, and deep breathing exercises.

If difficult or painful breathing occurs, deep breathing exercises are often ordered to improve a person’s shallow breathing. Long-term shallow breathing can lead to complications, such as pneumonia.

A person with intercostal muscle strain should not do any stretching exercise unless under the supervision of a physical therapist or other healthcare providers.

Stretching should be stopped immediately if it increases pain or makes symptoms worse.

Mild intercostal muscle strain commonly heals within a few days. Moderate strains may take 3 to 7 weeks to heal, and severe strains that involve a complete tear of the muscles can take longer.

In general, most intercostal muscle sprains should heal within a 6-week time span.

Prevention of future muscle strains involves warming up and stretching before strenuous exercises are performed. It is important not to overdo it when it comes to working out or taking part in sports.

Keeping muscles strong also helps with the prevention of intercostal muscle strain.

Intercostal neuralgia – causes, symptoms, treatment of intercostal neuralgia in Moscow at Spina Zdorova clinic

What is intercostal neuralgia?

Let’s start with the fact that intercostal neuralgia is not a disease. This is the name of the pain that occurs when the intercostal nerves are exposed to various pathological factors, for example, herpes infection, tumors, injuries, disc herniation, protrusion, osteochondrosis, etc. In other words, not any chest pain can be called thoracic intercostal neuralgia, but only that where the intercostal nerves are involved. And this must be clearly understood so that there is no confusion that you often encounter at the everyday level, when you hear how people use the term intercostal neuralgia, but at the same time, they mean a completely different pathology. By the way, even some doctors sometimes make a diagnosis of intercostal neuralgia erroneously, while in fact it most often turns out to be a myofascial syndrome.

Intercostal neuralgia, myalgia, myositis, myofascial syndrome, osteochondrosis, disc herniation, protrusion and many other terms are not synonyms. These are the names of specific pathologies that have their own characteristics and differences. And, since they are different, then the approach to them must also be different, otherwise there will be no sense in the treatment.

In general, the term intercostal neuralgia should not be used haphazardly, and it is not worth calling all pains in this area that way.

Intercostal neuralgia in women & Intercostal neuralgia in men.

Intercostal neuralgia in men is as common as in women, but at the same time, intercostal neuralgia in women has its own characteristics. For example, women often perceive pain in intercostal neuralgia as a manifestation of mammary gland disease, and not as neuralgia. And it is clear that such thoughts can only cause additional anxiety and anxiety. But, one consolation is that although the pathology of the mammary glands is indeed common, but even if it is present, the vast majority of pain is not associated with it, but with the spine, nerves and muscles. This does not cancel periodic examinations by a mammologist, but it says that you should never panic. And most importantly, keep in mind that in medicine there is such a thing – a disease “under the mask”, when one disease is masked by another. What is the insidiousness of this problem, let’s look at our example. The pathology of the mammary glands is a psychological dominant that causes much more concern than intercostal neuralgia. Accordingly, if a woman, at the same time, has thoracic intercostal neuralgia and pathology of the mammary glands, then all her thoughts will be riveted to the glands. The rest will fade into the background. And it is quite natural that in this situation a woman, first of all, will turn to a mammologist. If a mammologist turns out to be knowledgeable, he will quickly figure out what caused the pain: glands or neuralgia. And, if neuralgia – refer the patient to a chiropractor. By the way, it is the chiropractor who is the main doctor for intercostal neuralgia (but we’ll talk about this later). And if a mammologist comes across an inexperienced or reinsurer, what will he do? Most likely, having discovered his profile pathology in the patient, he will also focus on this pathology and will not “dig” deeper. Therefore, if in reality the patient was worried about pain during intercostal neuralgia, and the pathology of the mammary glands was only a background that did not cause pain, then treatment by a mammologist will not solve the problem. The pain will remain. And this will cause a woman even more anxiety. Her faith in doctors will suffer. Time and nerves will be wasted. This is what the disease “under the mask” turns into. And, meanwhile, intercostal neuralgia in women very often occurs under the guise of pathology of the mammary glands. Be sure to remember this!

Dear women, the best advice for pain in this area is to contact two specialists at once. A mammologist will give you confidence and relieve fears, and a chiropractor will cure intercostal neuralgia. After all, as we have already said, a chiropractor is a key doctor for intercostal neuralgia. This approach is the most reasonable. It will save you both time and nerves.

Intercostal neuralgia in men also has its own characteristics, and these are not always differences. For example, psychological aspects are very similar. So, if in women intercostal neuralgia often occurs under the guise of pathology of the mammary glands, then in men – under the guise of heart disease. By the way, it is the “disguise” for heart disease that distinguishes left intercostal neuralgia from intercostal neuralgia on the right side. Do you know how to distinguish intercostal neuralgia from a heart attack at home? Very simple. Heart pain is relieved by nitroglycerin, but neuralgia is not.

According to statistics, intercostal neuralgia on the left in the region of the heart equally often causes false alarms in both men and women. Moreover, in women, both the heart and the mammary gland are “under suspicion”. And, here, the right intercostal neuralgia is “suspicious” only to women. Men immediately understand that this is intercostal neuralgia.

Symptoms of intercostal neuralgia

It is believed that the main symptom of intercostal neuralgia is pain in the intercostal space. But, how to distinguish intercostal neuralgia by one, even such a bright symptom? After all, pain in the ribs is also found in other pathologies. Obviously, more signs of intercostal neuralgia are needed for an accurate diagnosis. Therefore, we decided to talk about the symptoms and causes of intercostal neuralgia in more detail.

The name intercostal nerves speaks for itself. They are indeed located between the ribs. Starting from the spine, they cover the chest from two sides. The intercostal nerve cannot suffer from a small or even medium bruise, since it is located deep under the rib. Therefore, serious injuries, such as a fracture, can become a mechanical cause of intercostal neuralgia; a tumor that compresses the nerve, or dystrophic pathology of the spine – osteochondrosis, hernia and disc protrusion.

In addition to mechanical, there are also infectious causes of intercostal neuralgia, most often a herpes infection. Due to its characteristics, it often affects these nerves. Herpes, as a sign of intercostal neuralgia, is easily recognized by characteristic rashes that coincide with the area of ​​pain.

Thus, the causes of intercostal neuralgia are infectious and mechanical. And, here, the connection between intercostal neuralgia and respiration is a myth. Remember, at the beginning of the article we talked about the difference between real intercostal neuralgia and what many people mistakenly consider as such. For example, the appearance of intercostal neuralgia after a cold is not neuralgia at all, but a myofascial syndrome. If you are not aware, myofascial syndrome is a muscle disease in which small painful areas are formed in the muscles – trigger points. These points, for a long time, may be in a latent state and do not manifest themselves in any way. But, as soon as they are activated, pain immediately arises. The most common factor in the activation of trigger points is the overload of the affected muscles. The intercostal muscles are related to the respiratory muscles, since they are involved in the act of breathing. Cough is a forced breath. Therefore, intercostal neuralgia when coughing or after a cold is not neuralgia, as many people mistakenly think, but a myofascial syndrome provoked by an overload of the respiratory muscles from coughing. By the way, an indirect sign of how to distinguish intercostal neuralgia from myofascial syndrome is the duration of the disease. Real intercostal neuralgia is treated for a long time. Especially if it is caused by a fracture or tumor. And myofascial syndrome has a shorter treatment period. But it is impossible to say exactly how long intercostal neuralgia lasts without seeing the patient. Firstly, you need to make sure that this is intercostal neuralgia, and not some other pathology, and, secondly, it all depends on the situation. Agree, neuralgia from herpes and from a fracture will have completely different terms of treatment.

Separately, it must be said about the so-called false symptoms of intercostal neuralgia. Muscle tension, muscle twitches, increased pain when coughing, sneezing, turning the torso; forced position of the body to relieve pain, sweating, high blood pressure and a number of other symptoms are not signs of intercostal neuralgia, although they are often attributed to it. These symptoms refer to pathologies similar to neuralgia. To be able to distinguish between similar pathology is one of the main skills of the doctor, which is specially trained, and which allows the doctor to make an accurate and correct diagnosis. It remains only to recall that a doctor for intercostal neuralgia is a chiropractor, and even better, a chiropractor-neurologist.

Treatment of intercostal neuralgia

Treatment for intercostal neuralgia depends on what causes it. Statistics claim that the vast majority of pain in this area is caused by mechanical causes – pathology of the spine and muscles – osteochondrosis, disc herniation, protrusion, myalgia and myofascial syndrome. Therefore, the answer to the question of how to treat intercostal neuralgia is obvious. Since most of the causes are mechanical, then they should be eliminated mechanically. This means that the best way to treat thoracic intercostal neuralgia is manual therapy. Moreover, not ordinary, but soft manual therapy, which is not only softer, but also much more effective than simple reduction of the vertebrae. Soft manual therapy acts exceptionally gently and delicately. Its main advantage is the safe elimination of muscle clamps that “pinch” the nerve and enslave the spine. That is why the chiropractor is the main doctor for intercostal neuralgia. In cases where the problem is advanced, manual therapy can be supplemented with drugs and physiotherapy.

Treatment of intercostal neuralgia with herpetic lesions requires parallel treatment by a dermatologist. Rare and severe forms caused by fractures and tumors are high-tech and expensive medical care, which is carried out in specialized clinics under state programs.

How to relieve pain with intercostal neuralgia, if a person is far from full-fledged medicine and nearby is only a pharmacy? Pain in acute intercostal neuralgia is best relieved by the combined use of non-steroidal and steroidal anti-inflammatory drugs. But, we draw your attention – as soon as possible, see a specialist. This must be done even if the pain stops completely. It is in your interest to be sure that there is nothing more serious behind the pain and intercostal neuralgia.

Treatment of intercostal neuralgia in Moscow

Free appointment
and diagnostics

Pain relief
in 1-2 sessions

Author’s method
treatment

Internships in the USA,
Israel, Germany

A sudden attack can unbalance a person, frighten and make them wary. The pain that cuts through the chest “beats” strongly, radiates to the lumbar region or abdomen and returns to the heart. All this complements the feeling of lack of air, the inability to take a deep breath. Among all the reasons for the development of such a condition, the most likely is intercostal neuralgia, which in Greek means “pain along the course of the nerves.”

What is chest neuralgia

The disease is always accompanied by pain that goes along the intercostal nerve. Its branches run through every gap between the ribs on either side of the chest. Nervous structures of this area territorially lie down to the anterior abdominal wall. This is the main reason why sharp pain radiates to different parts of the body. It is often attributed to symptoms of diseases of the lungs, heart, stomach, liver and pancreas.

When sensory nerve fibers are damaged, pain occurs, motor – shortness of breath and breathing problems, vegetative – excessive sweating in the chest area. Experts say the pain is so intense that it’s often mistaken for a heart attack, stomach ulcer, or other serious medical condition. The main differences are:

• the doctor can feel the source of the pain;
• The discomfort is intense and lasts for hours (sometimes days).

Pathology manifests itself mainly in middle and older age. Up to this point, the disease practically does not occur.

Neuralgia on the left side of the thoracic region

Symptoms of the disease often appear on one side of the body, because of this, an attack is mistaken for a symptom of a malfunction of some internal organ. With pain on the left, it is easy to confuse the pathology with a heart attack. With intercostal neuralgia, pain in the left side of the chest is very strong. Sometimes they are supplemented by shortness of breath, which looks very much like a heart.

The most severe pain may occur below the shoulder blades, in the region of the spinal column and in the front of the chest. Unpleasant sensations often radiate very sharply to the left shoulder and arm, shooting through the limb to the very hand. Strong discomfort permeates the body with simple breaths, changing body position, coughing and talking loudly.

It becomes a little easier when a person with intercostal neuralgia leans to the healthy (in this case, to the right) side. This rotation of the torso allows you to reduce pressure on the nerve roots by expanding the intercostal spaces. When a neurologist conducts an examination, he may focus on areas with reduced sensitivity, reddening of the skin or pallor of the integument.

Signs of this kind do not cause concern in patients, but they are taken into account by the doctor for differential diagnosis. The condition does not pose a threat to life, so the therapy is carried out on an outpatient basis. In the absence of effect, a short hospitalization of the patient is possible.

Neuralgia on the right under the ribs

Right-sided pathology is less common. Pain in this area is usually not perceived as deadly, and therefore patients in most cases do not go to doctors. This behavior is not approved by experts, because discomfort can be quickly removed, it is not necessary to endure it for a long time.

In some situations, neuralgia can deprive a person of the ability to perform normal work functions. It literally paralyzes the patient, depriving him of the ability to move normally. Pain symptoms often go along the intercostal space, as if encircling the body. The slightest overexertion can bring torment. On palpation, the pain increases, acquires a shooting character.

The treatment of the disease does not differ much from the treatment of left-sided intercostal neuralgia. Of the general recommendations – sleeping on a hard mattress, avoiding large pillows, limiting exercise and various activities. Specialists prescribe corrective measures to relieve the acute stage and normalize well-being.

Free medical consultation and diagnostics

• Chiropractor
• Vertebrologist
• Osteopath
• Neurologist

At the consultation, we carry out a thorough diagnosis. As a result of the consultation
We give detailed recommendations for treatment and, if necessary, prescribe additional diagnostics.

1

Carry out functional diagnostics

2

Let’s perform a manipulation that significantly relieves pain

3

Let’s create an individual treatment program

Sign up for a free appointment

Symptoms of chest neuralgia

Intercostal neuralgia of the chest occurs due to irritation of the nerve branches of the department. It can be recognized by the following symptoms:

• pain in the side of the trunk or chest;
• persistent discomfort in the back, girdle pain backache to the thoracic region;
• when pressing on the nerve provocateur, a pain symptom develops, it grows intensively, becomes stronger when turning, bending, coughing.

Additionally, there may be numbness of the skin in the places of lumbago, muscle twitching, increased tone of muscle fibers, vegetative disorders. Since partial paralysis of the muscular corset develops in the chest, shortness of breath may occur due to compression of the lungs.

Diagnosis of thoracic neuralgia

First of all, at the appointment, the doctor collects the patient’s complaints, finds out the circumstances of the appearance of the symptoms of the disease. The specialist asks leading questions that help him identify:

• when the first symptoms of the disease appeared;
• how the pain manifests itself, how long the attack lasts, what medicines it is taken off;
• whether the patient has a history of trauma and mechanical damage to the chest;
• whether there were infectious diseases of the lungs not so long ago.

Neurological examination with palpation of the affected area is performed in the clinic’s office. To clarify the clinical picture, the patient is sent for testing. He is assigned a general blood test (CBC), which can show deviations from the norm and signs of inflammation in the body. Electrocardiography is also done to assess the electrical activity of the heart, which makes it possible to exclude pathologies in the work of the heart muscle. To exclude diseases of the stomach and esophagus, fibrogastroduodenoscopy is performed.

Treatment of intercostal neuralgia

During attacks, bed rest with placement on a hard surface, application of heat to the chest (heating pad), use of warming ointments, taking drugs with analgesic effect is recommended. When the acute moment passes, the doctor may prescribe vitamin therapy with a predominant intake of B vitamins, acupuncture, medications for inflammation, pain. Hormone-containing anti-inflammatory formulas may also be recommended.

Drug treatment

Pain relievers such as Spazgan, Spazmalgon, non-steroidal analgesics such as Diclofenac, Ibuprofen and anticonvulsants will help relieve pain during an attack of intercostal neuralgia. Antidepressants, muscle relaxants may be prescribed.

Breathing exercises are performed to relieve discomfort. It is strictly forbidden to prescribe medications on your own. The patient needs a thorough examination under the supervision of a doctor. Otherwise, taking pills and using ointments can have the opposite effect.

Physiotherapy

Physiotherapy techniques have a good effect, relieving discomfort and soreness. Microwave exposure through the energy of the electromagnetic field and darsonvalization can be cited as examples of effective therapy. The latter technique involves the use of a profile apparatus that allows you to work with high-frequency pulsed currents.

This device:

• stimulates blood circulation in the treatment area;
• activates cellular metabolism;
• anesthetizes, relieves spasmodic attacks.

At the moments of spasms, UV irradiation, UHF and UHF therapy proved to be good. Often, the patient is prescribed electrophoresis using lidocaine supplements.

If intercostal neuralgia occurs against the background of diseases of the spinal column, therapeutic mud is prescribed in the form of applications on painful areas, paraffin therapy, irradiation with Solux lamp light. By raising the body temperature in the treated areas, the doctor dilates blood vessels, improves blood supply to tissues, and enhances metabolic processes.

Manual therapy

Gentle manual treatment allows you to delicately treat painful areas of the body, restoring physiologically correct parameters of the location of internal organs and structures. As a result of the master’s work:

• the vertebrae fall into place;
• muscle tone returns to normal;
• the effect of general healing is achieved.

An experienced specialist of Dr. Length clinic quickly and accurately finds violations, immediately eliminates them, seeking to restore normal well-being.

The founder of the clinic, SVDlin, is known for his author’s methods based on the best achievements of Russian medicine and progressive Western trends. In the course of using such funds, it is possible to obtain a lasting effect that lasts as long as possible.

Material verified by an expert

Mikhailov Valeriy Borisovich

Manual therapist, vertebrologist, neurologist

Work experience – 25 years

Video reviews of patients

Joint block in the neck

Hernias in the lower back and neck

I came to Dr. Length’s clinic with spinal problems. With two intervertebral lower hernias and two intervertebral hernias in the neck. I was assigned a comprehensive 10 step program. In 4 months, my lower vertebrae completely disappeared and crunches in my neck disappeared …

Hernia of the lumbosacral region

“After the first time, my back stopped hurting. I felt relieved. Now 7 sessions have already passed and the back really does not hurt. I began to forget about it. And at first it hurt a lot.”

Inflammation of the sciatic nerve

“For 4 months I suffered from severe inflammation of the sciatic nerve on the right side. After the first visit, relief came immediately within six hours. After 6 courses, the pain was almost gone.

Pain in the lower back and leg

Yakovleva Natalya Mikhailovna
Head of the department, surgeon of the highest category, oncologist-mammologist
I want to express my deep gratitude for the fact that I was put on my feet in the truest sense of the word. I came to the clinic a month and a half ago with severe pain in the lower back and leg. These complaints were long enough and the treatment that I used in the past was ineffective. Fortunately, I ended up in the clinic of Dr. Length and his team of super professionals!

Osteochondrosis of the cervical spine

“I applied 2 months ago with osteochondrosis of the cervical spine. I have a sedentary job and my neck muscles were very cramped. It was impossible to work. Before that, I went to other doctors, but this did not solve my problem. For 2 months I have a fairly positive dynamics. Every week it gets better and better.”

Bechterew’s disease

“I have had Bechterew’s disease for 10 years. The vertebrae began to move out, I began to slouch. I turned to other chiropractors, very famous, media ones. In the end, I didn’t get any results. After 2 sessions I felt much better. Now I don’t have any pain.”

Pain in the spine

“I came in with problems in my back, cervical, thoracic and lumbar spine. I was prescribed procedures, had a massage, and was assigned to do physical education at home. This made it much easier for me. I’m already turning my head. I have no pain.”

Shoulder shoulder periarthrosis

I came to the clinic with severe pain in my shoulder. My hand did not rise, I could not sleep at night, I woke up from pain. After the first treatment session, I felt much better. Somewhere in the middle of the course, my hand began to rise, I began to sleep at night.

Osteoarthritis of the knee joint, 2nd degree

Came with a very serious illness. I could not walk, I have arthrosis of the 2nd degree of the knee joint. I went through a course of treatment at the Clinic and now I am going 100%.

Herniated disc

“I came to the clinic after I had back pain and it turned out to be a herniated disc. I went to other places, but they only relieved attacks of pain. Hope for a return to normal life was given only by Sergei Vladimirovich, his golden hands!

Scoliosis

“Since I was a teenager, I have suffered from scoliosis in the thoracic region. I felt a feeling of discomfort, tension, periodic pain in the spine. I turned to various specialists, a massage therapist, an osteopath, but I did not feel a strong effect. After treatment, Length S.V. I almost have a straight spine. Currently, I do not feel any problems and discomfort.”

Intervertebral hernia

“At the 5th-6th session there was an improvement. I felt much better. The pain is gone. Improvement progressed more and more each time. Lesson 10 today. I feel great.”

Pain in the lumbar and cervical region

“I am 21 years old. I went to the clinic with discomfort in the lumbar and cervical region. I also sometimes had sharp pains. After undergoing therapy, I felt a significant improvement in my back. I have no pain. The condition as a whole has improved.”

Back pain

“At the beginning of the path of treatment, my back hurt very badly. I could no longer walk. I take 5 steps and stop. My entire journey consisted of such stops. In the very first procedure, I left the office with no pain in my spine. ”

Cervical hernia

“I came in with a problem in my neck and my right arm was very sore. The neck did not turn, the hand did not rise. After the 3rd session, I felt better. After the 5th, all this pain began to decrease. It turns out I have 2 hernias in my cervical vertebrae. After the sessions, I did an MRI and one hernia decreased. Now he began to move, his hand earned.

Pain in the neck

“I went to Dr. Long because I had a very bad pain in my neck on the right side. I fell on a snowboard 5 years ago, even went to an osteopath, but somehow it didn’t really help. Now everything is fine, there are some consequences left, the muscles were spasmodic. When I came, I had steel muscles, now my neck is very soft.”

Pain in the thoracic region

“I came to the clinic with back pain, namely in the thoracic region. After 10 sessions of treatment, I could already calmly go about my usual business, stay at work until lunch, without howling in pain. Now I’ve come back for an adjustment after 2 months.