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Rib pain from shingles: Shingles Treatment, Causes, Pictures & Symptoms

Intercostal Neuralgia: Overview and More

Intercostal neuralgia is neuropathic pain in the intercostal nerves, the nerves arising from the spinal cord, just below the ribs. Intercostal neuralgia often causes thoracic (upper back) pain that radiates into the chest wall and the upper trunk. Intercostal neuralgia is also known as chest wall pain.

Here is what you need to know about intercostal neuralgia, including symptoms, potential causes, diagnosis, treatment, and prevention.

Verywell / Julie Bang

Intercostal Neuralgia Symptoms 

The main symptom experienced by people with intercostal neuralgia is pain in the rib cage area. People who experience this type of rib pain may describe the pain as stabbing, sharp, tender, aching, gnawing, burning, and/or spasm-like.

Pain may cover the entire chest or radiate from the back towards the chest. Sometimes, a person may feel pain along the length of the ribs. Pain episodes tend to be sporadic and may intensity with activity, including lifting, turning and twisting the torso, coughing, sneezing, or laughing. 

Other symptoms of intercostal neuralgia may include: 

  • Abdominal pain
  • Fever
  • Itchiness
  • Numbness
  • Tingling
  • Restricted mobility of shoulders and back
  • Pain in the arms, shoulders, or back 

When To Call Your Doctor 

There are times when rib and chest pain may indicate a life-threatening condition. Intercostal neuralgia can cause severe and debilitating pain that makes it hard to breathe. Sometimes, rib cage pain or chest area pain can be a sign of a condition that may require emergency medical treatment. For example, chest pain may indicate a heart attack.

Seek immediate medical attention or call 911 if you or someone you are with starts to have chest pain that is severe and of an unknown cause.

Other symptoms that may indicate a medical emergency include: 

  • Chest or rib pain that spreads into the left arm, jaw, shoulder, or back
  • Chest pressure or tightening in the chest
  • Coughing up yellow-green colored mucus
  • Heart palpitations or a fluttering feeling in the chest
  • Breathing problems, such as shortness of breath or inability to take a full breath
  • Severe abdominal pain
  • Severe chest pain with breathing or coughing
  • Sudden confusion or dizziness, or changes in consciousness, such as passing out or unresponsiveness

Causes

Intercostal neuralgia is caused by inflammation and irritation in or compression of the intercostal nerves.

Causes of Intercostal nerve pain include:

  • Chest trauma, such as a broken rib or bruised chest
  • Viral infections, such as shingles
  • Intercostal nerve entrapment
  • Neuritis (inflammation of a nerve or group of nerves)
  • A surgical complication of a procedure that involved opening the chest to access the throat, lungs, heart, or diaphragm
  • A tumor in the chest or abdomen pressing on the intercostal nerves—these tumors can be benign (not cancer) or cancerous
  • A pulled or strained muscle in the chest wall, shoulders, or back

Sometimes, intercostal neuralgia has no known cause. If your doctor is unable to determine a case, you may be diagnosed with idiopathic intercostal neuralgia. The term “idiopathic” is used to describe medical conditions that have no identifiable or clear cause.

Risk Factors

There are a number of risk factors that increase the chance of developing intercostal neuralgia.

Risk factors include:

  • Infection with the varicella-zoster virus, the virus known for causing chickenpox and shingles
  • Participation in high speed or contact sports, such as skiing, snowboarding, football, and wrestling
  • Unsafe driving and automobile accidents, which may lead to injury to the intercostal nerves or ribs
  • Having a condition that causes systemic inflammation, such as inflammatory arthritis

Diagnosis

The majority of people with intercostal neuralgia first seek medical care because they think they may be having a heart attack or other cardiac problem.

The physical exam is an important part of the intercostal neuralgia diagnosis. This involves inspecting the area where the intercostal nerves are located. Pain produced from simple light pressure can help to assess the extent of pain.

To rule out other potential causes of chest wall pain, rib pain, or back pain, additional testing will be done. This will help your doctor to determine if the intercostal nerves are the source of pain or to diagnose other causes of chest pain, such as lung or cardiovascular disease.

Other tests to help evaluate causes of pain related to the intercostal nerves include:

  • Chest X-ray: Can look for sources of chest, rib, and back pain and find problems in the airways, bones, heart, or lungs.
  • Nerve conduction velocity testing: Assesses nerve damage and dysfunction.
  • Electromyography: Evaluates the muscles and nerve cells that control them.
  • Musculoskeletal ultrasound: This musculoskeletal imaging technique involves more in-depth imaging than traditional X-rays or other imaging studies.

If you have risk factors for heart disease, such as diabetes, high blood pressure, a history of smoking, or a family history of heart disease, your doctor will want to test your heart function. 

Testing may include:

  • Exercise stress testing: Sometimes called a treadmill test, this test helps your doctor figure out how much the heart can handle with exertion. As the body works harder, it needs more oxygen so it must pump more blood. The stress test can show if the blood supply to the arteries supporting the heart is reduced.
  • Electrocardiogram: An electrocardiogram is a simple, painless test that measures the electrical activity of the heart.
  • Echocardiography: This test uses sound waves to produce live images of the heart to allow your doctor to figure out how your heart and its valves are functioning.
  • Bloodwork: Measures levels of certain cardiac enzymes. If cardiac enzymes are increased, this may indicate a problem with the heart.

Treatment

Treatment for intercostal neuralgia may depend on the underlying cause, but it is possible for symptoms to resolve without treatment. 

Treatments for intercostal neuralgia include:

  • Intercostal nerve blocks: Injections of either a local anesthetic or a corticosteroid given around the affected intercostal nerves
  • Nonsteroidal anti-inflammatory drugs (NSAIDs): NSAID pain relievers, such as Advil (ibuprofen), and Aleve (naproxen) can help reduce inflammation and pain. 
  • Radiofrequency ablation: This treatment is usually offered to people who experience frequent episodes of intercostal nerve pain. It involves destroying the specific part of the nerve that is causing pain and other symptoms of intercostal neuralgia.
  • Anti-depressants: The drugs have been found to be helpful for reducing and treating nerve pain.
  • Capsaicin cream: Can help with pain relief
  • Neuropathic pain medication: Medications, such as Neurontin (gabapentin), can be used to block the action of nerves causing pain.

Your doctor may also recommend complementary therapies, such as acupuncture, massage therapy, and yoga, to help manage your symptoms. These therapies are to be used in conjunction with traditional treatments, and not as lone therapies or as substitutes for medicinal therapies.

Prevention

Some healthy lifestyle habits may prevent intercostal neuralgia and reduce your risk of developing the condition. 

Things you can do to reduce your risk are:

  • Driving motor vehicles safely and wearing a seatbelt
  • Getting vaccinated for chickenpox
  • Getting vaccinated for herpes or shingles if you are age 60 and older
  • Wearing protective sports equipment, including helmets and padding
  • Working with your doctor to manage symptoms of an inflammatory disease

A Word From Verywell

Intercostal neuralgia varies from person to person. Your doctor is in the best position to explain what to expect and how treatment can help. Untreated pain—regardless of the location or source—can lead to complications, including sleep problems, loss of appetite, or mood disorders, such as anxiety and depression.

If you find treatments aren’t helping to manage symptoms of intercostal neuralgia, ask your doctor about a referral to a pain management specialist. A specialist can work with you to come up with a pain relief solution that is safe and helps to manage your pain.

Lasting pain after shingles – InformedHealth.org

Pain that continues for a long time after a shingles rash has disappeared is called post-herpetic neuralgia. This is the most common complication of shingles. It’s still not clear how it can be prevented or what the best treatment is.

Shingles typically causes a rash accompanied by pain in the affected area. The pain normally goes away when the rash goes away. This usually happens after two to four weeks. Pain that continues for longer is referred to as post-herpetic neuralgia. The word “post-herpetic” means “post-herpes” because the pain arises after infection by the herpes zoster (shingles) virus. In very rare cases pain can come back after a shingles infection, even if it had already gone away and the rash has disappeared.

The main symptom of post-herpetic neuralgia is pain in the nerves (neuralgia). The skin is often overly sensitive and itchy as well. This can make it difficult or painful to wash yourself, turn over in bed, or hug someone. The pain and itching can be very severe and might keep you from sleeping.

What increases the risk of long-lasting pain?

The risk of developing post-herpetic neuralgia increases with age. Four weeks after getting shingles,

Women seem to be more likely to have longer-lasting nerve pain than men. Post-herpetic neuralgia is also more likely to develop if your eyes were affected by shingles.

Can post-herpetic neuralgia be prevented?

People who have a severe case of shingles or who are at a higher risk of developing complications are often advised to take antiviral (virus-fighting) drugs to try to prevent post-herpetic neuralgia.

Several studies have tested whether antiviral therapy can actually prevent long-lasting nerve pain. They showed that treatment with the antiviral drug aciclovir did not prevent post-herpetic neuralgia: The same number of people still had pain both 4 and 6 months after having shingles – regardless of whether they had taken aciclovir or a fake drug (placebo).

There’s not enough research on the other antiviral drugs brivudine, famciclovir and valaciclovir to be able to say whether they can prevent post-herpetic neuralgia.

In rare cases, preventive treatment with steroids is also recommended. Steroids can be taken in the form of tablets or injected into a muscle. But research has shown that this also doesn’t have any advantages over treatment with a placebo.

How is post-herpetic neuralgia treated?

Lasting nerve pain can be treated in different ways:

  • with anticonvulsants (anti-epileptic drugs),

  • painkillers,

  • antidepressants (anti-anxiety drugs), and

  • anesthetic (pain-numbing) patches.

Anticonvulsants like pregabalin or gabapentin are often used for persistent nerve pain. It takes a while for them to start working, so they are combined with painkillers to start off with. The treatment with painkillers can then be stopped.

If the anticonvulsants don’t help enough, it’s possible to take antidepressants as well. Both drugs reduce the transfer of pain signals to the brain and lower the sensitivity of the affected nerves.

If the pain is limited to one area of the body, patches with anesthetic drugs such as lidocaine or capsaicin could help. Studies suggest that patches with high doses of capsaicin (8%) can reduce nerve pain.

The right drug and combination will depend on how severe the pain is and how well tolerated the particular medicine is. That’s why it’s very important to describe the following to your doctor in as much detail as possible: how severe the pain is, how effective the drugs are and whether you experience any side effects.

There’s a lack of research on other types of treatments, such as acupuncture or TENS (transcutaneous electrical nerve stimulation). So it’s difficult to say for sure whether they work and how well they are tolerated.

If the pain continues despite treatment, it may be a good idea to see a specialized pain therapist or neurologist, or to contact a pain center or pain clinic.

Sources

  • IQWiG health information is written with the aim of helping
    people understand the advantages and disadvantages of the main treatment options and health
    care services.

    Because IQWiG is a German institute, some of the information provided here is specific to the
    German health care system. The suitability of any of the described options in an individual
    case can be determined by talking to a doctor. We do not offer individual consultations.

    Our information is based on the results of good-quality studies. It is written by a
    team of
    health care professionals, scientists and editors, and reviewed by external experts. You can
    find a detailed description of how our health information is produced and updated in
    our methods.

Rib Pain – Chiropractors in Newmarket, ON

Intercostal neuralgia is a condition that causes pain along the intercostal nerves. These nerves are located between your ribs. Ribs are

long, slender bones that curve around your chest to create your rib cage. The rib cage moves with every breath taken. The top 10 ribs on both sides of your body attach to your thoracic (midback) spine and breastbone (sternum). The bottom two ribs attach to the spine only. These ribs are  called the “floating” ribs. The intercostal areas between the ribs contain muscles and nerves.  Intercostal nerves can become  inflamed due to sports injuries, trauma, coughing, slips and falls, etc., resulting in intercostal neuralgia.



PAIN

Intercostal neuralgia may produce sporadic episodes of acute pain or pain that is dull and constant. The pain is often described as stabbing, tearing, sharp, spasm-like, tender, aching or gnawing. It typically feels like the pain wraps around your upper chest in a band-like pattern. The pain may intensify during exertion or with sudden movements involving the upper body, such as coughing,sneezing, or laughing. Intercostal neuralgia is often associated with injury or inflammation of the nerves, muscles, cartilage and ligaments of the rib cage and midback.  Common causes include pregnancy, chest or rib injury, surgery, obesity,   sports injury, and shingles.



SYMPTOMS

The main symptom of intercostal neuralgia is pain in the rib cage area, often described as

stabbing, sharp, spasm-like, tearing, tender,

aching or gnawing. The pain may wrap around your chest or radiate from the back toward the front of your chest in a band-like pattern. Sometimes you may feel pain uniformly along the length of your ribs. The pain is aggravated by sudden, jerky movements, and is relieved with inactivity.  Point tenderness is noticeable over the misaligned rib head, close to the spine.



TREATMENT



CHIROPRACTIC


is very effective in the treatment of Intercostal Neuralgia or rib pain.  Examination of the chest and mid back starts with light touch, hands on, palpation of the Thoracic spine, Rib cage, Sternum, and musculature in order to determine the Rib head that is involved.  Low volt TENS, ULTRASOUND, MASSAGE, is used to decrease the amount of inflammation present.  A gentle CHIROPRACTIC adjustment will restore normal mechanics and re-align the Rib with the Vertebrae.  Patients are told to rest, apply ICE to the area, avoid any physical activity for a couple of days.  Normally, Intercostal Neuralgia will subside with 3-4 CHIROPRACTIC treatments.  If the pain persists, the CHIROPRACTOR advise the patient to see their MD to rule out Shingles, and other non mechanical causes.

Chest Problems | HealthLink BC

Do you have a problem in the chest area, such as pain or an injury?

Yes

Symptoms in chest area

How old are you?

Less than 12 years

Less than 12 years

12 years or older

12 years or older

Are you male or female?

Why do we ask this question?

The medical assessment of symptoms is based on the body parts you have.

  • If you are transgender or non-binary, choose the sex that matches the body parts (such as ovaries, testes, prostate, breasts, penis, or vagina) you now have in the area where you are having symptoms.
  • If your symptoms aren’t related to those organs, you can choose the gender you identify with.
  • If you have some organs of both sexes, you may need to go through this triage tool twice (once as “male” and once as “female”). This will make sure that the tool asks the right questions for you.

Do you have only breathing problems with no other symptoms?

Do you have moderate or severe belly pain?

This is not the cramping type of pain you have with diarrhea.

Is your main symptom a cough?

Do you have any shortness of breath that is not caused by pain?

Pain may make it hurt to breathe, but this is not the same as being short of breath.

Would you describe your shortness of breath as severe, moderate, or mild?

Severe

Severe shortness of breath

Moderate

Moderate shortness of breath

Mild

Mild shortness of breath

Have you been diagnosed with angina?

Has there been a change in your angina over the past week?

Yes

Change in angina in the past week

No

Change in angina in the past week

Is your treatment plan controlling the angina?

If the plan is working, it should either make the symptoms go away or get them back to the level they were at before the angina got worse.

Yes

Treatment plan is controlling symptoms

No

Treatment plan is controlling symptoms

Over the last few months, have you been getting angina more often or has it been worse than usual?

Yes

Angina occurring more often or getting worse

No

Angina occurring more often or getting worse

Have you had any symptoms that you think may have been caused by your heart?

These could include pain, pressure, or a strange feeling in the chest or a nearby area, like your neck or shoulder. Other symptoms can include shortness of breath, nausea or vomiting, or light-headedness.

Yes

Possible heart symptoms

No

Possible heart symptoms

How recently did you have these symptoms?

Within the past week

Heart-related symptoms within the past week

More than a week ago

Heart-related symptoms more than a week ago

Have you had an injury to your chest in the past 2 weeks?

Yes

Chest injury within past 2 weeks

No

Chest injury within past 2 weeks

Is there any blood in your urine?

This can happen if you get hit in the ribs or side and damage the kidneys.

Are you coughing up blood?

This means blood that is coming up from your chest or throat. Blood that is draining down from your nose into your throat (because of a nosebleed, for example) is not the same thing.

How much blood is there?

A lot of bright red blood [10 mL (2 tsp) or more]

Large amount [10 mL (2 tsp)] of bright red blood in sputum

Streaks of bright red blood

Streaks of bright red blood in sputum

Specks or spots of blood

Specks or spots of blood in sputum

Has this been going on for more than 2 days?

Yes

Specks or spots of blood in sputum for more than 2 days

No

Specks or spots of blood in sputum for more than 2 days

Do you take a medicine that affects the blood’s ability to clot, such as ASA, warfarin (such as Coumadin), enoxaparin (Lovenox), or clopidogrel (Plavix)?

These medicines can cause bleeding and can make it harder to control bleeding.

Yes

Takes medicine that affects blood’s ability to clot

No

Takes medicine that affects blood’s ability to clot

Do you have pain in your ribs or the muscles of your chest?

This type of pain may feel worse when you press on or move the area or when you take a deep breath.

How bad is the pain on a scale of 0 to 10, if 0 is no pain and 10 is the worst pain you can imagine?

8 to 10: Severe pain

Severe pain

5 to 7: Moderate pain

Moderate pain

1 to 4: Mild pain

Mild pain

Has the pain:

Gotten worse?

Pain is getting worse

Stayed about the same (not better or worse)?

Pain is unchanged

Gotten better?

Pain is getting better

Do you know what caused the pain, such as severe sneezing or coughing?

Yes

Pain is from sneezing, coughing, or other known cause

No

Pain is from sneezing, coughing, or other known cause

Has the pain lasted for more than 2 days?

Yes

Pain for more than 2 days

No

Pain for more than 2 days

Do you have pain deep in one leg?

Sudden chest pain that occurs with deep pain or swelling in one leg can be a symptom of a blood clot that has moved from the leg to the lung.

Do you think the chest problem may be causing a fever?

Do you have a new rash on only one side of your chest? The rash may be in a strip or band.

Yes

New rash on only one side

No

New rash on only one side

Have you had symptoms for more than a week?

Yes

Chest symptoms for more than a week

No

Chest symptoms for more than a week

Many things can affect how your body responds to a symptom and what kind of care you may need. These include:

  • Your age. Babies and older adults tend to get sicker quicker.
  • Your overall health. If you have a condition such as diabetes, HIV, cancer, or heart disease, you may need to pay closer attention to certain symptoms and seek care sooner.
  • Medicines you take. Certain medicines and natural health products can cause symptoms or make them worse.
  • Recent health events, such as surgery or injury. These kinds of events can cause symptoms afterwards or make them more serious.
  • Your health habits and lifestyle, such as eating and exercise habits, smoking, alcohol or drug use, sexual history, and travel.

Try Home Treatment

You have answered all the questions. Based on your answers, you may be able to take care of this problem at home.

  • Try home treatment to relieve the symptoms.
  • Call your doctor if symptoms get worse or you have any concerns (for example, if symptoms are not getting better as you would expect). You may need care sooner.

Pain in adults and older children

  • Severe pain (8 to 10): The pain is so bad that you can’t stand it for more than a few hours, can’t sleep, and can’t do anything else except focus on the pain.
  • Moderate pain (5 to 7): The pain is bad enough to disrupt your normal activities and your sleep, but you can tolerate it for hours or days. Moderate can also mean pain that comes and goes even if it’s severe when it’s there.
  • Mild pain (1 to 4): You notice the pain, but it is not bad enough to disrupt your sleep or activities.

Severe trouble breathing means:

  • You cannot talk at all.
  • You have to work very hard to breathe.
  • You feel like you can’t get enough air.
  • You do not feel alert or cannot think clearly.

Moderate trouble breathing means:

  • It’s hard to talk in full sentences.
  • It’s hard to breathe with activity.

Mild trouble breathing means:

  • You feel a little out of breath but can still talk.
  • It’s becoming hard to breathe with activity.

Shock is a life-threatening condition that may quickly occur after a sudden illness or injury.

Adults and older children often have several symptoms of shock. These include:

  • Passing out (losing consciousness).
  • Feeling very dizzy or light-headed, like you may pass out.
  • Feeling very weak or having trouble standing.
  • Not feeling alert or able to think clearly. You may be confused, restless, fearful, or unable to respond to questions.

Shock is a life-threatening condition that may occur quickly after a sudden illness or injury.

Babies and young children often have several symptoms of shock. These include:

  • Passing out (losing consciousness).
  • Being very sleepy or hard to wake up.
  • Not responding when being touched or talked to.
  • Breathing much faster than usual.
  • Acting confused. The child may not know where he or she is.

Symptoms of a heart attack may include:

  • Chest pain or pressure, or a strange feeling in the chest.
  • Sweating.
  • Shortness of breath.
  • Nausea or vomiting.
  • Pain, pressure, or a strange feeling in the back, neck, jaw, or upper belly, or in one or both shoulders or arms.
  • Light-headedness or sudden weakness.
  • A fast or irregular heartbeat.

The more of these symptoms you have, the more likely it is that you’re having a heart attack. Chest pain or pressure is the most common symptom, but some people, especially women, may not notice it as much as other symptoms. You may not have chest pain at all but instead have shortness of breath, nausea, or a strange feeling in your chest or other areas.

Seek Care Today

Based on your answers, you may need care soon. The problem probably will not get better without medical care.

  • Call your doctor today to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care today.
  • If it is evening, watch the symptoms and seek care in the morning.
  • If the symptoms get worse, seek care sooner.

Make an Appointment

Based on your answers, the problem may not improve without medical care.

  • Make an appointment to see your doctor in the next 1 to 2 weeks.
  • If appropriate, try home treatment while you are waiting for the appointment.
  • If symptoms get worse or you have any concerns, call your doctor. You may need care sooner.

Seek Care Now

Based on your answers, you may need care right away. The problem is likely to get worse without medical care.

  • Call your doctor now to discuss the symptoms and arrange for care.
  • If you cannot reach your doctor or you don’t have one, seek care in the next hour.
  • You do not need to call an ambulance unless:
    • You cannot travel safely either by driving yourself or by having someone else drive you.
    • You are in an area where heavy traffic or other problems may slow you down.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Call 911 Now

Based on your answers, you need emergency care.

Call 911 or other emergency services now.

After you call 911, the operator may tell you to chew 1 adult-strength (325 mg) or 2 to 4 low-dose (81 mg) aspirin. Wait for an ambulance. Do not try to drive yourself.

Sometimes people don’t want to call 911. They may think that their symptoms aren’t serious or that they can just get someone else to drive them. But based on your answers, the safest and quickest way for you to get the care you need is to call 911 for medical transport to the hospital.

Abdominal Pain, Age 11 and Younger

Respiratory Problems, Age 11 and Younger

Coughs, Age 12 and Older

Abdominal Pain, Age 12 and Older

Respiratory Problems, Age 12 and Older

Coughs, Age 11 and Younger

Intercostal Neuralgia | Musculoskeletal Key

Physical Examination

Physical examination of a patient with intercostal neuralgia focuses on excluding other sources of chest and abdominal pain. First, it is important to exclude cardiac and other visceral sources of pain ( Table 104.1 ). Although point tenderness is uncommon during myocardial infarction, the presence of point tenderness does not exclude significant cardiac disease. In intercostal neuralgia, there are no constitutional signs, such as fever, dyspnea, diaphoresis, or shortness of breath. Cardiopulmonary examination findings should be normal or stable if prior cardiovascular or pulmonary disease exists.

Table 104.1

Other Causes of Chest Pain

Cardiovascular

  • Myocardial ischemia

  • Pericarditis

  • Aortic dissection

Pulmonary

  • Pneumonia

  • Pneumothorax

  • Pleurisy

  • Pulmonary embolus

  • Tumor

Gastrointestinal

  • Esophageal

    • Esophagitis

    • Reflux

    • Perforation

    • Spasm

    • Cancer

  • Biliary

    • Cholelithiasis

    • Cholecystitis

    • Cholangitis

    • Colic

  • Pancreatic

  • Intestinal

    • Peptic ulcer

    • Gastritis

    • Cancer

Musculoskeletal

  • Vertebral compression fracture

  • Tietze syndrome

  • Thoracic radiculopathy

  • Thoracic disc herniation

  • Cervical disc herniation

  • Costochondritis

  • Rib fracture

  • Costovertebral pain

  • Chest contusion

  • Spondylitis

Infective
Psychiatric

  • Depression

  • Anxiety

  • Hyperventilation

Renal

  • Nephrolithiasis

  • Pyelonephritis

  • Tumor

 

Intercostal neuralgia is common after thoracotomy. However, chest pain that recurs after a pain-free period following a thoracotomy for tumor resection is likely (90%) to be due to tumor recurrence. On the other hand, pain that persists for months or years after thoracotomy is most likely (70%) intercostal neuralgia.

Once the chest pain has been determined to be neuromusculoskeletal and nonvisceral, the task becomes one of differentiation of intercostal neuralgia from thoracic radiculopathy, herpes zoster, rib fracture, costochondritis, and local contusion. History of trauma, ecchymosis, crepitus, and point tenderness over a rib suggests rib fracture. If the trauma was minor, a contusion or intercostal neuralgia may be the source of discomfort. Contusions typically improve quickly during a period of weeks and are responsive to simple analgesics, such as acetaminophen and nonsteroidal anti-inflammatory medications. In contrast, pain from intercostal neuralgia persists and can be refractory to acetaminophen, nonsteroidal anti-inflammatory drugs, and even low-dose narcotics.

Careful palpation along the thoracotomy scar or rib may reveal a neuroma with the presence of a Tinel sign. Larger neuromas can often be visualized on magnetic resonance imaging. Sensory examination often reveals a small (1 to 2 cm) band of dermatomal sensory loss.

Examination of the thoracic spine in patients with intercostal neuralgia reveals full active range of motion without tenderness. In contrast, thoracic radiculopathy may be accompanied by pain with range of motion and at times thoracic spinal tenderness. Still, pain from thoracic radiculopathy is similar in quality and distribution to intercostal neuralgia.

Intercostal neuralgia is distinct from postherpetic neuralgia (shingles), and no herpes zoster virus can be identified in cases of intercostal neuralgia. Furthermore, in most cases of shingles, the chest pain is followed within a matter of days to weeks by a vesicular, linear eruption. The more debilitating pain of postherpetic neuralgia follows the skin lesions of shingles.

Exercises for Intercostal Neuralgia | Livestrong.com

Gentle stretching can help relieve intercostal neuralgia.

Image Credit: nuiiko/iStock/GettyImages

Intercostal muscles are those that connect the rib cage and help hold the chest wall together. When you strain or pull one of these muscles, you may experience difficulty breathing or expanding the chest, as well as difficulty or pain when twisting, turning or bending. Although chest pain can be scary, intercostal neuralgia is not life-threatening.

Intercostal Neuralgia Symptoms

Peripheral nerve damage can cause intercostal neuralgia. The majority of patients feel pain associated with this condition in the upper chest muscles, under the arm and around to the back of the scapula or shoulder blade.

Pain often is intermittent, but makes the touch of cloth, skin pressure and normal daily activities such as sitting or lying difficult and painful.

Causes of Nerve Pain

Herpes zoster, or shingles, can cause postherpetic neuralgia, a chronic condition. Pain is caused by damage or destruction of nerve pathways of the sensory nerve system, also known as the peripheral nervous system.

Intercostal neuralgia also can be caused by pressure against a nerve, aftereffects of surgical procedures or traumatic injury to the chest cavity or the spine.

Intercostal Muscle Exercises

Perform stretches that lift the arms over the head or to the side to open the chest cavity and stretch intercostal muscles, vessels and nerves found between the ribs.

  • Lift the arms above the head and clasp your hands together. Gently lean to your right, holding the stretch for several moments. Return to your starting position; then lean to your left, again holding the stretch for several seconds.
  • Another stretch that may help relieve pain is to stand in a doorway, holding the jambs with your elbows bent and at a 90-degree angle to your body. With your feet shoulder-distance apart, lean slightly forward, feeling a stretch not only in your back between your shoulder blades, but along the front of the chest as well. Stretch every morning and every evening, repeating a stretch between three to five times each.
  • Stretching exercises followed by massage may help relieve pain in the torso and pain associated with a pinched or compressed nerve. Massage exercises such as pressing on the inferior or insides of the side of the chest just below the clavicle may help relieve pain caused by compressed nerves.

Read more: Intercostal Muscle Stretches

Sit Up Straight

You may find some relief from intercostal neuralgia through exercises that help improve your posture. Standing straight, shoulders pulled back and pelvis tucked slightly under may help.

Open the rib cage and stretch intercostal muscles by placing your arms at your side, elbows touching your body. Extend your hands outward until your fists are even with your body. Gently press your hands behind you, trying to touch your shoulder blades together. Press your hands backward in small motions 10 to 20 times. Repeat this exercise throughout the day or at the least in the morning and evening to release tension and help with pain relief.

Other Neuralgia Interventions

Intercostal neuralgia is also medically treated with pain medications, nerve block injections, biofeedback and local application of heat or ice.

Read more: Therapy for Intercostal Muscles

Intercostal Neuralgia Article

[1]

Williams EH,Williams CG,Rosson GD,Heitmiller RF,Dellon AL, Neurectomy for treatment of intercostal neuralgia. The Annals of thoracic surgery. 2008 May;     [PubMed PMID: 18442581]

[2]

Samlaska S,Dews TE, Long-term epidural analgesia for pregnancy-induced intercostal neuralgia. Pain. 1995 Aug;     [PubMed PMID: 8545151]

[3]

Keller SM,Carp NZ,Levy MN,Rosen SM, Chronic post thoracotomy pain. The Journal of cardiovascular surgery. 1994 Dec;     [PubMed PMID: 7775532]

[4]

Santos PS,Resende LA,Fonseca RG,Lemônica L,Ruiz RL Jr,Catâneo AJ, Intercostal nerve mononeuropathy: study of 14 cases. Arquivos de neuro-psiquiatria. 2005 Sep;     [PubMed PMID: 16258655]

[6]

Peng Z,Li H,Zhang C,Qian X,Feng Z,Zhu S, A retrospective study of chronic post-surgical pain following thoracic surgery: prevalence, risk factors, incidence of neuropathic component, and impact on qualify of life. PloS one. 2014;     [PubMed PMID: 24587187]

[7]

Maguire MF,Ravenscroft A,Beggs D,Duffy JP, A questionnaire study investigating the prevalence of the neuropathic component of chronic pain after thoracic surgery. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 2006 May;     [PubMed PMID: 16581259]

[9]

Perttunen K,Tasmuth T,Kalso E, Chronic pain after thoracic surgery: a follow-up study. Acta anaesthesiologica Scandinavica. 1999 May;     [PubMed PMID: 10342006]

[10]

Steegers MA,Snik DM,Verhagen AF,van der Drift MA,Wilder-Smith OH, Only half of the chronic pain after thoracic surgery shows a neuropathic component. The journal of pain : official journal of the American Pain Society. 2008 Oct;     [PubMed PMID: 18632308]

[11]

Kalso E,Perttunen K,Kaasinen S, Pain after thoracic surgery. Acta anaesthesiologica Scandinavica. 1992 Jan;     [PubMed PMID: 1539485]

[12]

Gotoda Y,Kambara N,Sakai T,Kishi Y,Kodama K,Koyama T, The morbidity, time course and predictive factors for persistent post-thoracotomy pain. European journal of pain (London, England). 2001;     [PubMed PMID: 11394926]

[13]

Rogers ML,Duffy JP, Surgical aspects of chronic post-thoracotomy pain. European journal of cardio-thoracic surgery : official journal of the European Association for Cardio-thoracic Surgery. 2000 Dec;     [PubMed PMID: 11113680]

[14]

Bayman EO,Brennan TJ, Incidence and severity of chronic pain at 3 and 6 months after thoracotomy: meta-analysis. The journal of pain : official journal of the American Pain Society. 2014 Sep;     [PubMed PMID: 24968967]

[15]

Beuerlein KG,Strowd LC, Multidermatomal herpes zoster: a pain in the neck? Dermatology online journal. 2019 Nov 15;     [PubMed PMID: 32045156]

[16]

Gershon AA,Gershon MD,Breuer J,Levin MJ,Oaklander AL,Griffiths PD, Advances in the understanding of the pathogenesis and epidemiology of herpes zoster. Journal of clinical virology : the official publication of the Pan American Society for Clinical Virology. 2010 May;     [PubMed PMID: 20510263]

[17]

Forbes HJ,Thomas SL,Smeeth L,Clayton T,Farmer R,Bhaskaran K,Langan SM, A systematic review and meta-analysis of risk factors for postherpetic neuralgia. Pain. 2016 Jan;     [PubMed PMID: 26218719]

[18]

Gauthier A,Breuer J,Carrington D,Martin M,Rémy V, Epidemiology and cost of herpes zoster and post-herpetic neuralgia in the United Kingdom. Epidemiology and infection. 2009 Jan;     [PubMed PMID: 18466661]

[19]

Yawn BP,Saddier P,Wollan PC,St Sauver JL,Kurland MJ,Sy LS, A population-based study of the incidence and complication rates of herpes zoster before zoster vaccine introduction. Mayo Clinic proceedings. 2007 Nov;     [PubMed PMID: 17976353]

[20]

Arvin A, Aging, immunity, and the varicella-zoster virus. The New England journal of medicine. 2005 Jun 2;     [PubMed PMID: 15930416]

[21]

Jeon YH, Herpes Zoster and Postherpetic Neuralgia: Practical Consideration for Prevention and Treatment. The Korean journal of pain. 2015 Jul;     [PubMed PMID: 26175877]

[22]

Johnson BH,Palmer L,Gatwood J,Lenhart G,Kawai K,Acosta CJ, Annual incidence rates of herpes zoster among an immunocompetent population in the United States. BMC infectious diseases. 2015 Nov 6;     [PubMed PMID: 26546419]

[24]

Devor M, Sodium channels and mechanisms of neuropathic pain. The journal of pain : official journal of the American Pain Society. 2006 Jan;     [PubMed PMID: 16426998]

[25]

Smart KM,Blake C,Staines A,Thacker M,Doody C, Mechanisms-based classifications of musculoskeletal pain: part 3 of 3: symptoms and signs of nociceptive pain in patients with low back (± leg) pain. Manual therapy. 2012 Aug;     [PubMed PMID: 22464885]

[26]

Miller KJ, Physical assessment of lower extremity radiculopathy and sciatica. Journal of chiropractic medicine. 2007 Jun;     [PubMed PMID: 19674698]

[27]

Kanner R, Diagnosis and management of neuropathic pain in patients with cancer. Cancer investigation. 2001;     [PubMed PMID: 11338889]

[28]

Benedetti F,Amanzio M,Casadio C,Filosso PL,Molinatti M,Oliaro A,Pischedda F,Maggi G, Postoperative pain and superficial abdominal reflexes after posterolateral thoracotomy. The Annals of thoracic surgery. 1997 Jul;     [PubMed PMID: 9236362]

[29]

Benedetti F,Vighetti S,Ricco C,Amanzio M,Bergamasco L,Casadio C,Cianci R,Giobbe R,Oliaro A,Bergamasco B,Maggi G, Neurophysiologic assessment of nerve impairment in posterolateral and muscle-sparing thoracotomy. The Journal of thoracic and cardiovascular surgery. 1998 Apr;     [PubMed PMID: 9576220]

[30]

Espy MJ,Teo R,Ross TK,Svien KA,Wold AD,Uhl JR,Smith TF, Diagnosis of varicella-zoster virus infections in the clinical laboratory by LightCycler PCR. Journal of clinical microbiology. 2000 Sep;     [PubMed PMID: 10970354]

[31]

Roumen RM,Scheltinga MR, [Abdominal intercostal neuralgia: a forgotten cause of abdominal pain]. Nederlands tijdschrift voor geneeskunde. 2006 Sep 2;     [PubMed PMID: 16999272]

[32]

Dietze DD Jr,Fessler RG, Thoracic disc herniations. Neurosurgery clinics of North America. 1993 Jan     [PubMed PMID: 8428158]

[33]

McGreevy K,Bottros MM,Raja SN, Preventing Chronic Pain following Acute Pain: Risk Factors, Preventive Strategies, and their Efficacy. European journal of pain supplements. 2011 Nov 11;     [PubMed PMID: 22102847]

[34]

Gottschalk A,Cohen SP,Yang S,Ochroch EA, Preventing and treating pain after thoracic surgery. Anesthesiology. 2006 Mar;     [PubMed PMID: 16508407]

[35]

Katz J,Kavanagh BP,Sandler AN,Nierenberg H,Boylan JF,Friedlander M,Shaw BF, Preemptive analgesia. Clinical evidence of neuroplasticity contributing to postoperative pain. Anesthesiology. 1992 Sep;     [PubMed PMID: 1519781]

[36]

Doyle E,Bowler GM, Pre-emptive effect of multimodal analgesia in thoracic surgery. British journal of anaesthesia. 1998 Feb;     [PubMed PMID: 9602575]

[37]

Obata H,Saito S,Fujita N,Fuse Y,Ishizaki K,Goto F, Epidural block with mepivacaine before surgery reduces long-term post-thoracotomy pain. Canadian journal of anaesthesia = Journal canadien d’anesthesie. 1999 Dec;     [PubMed PMID: 10608205]

[38]

Sentürk M,Ozcan PE,Talu GK,Kiyan E,Camci E,Ozyalçin S,Dilege S,Pembeci K, The effects of three different analgesia techniques on long-term postthoracotomy pain. Anesthesia and analgesia. 2002 Jan;     [PubMed PMID: 11772793]

[39]

Katz J,Jackson M,Kavanagh BP,Sandler AN, Acute pain after thoracic surgery predicts long-term post-thoracotomy pain. The Clinical journal of pain. 1996 Mar;     [PubMed PMID: 8722735]

[40]

Sabanathan S, Has postoperative pain been eradicated? Annals of the Royal College of Surgeons of England. 1995 May;     [PubMed PMID: 7598419]

[41]

Ochroch EA,Gottschalk A, Impact of acute pain and its management for thoracic surgical patients. Thoracic surgery clinics. 2005 Feb;     [PubMed PMID: 15707349]

[42]

Soto RG,Fu ES, Acute pain management for patients undergoing thoracotomy. The Annals of thoracic surgery. 2003 Apr;     [PubMed PMID: 12683601]

[43]

Baidya DK,Khanna P,Maitra S, Analgesic efficacy and safety of thoracic paravertebral and epidural analgesia for thoracic surgery: a systematic review and meta-analysis. Interactive cardiovascular and thoracic surgery. 2014 May;     [PubMed PMID: 24488821]

[45]

Eng J,Sabanathan S, Continuous extrapleural intercostal nerve block and post-thoracotomy pulmonary complications. Scandinavian journal of thoracic and cardiovascular surgery. 1992;     [PubMed PMID: 1287837]

[46]

Razi SS,Stephens-McDonnough JA,Haq S,Fabbro M 2nd,Sanchez AN,Epstein RH,Villamizar NR,Nguyen DM, Significant reduction of postoperative pain and opioid analgesics requirement with an Enhanced Recovery After Thoracic Surgery protocol. The Journal of thoracic and cardiovascular surgery. 2020 Apr 3;     [PubMed PMID: 32386754]

[47]

Rhodes M,Conacher I,Morritt G,Hilton C, Nonsteroidal antiinflammatory drugs for postthoracotomy pain. A prospective controlled trial after lateral thoracotomy. The Journal of thoracic and cardiovascular surgery. 1992 Jan;     [PubMed PMID: 1728708]

[48]

Clarke H,Bonin RP,Orser BA,Englesakis M,Wijeysundera DN,Katz J, The prevention of chronic postsurgical pain using gabapentin and pregabalin: a combined systematic review and meta-analysis. Anesthesia and analgesia. 2012 Aug;     [PubMed PMID: 22415535]

[49]

Finnerup NB,Attal N,Haroutounian S,McNicol E,Baron R,Dworkin RH,Gilron I,Haanpää M,Hansson P,Jensen TS,Kamerman PR,Lund K,Moore A,Raja SN,Rice AS,Rowbotham M,Sena E,Siddall P,Smith BH,Wallace M, Pharmacotherapy for neuropathic pain in adults: a systematic review and meta-analysis. The Lancet. Neurology. 2015 Feb;     [PubMed PMID: 25575710]

[50]

Sansone RA,Sansone LA, Pain, pain, go away: antidepressants and pain management. Psychiatry (Edgmont (Pa. : Township)). 2008 Dec;     [PubMed PMID: 19724772]

[51]

Sampathkumar P,Drage LA,Martin DP, Herpes zoster (shingles) and postherpetic neuralgia. Mayo Clinic proceedings. 2009 Mar;     [PubMed PMID: 19252116]

[52]

Oxman MN,Levin MJ,Johnson GR,Schmader KE,Straus SE,Gelb LD,Arbeit RD,Simberkoff MS,Gershon AA,Davis LE,Weinberg A,Boardman KD,Williams HM,Zhang JH,Peduzzi PN,Beisel CE,Morrison VA,Guatelli JC,Brooks PA,Kauffman CA,Pachucki CT,Neuzil KM,Betts RF,Wright PF,Griffin MR,Brunell P,Soto NE,Marques AR,Keay SK,Goodman RP,Cotton DJ,Gnann JW Jr,Loutit J,Holodniy M,Keitel WA,Crawford GE,Yeh SS,Lobo Z,Toney JF,Greenberg RN,Keller PM,Harbecke R,Hayward AR,Irwin MR,Kyriakides TC,Chan CY,Chan IS,Wang WW,Annunziato PW,Silber JL, A vaccine to prevent herpes zoster and postherpetic neuralgia in older adults. The New England journal of medicine. 2005 Jun 2;     [PubMed PMID: 15930418]

[53]

Hempenstall K,Nurmikko TJ,Johnson RW,A’Hern RP,Rice AS, Analgesic therapy in postherpetic neuralgia: a quantitative systematic review. PLoS medicine. 2005 Jul;     [PubMed PMID: 16013891]

[54]

Tyring S,Barbarash RA,Nahlik JE,Cunningham A,Marley J,Heng M,Jones T,Rea T,Boon R,Saltzman R, Famciclovir for the treatment of acute herpes zoster: effects on acute disease and postherpetic neuralgia. A randomized, double-blind, placebo-controlled trial. Collaborative Famciclovir Herpes Zoster Study Group. Annals of internal medicine. 1995 Jul 15;     [PubMed PMID: 7778840]

[55]

Chen N,Li Q,Yang J,Zhou M,Zhou D,He L, Antiviral treatment for preventing postherpetic neuralgia. The Cochrane database of systematic reviews. 2014 Feb 6;     [PubMed PMID: 24500927]

[56]

Whitley RJ,Weiss H,Gnann JW Jr,Tyring S,Mertz GJ,Pappas PG,Schleupner CJ,Hayden F,Wolf J,Soong SJ, Acyclovir with and without prednisone for the treatment of herpes zoster. A randomized, placebo-controlled trial. The National Institute of Allergy and Infectious Diseases Collaborative Antiviral Study Group. Annals of internal medicine. 1996 Sep 1;     [PubMed PMID: 8702088]

[57]

Kumar V,Krone K,Mathieu A, Neuraxial and sympathetic blocks in herpes zoster and postherpetic neuralgia: an appraisal of current evidence. Regional anesthesia and pain medicine. 2004 Sep-Oct;     [PubMed PMID: 15372391]

[58]

Zin CS,Nissen LM,Smith MT,O’Callaghan JP,Moore BJ, An update on the pharmacological management of post-herpetic neuralgia and painful diabetic neuropathy. CNS drugs. 2008;     [PubMed PMID: 18399710]

[59]

Sabatowski R,Gálvez R,Cherry DA,Jacquot F,Vincent E,Maisonobe P,Versavel M, Pregabalin reduces pain and improves sleep and mood disturbances in patients with post-herpetic neuralgia: results of a randomised, placebo-controlled clinical trial. Pain. 2004 May;     [PubMed PMID: 15082123]

[60]

Rowbotham M,Harden N,Stacey B,Bernstein P,Magnus-Miller L, Gabapentin for the treatment of postherpetic neuralgia: a randomized controlled trial. JAMA. 1998 Dec 2;     [PubMed PMID: 9846778]

[61]

Wu CL,Raja SN, An update on the treatment of postherpetic neuralgia. The journal of pain : official journal of the American Pain Society. 2008 Jan;     [PubMed PMID: 18166462]

[62]

Galer BS,Jensen MP,Ma T,Davies PS,Rowbotham MC, The lidocaine patch 5% effectively treats all neuropathic pain qualities: results of a randomized, double-blind, vehicle-controlled, 3-week efficacy study with use of the neuropathic pain scale. The Clinical journal of pain. 2002 Sep-Oct;     [PubMed PMID: 12218500]

[63]

Bernstein JE,Korman NJ,Bickers DR,Dahl MV,Millikan LE, Topical capsaicin treatment of chronic postherpetic neuralgia. Journal of the American Academy of Dermatology. 1989 Aug;     [PubMed PMID: 2768576]

[64]

Lin CS,Lin YC,Lao HC,Chen CC, Interventional Treatments for Postherpetic Neuralgia: A Systematic Review. Pain physician. 2019 May;     [PubMed PMID: 31151330]

[65]

Dworkin RH,Barbano RL,Tyring SK,Betts RF,McDermott MP,Pennella-Vaughan J,Bennett GJ,Berber E,Gnann JW,Irvine C,Kamp C,Kieburtz K,Max MB,Schmader KE, A randomized, placebo-controlled trial of oxycodone and of gabapentin for acute pain in herpes zoster. Pain. 2009 Apr;     [PubMed PMID: 19195785]

[66]

Derry S,Rice AS,Cole P,Tan T,Moore RA, Topical capsaicin (high concentration) for chronic neuropathic pain in adults. The Cochrane database of systematic reviews. 2017 Jan 13     [PubMed PMID: 28085183]

[67]

Tamburini N,Bollini G,Volta CA,Cavallesco G,Maniscalco P,Spadaro S,Qurantotto F,Ragazzi R, Capsaicin patch for persistent postoperative pain after thoracoscopic surgery, report of two cases. Journal of visualized surgery. 2018     [PubMed PMID: 29682461]

[68]

[Private contract settled: 357 kr. in graduated increases – hourly wages discontinued – supplementary time remains overtime]., Johansson H,, Vardfacket, 1978 Sep 28     [PubMed PMID: 28905362]

[69]

Weksler N,Klein M,Gurevitch B,Rozentsveig V,Rudich Z,Brill S,Lottan M, Phenol neurolysis for severe chronic nonmalignant pain: is the old also obsolete? Pain medicine (Malden, Mass.). 2007 May-Jun;     [PubMed PMID: 17610455]

[70]

Yin C,Matchett G, Intercostal administration of liposomal bupivacaine as a prognostic nerve block prior to phenol neurolysis for intractable chest wall pain. Journal of pain     [PubMed PMID: 24476569]

[71]

Kang J,Liu Y,Niu L,Wang M,Meng C,Zhou H, Anesthesia upstream of the alcoholic lesion point alleviates the pain of alcohol neurolysis for intercostal neuralgia: a prospective randomized clinical trial. Clinics (Sao Paulo, Brazil). 2020;     [PubMed PMID: 31967283]

[72]

Abd-Elsayed A,Lee S,Jackson M, Radiofrequency Ablation for Treating Resistant Intercostal Neuralgia. The Ochsner journal. 2018 Spring;     [PubMed PMID: 29559878]

[73]

Engel AJ, Utility of intercostal nerve conventional thermal radiofrequency ablations in the injured worker after blunt trauma. Pain physician. 2012 Sep-Oct;     [PubMed PMID: 22996865]

[74]

Schenk R,Donaldson M,Parent-Nichols J,Wilhelm M,Wright A,Cleland JA, Effectiveness of cervicothoracic and thoracic manual physical therapy in managing upper quarter disorders – a systematic review. The Journal of manual     [PubMed PMID: 34252013]

[75]

Locher H, [Manual medicine, manual treatment : Principles, mode of action, indications and evidence]. Der Unfallchirurg. 2021 Jun;     [PubMed PMID: 34009423]

[76]

Spaić M,Ivanović S,Slavik E,Antić B, [DREZ (dorsal root entry zone) surgery for the treatment of the postherpetic intercostal neuralgia]. Acta chirurgica Iugoslavica. 2004;     [PubMed PMID: 16018410]

[77]

Cappellari AM,Tiberio F,Alicandro G,Spagnoli D,Grimoldi N, Intercostal Neurolysis for The Treatment of Postsurgical Thoracic Pain: a Case Series. Muscle     [PubMed PMID: 29995980]

[78]

Dorsi MJ,Lambrinos G,Dellon AL,Belzberg AJ, Dorsal rhizotomy for treatment of bilateral intercostal neuralgia following augmentation mammaplasty: case report and review of the literature. Microsurgery. 2011 Jan;     [PubMed PMID: 21207497]

[79]

Wilkinson HA,Chan AS, Sensory ganglionectomy: theory, technical aspects, and clinical experience. Journal of neurosurgery. 2001 Jul;     [PubMed PMID: 11453399]

[80]

Kawai K,Gebremeskel BG,Acosta CJ, Systematic review of incidence and complications of herpes zoster: towards a global perspective. BMJ open. 2014 Jun 10     [PubMed PMID: 24916088]

[81]

Jung BF,Johnson RW,Griffin DR,Dworkin RH, Risk factors for postherpetic neuralgia in patients with herpes zoster. Neurology. 2004 May 11     [PubMed PMID: 15136679]

[82]

Pica F,Gatti A,Divizia M,Lazzari M,Ciotti M,Sabato AF,Volpi A, One-year follow-up of patients with long-lasting post-herpetic neuralgia. BMC infectious diseases. 2014 Nov 1     [PubMed PMID: 25361823]

[83]

Gabutti G,Bolognesi N,Sandri F,Florescu C,Stefanati A, Varicella zoster virus vaccines: an update. ImmunoTargets and therapy. 2019;     [PubMed PMID: 31497569]

[84]

Harpaz R,Ortega-Sanchez IR,Seward JF, Prevention of herpes zoster: recommendations of the Advisory Committee on Immunization Practices (ACIP). MMWR. Recommendations and reports : Morbidity and mortality weekly report. Recommendations and reports. 2008 Jun 6;     [PubMed PMID: 18528318]

Shingles: “adult” variant of chickenpox

The first signs of herpes zoster, or “shingles” in everyday life, do not begin with the skin, as one might assume, but with a sharp pain in the ribs, more often at chest level. Patients with this symptom are initially examined for cardiac abnormalities and neuralgia. Whereas the specific signs of the disease appear somewhat later.

Varicella variant

Few people know, but chickenpox and herpes zoster are different “masks” of the same virus.

Varicella-Zoster (or herpes type 3) in children provokes chickenpox, and in adults – more often shingles.

The peculiarity of the virus is that, when it enters the body (for example, with chickenpox in childhood), the pathogen never leaves it again. And forever remains “to live” in the nerve fibers of the infected, though already under the strict supervision of the immune forces.

With the safety and adequacy of immunity, herpes may never manifest itself again. But the weakening of the body – literally removes the protection from the “confinement cell”, and allows the virus to roam.

Signs of reactivation

The “awakened” herpes virus begins to multiply actively, provoking the immune system to “remember” its responsibilities.

This causes a classic inflammatory process, accompanied by sudden pain, often along the ribs, and after 2-3 days – reddening of the skin and the appearance of “classic” herpetic vesicles.

Bubbles open over time and can merge with each other, forming a large-scale wound surface. That, in conditions of a weakening of the body, is accompanied by prolonged healing and, often, the addition of a bacterial infection.

Such “stripes” of lesions are always one-sided, which is a distinctive feature of “lichen”. But the geography of the location can vary.

Most often, the intercostal spaces of the chest or, less often, the lumbar region are hit. However, herpetic vesicles can appear in the ear canal and on the face, indicating damage to the nerve fibers of the brain (trigeminal, facial nerve, and others) and a high risk of severe neurological complications.

Diagnostics

In most cases, the characteristic symptoms of lichen can be diagnosed without any additional tests.

However, in case of doubts with a doctor, or if you want to be examined yourself, a blood test for antibodies will be required.

Detection of IgA antibodies to the Varicella-Zoster virus confirms the reactivation of the pathogen.

And the presence of IgG is a marker of the transferred chickenpox and the presence of the virus in the body.

Other research methods, such as PCR diagnostics of the elements of rashes, are not suitable for self-examination, since they have a number of important nuances in the collection of material.And only a dermatologist or venereologist can carry out the correct sampling of the material.

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Chest pain is a symptom of many diseases that are not always associated with the heart.

Between one third and half of chest pain cases are of musculoskeletal origin. In 10–20% of patients, pain is caused by diseases of the gastrointestinal tract, in 10%, chest pain is caused by exertional angina, 5% have various respiratory diseases, in 2–4% of patients develop acute myocardial ischemia, including myocardial infarction.

In the vast majority of cases, heart pain is associated with a lack of oxygen in the heart muscle (myocardial ischemia).Ischemia can be short-term benign (stable angina) or more dramatic, leading to the development of unstable angina or myocardial infarction.

The causes of myocardial ischemia lie in vascular disease. Like any other organ, the heart needs nourishment. From the aorta, the coronary arteries branch off and carry oxygen to the heart muscle. With coronary atherosclerosis (when cholesterol plaques form in the arteries, which fill part of the lumen of the vessel), the heart begins to feel a lack of oxygen.This shortage is especially felt during exercise, increased heart rate or increased blood pressure. This condition is called “exertional angina” or “stable angina”. After stopping physical activity, with stable angina pectoris, chest pain completely disappears until the next physical activity.

Pain with stable angina usually lasts 2 to 5 minutes and resolves after using nitroglycerin preparations. But when an atherosclerotic plaque ruptures, the body seeks to close the damage with a thrombus, which blocks the lumen of the vessel, which, in turn, causes an acute lack of oxygen (that is, acute myocardial ischemia).If this condition lasts more than 15 minutes, the cells of the heart muscle die and an acute myocardial infarction develops.

Chest pain in heart disease may be different in nature or be similar to other pathologies. When describing pain in the heart, the words “burning”, “squeezing”, “pressure” are often used (as if someone is sitting on the chest). Pain can occur in one area (for example, behind the sternum or in the left half of the chest) or radiate to the left arm, left shoulder blade, lower jaw, throat; increase with physical activity and weaken somewhat at rest; accompanied by frequent shortness of breath, nausea, vomiting, palpitations.In some cases, the patient finds it difficult to describe the nature of the pain, but correctly places his fist in the center of the sternum – the so-called “Levin sign”.

Described as sharp and stabbing pain, usually not associated with the heart.

Extra-cardiac problems causing chest pain:

  • Pain in the muscles of the chest. It occurs more often after physical exertion and lasts longer than with coronary artery disease. and becomes stronger when you change the position of the body, take a deep breath or press on the corresponding area of ​​the chest.
  • Inflammation of the cartilage that connects the ribs to the rib cage.
  • Inflammation of the shoulder joint.
  • Shingles.
  • Any trauma to the chest.
  • Esophagitis.
  • Gastroesophageal reflux disease (GERD).
  • Esophageal spasm.
  • Pulmonary embolism.
  • Pneumonia.
  • Pleurisy.
  • Pneumothorax.
  • Panic attack.
  • Radiating pain from other organs.

When to see a doctor

Heart disease is the rarest cause of chest pain, but also the most dangerous.Therefore, when a symptom appears, it is worth contacting a cardiologist or general practitioner, family doctor.

People with chest pain should seek medical attention immediately, as in the case of coronary artery disease, every minute before receiving adequate treatment increases the degree of damage to the heart muscle.

Chest pain

Chest pain can be caused by various reasons. Fortunately, this localization of pain makes a person cautious and encourages them to see a doctor.

Most often, chest pain is caused by diseases of the spine – prolonged static load at the computer, lack of physical activity, damage to the vertebrae of the thoracic spine. If nerve roots are pinched by them, even the smallest movement can cause severe stabbing pain. Sudden chest pain occurs when lifting heavy objects. Such an effort is especially dangerous for people with osteoporosis, because the vertebrae can break, causing an extremely serious problem.

The pain threshold can vary depending on the emotional state.

If pain occurs in a person who is frozen, wet in the rain or in a draft, it may indicate intercostal neuralgia , herpes zoster caused by herpes zoster . After several days, small, yellowish, burning bubbles appear on the aching intercostal space. After about a week, they disappear and the pain goes away, however, for a long time, increased sensitivity to touch may persist, and only recently has it become possible to eliminate it with the help of medications.

Pain, especially when inhaling deeply, can be caused by the pleura, the sheath of the lungs rich in nerve endings. Pain occurs, for example, in severe pneumonia, when fluid begins to accumulate in the inflamed pleural cavity . The doctor determines the cause by listening to the chest and X-ray examination.

Some young people have congenital vesicles on the outer surface of the lungs. Bursting, they fill the pleural cavity with air from , which compresses the lungs, causing pain and difficulty in breathing.In this case, surgical intervention is often necessary.

Sudden difficulty in breathing, a feeling of heaviness and pain in the chest and anxiety may be due to thromboembolism caused by a clogged pulmonary artery thrombus. Thromboembolism is more common in bedridden patients with chronic venous insufficiency, especially with venous inflammation, fibrillation, and after long flights.

A pronounced cause of chest pain is pulmonary tumor , if it has formed near the pleura rich in nerves.

Induced by reflux of the stomach pain and burning sensation behind the breastbone after eating;

Often, pain in the region of the heart, especially in young people, is caused by emotional experiences and vegetative dystonia . In this case, you need to rest and take sedatives.

It is most important to timely determine vascular diseases of the heart , usually accompanied by pressing, choking pain behind the sternum, often with shortness of breath and irregular heartbeat.An attack of angina pectoris , provoked by stress or exercise, can last from 3 to 20 minutes. She is considered a harbinger of a heart attack, although, fortunately, this catastrophe does not always occur. If an angina attack begins during exercise, the pain usually goes away when you are calm. This is helped by nitroglycerin, which dilates blood vessels. The impact should be felt in 4 minutes. If the pain persists, you should definitely call an ambulance!

With myocardial infarction tearing, burning pain usually lasts 20-30 minutes, but sometimes 2-3 hours.When an atherosclerotic plaque ruptures, a thrombus occurs, and part of the heart is not supplied with blood, i.e. not supplied with oxygen and nutrients.

Medical assistance must be received within 2-6 hours, because the cells are gradually dying. The faster circulation is resumed, the more of the heart muscle can be saved.

It may be necessary to place a stent or perform bypass surgery to dilate the vessels.

If you have severe chest pain, you should definitely call an ambulance – often every minute is important.

In other cases, a consultation is required

therapist .

List of symptoms 90,000 Pain in the rib area, rib pain on the left and right

Pain between or under the ribs is cause for concern, since the rib cage contains vital organs. This article is relevant for everyone who has rib pain: in it you can learn about the most common causes of this clinical manifestation.

Reasons for rib pain

Pain on the left or right under the ribs can have a different character – as well as the reasons that cause it. It can be strong and almost imperceptible, aching or harsh, arising at certain times or incessant. In almost every case, the cause of pain can be a disease that develops in the chest area.

Chest injury

It is customary to refer to rib cage injuries as fractures or bruises of the ribs.Fractures are characterized by tears in the bones and cartilage joints of one or more ribs. Depending on the injury, pain symptoms can be constant aching or be acute, intense.

For bruises, mild pain is characteristic, which is accompanied by edema and the appearance of a hematoma in the area of ​​injury. As a rule, pain symptoms disappear after seven to ten days. Fractures require mandatory diagnosis in order to exclude the possibility of injury to the soft tissues of the lung or other internal organs.Depending on the side of the injury, pain can be localized to the right or left under the ribs or between them. Its intensity and duration depends on how severe the injury was.

Intercostal neuralgia

Pain between the ribs along the nerves can occur due to the following diseases:

Seizures in the form of shooting pain, similar to an electric shock, occur due to pinching or irritation of the nerve roots, and their appearance can be provoked by the following factors:

  • hypothermia;
  • penetration of infection;
  • physical activity;
  • receiving a back injury.

The pain becomes worse with strong inhalation / exhalation or attempts to change the position of the body.

Costal chondrite

Rib chondritis (or, as it is also called, Tietze’s syndrome) is a disease in which there is a thickening of the cartilaginous tissue of the ribs, leading to their soreness. Pain sensations are not localized in one place and can spread to the entire sternum. They can be quite strong and appear brighter with sudden movements, deep breaths in / out, or coughing.Pain may be accompanied by:

  • local edema;
  • an increase in temperature in the area of ​​the pathological process.

It appears suddenly and in its manifestations is comparable to angina pectoris.

Angina pectoris

Angina pectoris is characterized by constant pressing pain behind the sternum and sometimes between the ribs. It is localized in the chest region and can spread to the left side of the neck, left arm and left side of the chest and may be accompanied by:

  • heart rhythm disturbance;
  • a sense of fear.

Other reasons

In addition, painful symptoms in the ribs can occur with the following diseases:

  • malignant neoplasms (in particular – rib osteosarcoma) – are characterized by dull pains at the onset of the disease, which become more and more pronounced as it develops;
  • fibromyalgia – pain occurs when trying to raise the arms or turn the trunk;
  • pleurisy – pain symptoms are manifested when coughing and deep breaths / exits;
  • Shingles – characterized by intense pain under the ribs in the right or left side, accompanied by itching or burning.

Another reason is the hypertonicity of the pectoral muscles, which occurs as a result of intense physical exertion. The pain in this case increases and is localized in the intercostal space.

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Pain specialist, anesthesiologist-resuscitator, head of the Pain Clinic, Ph.D.

Work experience 18 years

To make an appointment

Diagnosis of rib pain

If you suffer from pain in the ribs, contact the CELT Pain Clinic.We employ doctors of various specialties who will direct the entire arsenal of diagnostic and therapeutic capabilities of our multidisciplinary clinic to solve your problems. Since there are many reasons causing pain symptoms in the ribs, it is very important to correctly diagnose. This is the only way to correctly diagnose and prescribe treatment.

If pain occurs, please contact one of our specialists:

Diagnostics in our Pain Clinic, in addition to being examined by a doctor and taking anamnesis, may include:

Treatment of rib pain

Treatment of rib pain is primarily aimed at eliminating the original cause that caused it.In case of severe pain, symptomatic therapy is used. It provides for the use of pain relievers and anti-inflammatory drugs. If we are talking about diseases for which thermal procedures are indicated, ointments with a warming effect are used, if pain occurs due to muscle spasms – antispasmodics.

Passage of physiotherapy procedures, massage and manual therapy allows you to relieve painful sensations in the ribs with osteochondrosis and hypertonicity of the pectoral muscles.After the pain passes, the patient may be prescribed physiotherapy exercises.

In case of chest injuries, the specialists of the CELT Pain Clinic will recommend a state of rest, in which not only the injured area should be, but also the patient as a whole. Thus, healing will be much faster. Can use a chest bandage, excluding sudden movements and deep breaths in and out.

Turning to the CELT Pain Clinic, you can count on professional treatment that will definitely be successful!

90,000 Right side pain :: Clinician

The following specialists are involved in the treatment of pains in the right side of a different nature, leading the reception in our centers: gynecologist, gastroenterologist, infectious disease specialist, traumatologist, neurologist (neuropathologist).

Call the number of the single reference service of all our centers +7 (861) 231-1-231 and indicate which specialist you would like to make an appointment with, after which you will be connected to the selected center. Administrators will select a convenient day and hour for you to visit the doctor.


Conventionally, the right side of the abdomen is divided into two quadrants (or segments): right upper (right side above) and right lower (right side below).Localization of any symptom can now be tied to one of these quadrants.

For what diseases there is pain in the side on the right:

  • Pain in the right side from above . In this area, a person has organs such as the liver, gallbladder, part of the intestine, pancreas, and the right side of the diaphragm. Pain in the right hypochondrium may be due to liver inflammation (hepatitis). Pain in the right side from above may be associated with the gallbladder.Infection, poor liver function, or gallstones are often responsible for pain in the right upper abdomen. There is also another important organ in the abdomen – the pancreas. The most common cause of pancreatic pain is inflammation (pancreatitis), to which people who drink alcohol and suffer from gallbladder disease are especially prone. Sometimes renal disease causes pain in the right upper quadrant. The resulting pain can be felt in the right upper quadrant of the abdomen, as well as in the back.If there was a small stone in the kidney, and it is in the ureter, then the pain finds in waves, it is excruciating and often radiates to the groin.
  • Pain in the right side below . In the lower right quadrant is the appendix (a small piece of tissue that leaves the large intestine), the intestine, which can be affected by various diseases, as well as the ureter, which drains urine from the kidneys to the bladder, and the fallopian tubes in women. Any pain in the right lower abdomen may indicate appendicitis.If you can point the place of pain with one finger, if it lasts for more than 12 hours without relieving, if the pain is also localized near the navel, then it is most likely that you have appendicitis. In any case, if you suspect you have appendicitis, contact your gastroenterologist immediately! Lower right quadrant pain can also be caused by a bowel infection, shingles, and compression of the nerves that extend from the spine and end in this area. A kidney stone on its way down to the bladder through the ureter can also cause excruciating pain in this quadrant.Women in this area may experience pain during an ectopic pregnancy. An ectopic pregnancy occurs when a fertilized egg remains in the fallopian tube instead of descending into the uterus. Pain in this part of the abdomen can occur with sexually transmitted infections.

Which doctor should I contact if there is pain in the right side:

What research will help determine the cause of pain in the right side:


Are you experiencing pain in your right side? Do you need an inspection? Make an appointment with a specialist – the Clinician network of medical centers is always at your service! The leading doctors of Krasnodar will examine you, study the external signs and help determine the disease by symptoms, advise you and provide the necessary assistance.

How to contact our centers:
Call the number of the single reference service of all our centers +7 (861) 231-1-231 and indicate which specialist you would like to make an appointment with, after which you will be connected to the selected center. Administrators will select a convenient day and hour for you to visit the doctor.

You can also contact any of the centers of the Clinicist network of medical centers, where the specialists recommended for you are received.Detailed information about our centers and the location on the city map are indicated here. Check out the presentation of our activities on this page.


If you have previously undergone any research or have already been with a specialist, be sure to take their results for a consultation with a doctor. If you have not had any experience attending studies or seeing a doctor, we will do whatever is necessary at our centers.

You must be very careful about your health.People do not pay enough attention to the symptoms of diseases and do not realize that they can develop into a life-threatening condition. There are many diseases that at first do not manifest themselves in our body, but in the end it turns out that it is too late to treat them. Therefore, identifying symptoms is the first step in diagnosing diseases in general. To do this, it is necessary at least once a year to be examined by a doctor in order not only to prevent a terrible disease, but also to maintain a healthy state of all internal organs and systems.

If you want to ask a question to our specialists – use the section of the online consultation. You will also find answers to frequently asked questions there. If you are interested in reviews about visiting our centers, there is a special Reviews section for you, where you can also help other patients and leave your message after visiting our centers. We will be grateful to you!

90,000 Shingles – symptoms and treatment in ON CLINIC Ryazan, price

Like many other diseases provoked by a seasonal decrease in immunity, shingles in adults and children most often manifests itself in the fall, as well as at the end of winter and early spring.In addition, it is an eternal companion of people whose immune system, for whatever reason, cannot give an adequate response to aggressive external factors – cancer patients, patients with HIV, as well as the elderly, whose immunity decreases for objective reasons.

The causative agent of shingles in adults and young patients is a specific type of herpes virus. Every fifth person suffers from the symptoms of this disease with varying frequency.

Shingles: Symptoms

This disease is famous for its rather vivid manifestations. Most often, rashes are localized in the area of ​​the passage of the trigeminal nerve on the face, as well as on the back of the head or neck, shoulders or chest, buttocks or external genitals. The symptoms of shingles include:

  • at an early stage of the disease – general malaise: headache, fever, decreased performance, chills, and intestinal upset;
  • tingling and itching on the skin in the place where the rash will later appear;
  • Regional lymph nodes may enlarge and become painful;
  • in the active stage of the disease, characteristic rashes appear on the skin.Initially, they look like flat spots of bright pink color, in place of which, after a while, small bubbles with grayish-yellow (in the case of the gangrenous form of the disease – black) contents are formed, which are able to “crawl” from place to place;
  • After a while, gradually drying crusts form in place of the bubbles. On average, the active stage of shingles in adults lasts 2-3 weeks, and in elderly patients it can last for months or even years.

The appearance of rashes on the skin and all cycles of their development are accompanied by severe pain. Patients may describe them as dull or stinging, boring or cutting. The pain increases even with a slight touch on the skin in the area of ​​the rash.

Treatment of shingles

In principle, the symptoms of shingles in people of working age with a strong body, who do not suffer from any chronic diseases, disappear in a couple of weeks and without special treatment.Nevertheless, in the event of a relapse of the disease, a visit to a dermatologist is required! In “ON CLINIC in Ryazan” patients are received by the best specialists of the city every day.

The doctor develops a special treatment regimen for each patient, which may include:

  • antiviral therapy;
  • antibacterial agents topically to prevent infection of wounds;
  • pain relievers and anti-itching agents;
  • immunomodulators;
  • Plasmapheresis and other procedures related to a type of treatment such as physiotherapy

In the absence of treatment, a severe form of this disease can lead to the development in the patient of paralysis of a nerve located near the focus of infection, as well as disruption of the work of some internal organs.In particular, there are often lesions of the genitourinary organs, as well as the duodenum. In addition, the spread of the pathological process to the organs of vision can lead to a significant deterioration of the latter.

Are you interested in the price of shingles treatment in Ryazan in our family clinic? Call us and our administrators will make an appointment for you at any convenient time!

Thoracic neuralgia (intercostal neuralgia) – Quality of Life LLC

Neuralgia of the thoracic spine, or intercostal neuralgia, is a disease in which nerve endings are compressed by muscles, ribs, and intervertebral discs.This leads to the development of pain, mainly paroxysmal. Pathology usually occurs against the background of other neurological disorders of the musculoskeletal system.

CAUSES OF CHEST PAIN

  • 1. Chest pain, not associated with pathologies of the intervertebral discs and intercostal nerves. They are caused by bruising, frequent hypothermia, prolonged stay in a tense uncomfortable position, and posture disorders. They usually go away within 2 weeks.
  • 2 . Facet syndrome – develops as a result of inflammation and degenerative processes in the intervertebral joints.
  • 3. Intercostal neuralgia – pinching or irritation of the intercostal nerves.

There are many other possible causes of chest pain: angina pectoris, infectious diseases (for example, shingles), thoracic osteochondrosis, intervertebral hernia, aortic aneurysm, malignant tumors of the lungs and pleura, esophagus, diseases of the pancreas, previous operations on the chest cage.

Symptoms of neuralgia of the chest

  1. 1 . Most often, the pain is severe, but it can also manifest itself in the form of some discomfort.
  2. 2 . It intensifies after a change in body position (bending, turning), as well as when coughing or sneezing.
  3. 3 . It manifests itself as constant or paroxysmal.
  4. 4 . Burning sensations, stitching, pressing.
  5. 5 . Duration – from 1-2 hours to several days or more.
  6. 6. Even a slight touch on the intercostal spaces or in the paravertebral points makes the pain unbearable.
  7. 7 . Irradiation is observed in the arm, back, neck, anterior part of the chest on the left. It is this symptom that often leads to a false interpretation of the cause of the disease, as it resembles a heart attack.
  8. 8 . The skin along the trapped nerve changes sensitivity. There is paresthesia (distorted sensation) in the form of burning, crawling, tingling sensations.Sometimes a person complains of numbness in the affected area.
  9. 9 . The attack is often accompanied by sweating, paleness, and cramps in muscle fibers. The latter symptom is caused by impaired blood flow in this area and irritation. The local temperature drops and the area of ​​the body becomes cool.

All of the above symptoms can occur simultaneously. But it happens that only one or two signs appear. The degree of their severity depends on the threshold of sensitivity and other individual characteristics.

Other diseases that lead to chest pain have their own characteristic symptoms. In order to understand them correctly and establish an accurate diagnosis, the doctor asks the patient in detail, carefully examines

VARIETIES OF INTERCOSTAL NAVRALGIA

  • 1. Left-hand . Often confused with cardiac pathologies, which complicates treatment and threatens with complications. The pain is localized on the left side of the body, but it can radiate to the right.It is accompanied by a change in the rhythm of the heart. If discomfort increases with a change in the position of the torso, you should immediately consult a doctor for diagnosis.
  • 2 . Right-hand . Symptoms practically do not differ from the left-sided, except for the localization of sensations.
  • 3. Double-sided . It is characterized by girdle pain throughout the upper body, which limits the movement of the body.

HOW TO DIFFER INTERCOSTAL NEURALGIA FROM HEART PAIN

You need to know that not all chest pain is associated with the heart.Therefore, you do not need to be very scared right away. The diagnosis is made only by a doctor. If you have a stab in your chest, this is a significant reason to see a doctor. The doctor will deal with the cause of the pain. In addition, neuralgia also needs to be treated.

Intercostal neuralgia most often occurs in the elderly, but it also occurs at a young age (at risk – people leading a sedentary lifestyle, as well as swimming). In children, intercostal neuralgia can occur, as a rule, during a period of intensive growth.

A characteristic sign of intercostal neuralgia is severe pain along the affected nerve. The pain can come on in fits or be constant. Typically, the pain becomes more intense with inhalation, exhalation, and any movement that involves the chest. If you press on the area between the ribs where the causative nerve passes, the pain increases. In this case, the entire nerve is felt; pain can be given to the arm, neck, shoulder, lower back. Numbness and blanching of the skin may occur along the course of the affected nerve.

Thus, if, with pain in the chest area, there is a dependence on changes in body position, there is no shortness of breath (a typical symptom of cardiac pathology), the pain increases with palpation, then most likely neuralgia is taking place. You can also focus on the effectiveness of the drugs taken: cardiac drugs do not help with neuralgia, but sedatives can reduce pain.

However, in any case, it is necessary to consult a doctor for diagnosis and prescriptions.

METHODS FOR DIAGNOSING INTERCOSTAL NEURALGY

If you suspect intercostal neuralgia, consult a neurologist.

In most cases, the diagnosis is made on the basis of patient complaints, medical history and examination of the patient directly at the reception. The doctor pays attention to the patient’s posture: trying to reduce pain by reducing the pressure on the affected nerve, the patient tilts the body in the opposite direction. Palpation of intercostal spaces in the area of ​​pain localization is performed.Loss of sensitivity and blanching of the skin are established.

Sometimes instrumental and laboratory diagnostics may be required.

At the Quality of Life medical center, a neurologist of the highest category is seen.