Intercostal neuralgia (intercostal neuralgia) – causes, symptoms & therapy

Intercostal neuralgia is neuralgia , i.e. nerve pain, between the ribs. The nerve pain originates from the intercostal nerves, which run along the chest wall. The chest wall lines the chest cavity and is made up of both bone and soft tissue.

The severity of the nerve pain and the exact localization vary from patient to patient. It is intercostal neuralgia only if the pain between the ribs lasts for at least two to three days.

causes

Various injuries or diseases can be responsible for the occurrence of intercostal neuralgia. The nerve pain between the ribs is always a symptom of an underlying disease, but not an independent disease.A common cause of intercostal neuralgia is infection with herpes zoster, also known as shingles. This viral disease occurs mainly in people with a weakened immune system and is associated with inflammation of nerves. If the nerves in the space between the ribs become inflamed, this leads to the typical symptoms of intercostal neuralgia.

In addition, diseases of the spine can cause intercostal neuralgia. This happens, for example, due to wear and tear on the vertebral bodies of the spine, which causes nerve roots to become pinched, which leads to nerve pain. Lung diseases such as tuberculosis or pneumonia can also be associated with intercostal neuralgia.

Injuries such as broken ribs can also cause nerve pain. If the chest has to be opened as part of a surgical procedure, this can lead to what is known as post-thoracotomy syndrome, in which nerve pain occurs between the ribs after the operation.

symptoms and course

Typical symptoms of intercostal neuralgia:

• pain when breathing

• Cough

• itching

Intercostal neuralgia, i.e. nerve pain between the ribs, is a symptom of an underlying disease. Very often, the nerve pain in the ribs is stabbing and gets worse with movement. Some people also have severe pain when breathing because the chest moves and this makes the nerve pain worse. In most cases, coughing, sneezing or straining also worsens the symptoms. Those affected may also feel itching in the space between the ribs. The nerve pain does not always have to be limited to the ribs, many sufferers suffer from belt-like pain that runs from the chest to the back. The course of an intercostal neuralgia depends on the underlying disease. If this is treated successfully, the nerve pain usually disappears as well.

Diagnose

Rapid diagnosis of intercostal neuralgia is important because nerve pain can become chronic if left untreated. If the pain does not go away after two to three days, it is referred to as neuralgia. However, this is not the actual diagnosis, but only the determination of a symptom. In order to diagnose the underlying disease, the attending physician first collects an anamnesis. After that, he will do a physical exam. In the case of intercostal neuralgia, there are certain areas that react with pain when pressure is applied. Depending on the suspected diagnosis, the physical examination is followed by further examinations such as a chest X-ray or an ultrasound .

treatment and therapy

The causal therapy for intercostal neuralgia depends on the underlying disease. In some cases, the attending physicians are also unable to determine what is causing the intercostal neuralgia. In these cases and in acute cases, pure pain therapy is usually used.

Non-steroidal anti -inflammatory drugs are particularly suitable for this , i.e. drugs that act against rheumatism and the associated pain. These pain relievers are particularly effective for nerve pain because they work in the periphery of the body and not in the central nervous system. Muscle relaxants, i.e. substances that relax the muscles, are also administered to relieve pain.Since neuralgia often leads to unbearable pain, it may be necessary to administer strong painkillers such as morphine and other opioids to those affected. However, since the administration of opioids is delicate and often accompanied by severe side effects, local anesthesia of the painful area is often more effective.

This reduces the burden on the entire organism. An infiltration is carried out, i.e. the painkiller is injected directly into the affected region. The infiltration therapy ensures pain relief or even freedom from pain over a longer period of time. The causal therapy can consist of physiotherapy, among other things, in which an attempt is made to relieve the area in which the rib nerve is pinched.

prevention

Since intercostal neuralgia is merely a symptom of an underlying disease, targeted prevention is hardly possible. In the case of nerve pain, it is important to consult a doctor as quickly as possible, since many diseases can be better treated in the early stages.