Intercostal neuralgia: symptoms and treatment at home
Sudden chest pain is a serious cause for concern.The first thing that needs to be clarified is whether this pain is caused by cardiac pathology.If not, you need to think about intercostal neuralgia, which occurs often enough and can simulate a heart attack.Table of contents: Intercostal nerves Causes of neuralgia Symptoms of intercostal neuralgia Treatment of intercostal neuralgia
Intercostal nerves are a continuation of the thoracic spinal nerves.The latter leave the spinal canal through the intervertebral foramen.Intercostal nerves lie in intercostal spaces.
These nerves innervate the muscles and skin of the chest and abdominal walls, parietal sheets of the pleura and peritoneum, mammary glands.
Causes of neuralgia
Intercostal neuralgia refers to the appearance of pain in the direction of the intercostal nerves.This ailment develops as a result of irritation, compression, or inflammation of the intercostal nerves.Neuralgia can be provoked by squeezing the roots of the thoracic spinal nerves in the area of their exit from the spine or infringement( inflammation) of the nerves already in the intercostal space.That is, the source of pain should be sought in the thoracic spine or in the intercostal space.
Causes of intercostal neuralgia:
- Osteochondrosis of the thoracic spine.With this disease, degenerative changes occur in the vertebrae.Intervertebral discs collapse, sag, the diameter of the intervertebral foramens narrows, in addition, osteophytes form on the vertebrae.All these changes lead to compression of the spinal nerves.
- Sharp movements, excessive physical activity, hypothermia, sedentary work, sleep in an uncomfortable pose.All these factors lead to muscle spasm, which causes the muscle to squeeze the intercostal nerve.
- Injuries( bruises of chest and back, fractures of vertebrae and ribs).With trauma, muscle spasm occurs, and sometimes mechanical irritation of the intercostal nerves.Subsequently, the pain can persist when the nerve is irritated by the callus, formed after the injury.Intervertebral hernia of the thoracic region. .The falling part of the disk squeezes the nerve, which leaves the intervertebral foramen.
- Infectious diseases( SARS, herpes zoster, tuberculosis).Very often, intercostal neuralgia is a consequence of herpes zoster.
- Scoliosis.With pronounced deformation of the spine, intercostal nerves can be squeezed.
- Ankylosing spondylitis.Disease of intervertebral discs, which invariably leads to deformation of the vertebrae.
- Wearing a tight bra with solid bones.This is dangerous for skinny women with poorly developed subcutaneous tissue.
Symptoms of intercostal neuralgia
The most common symptom of intercostal neuralgia is the occurrence of pain in the chest.It is interesting that pain can acquire different characteristics.Someone complains of dull and aching pains, and someone's sharp and searing.In addition, pain can occur both in the form of seizures, and bother people all the time.Often patients describe neuralgic pain as the passage of an electric current through the chest.One thing can be said for sure: these pains are intense enough and they bring real torment to man.
Often, pain occurs on one half of the chest, extending in the direction of the intercostal nerve.She can irradiate in the arm, heart, stomach, waist.The pain is markedly increased by sneezing, coughing, trying to take a deep breath.Movements also cause increased pain.Therefore, patients with intercostal neuralgia often try to take the most comfortable position, usually by tilting the trunk to a healthy side.
The emergence of intense pain in the chest requires a thorough differential diagnosis with diseases of the heart, respiratory, digestive systems.The most dangerous condition is myocardial infarction, which also occurs with intense pain in the chest.
How to understand what exactly a person suffers?
With intercostal neuralgia, the pain is localized in the chest and in the side, and with myocardial infarction - behind the sternum and gives into the arm, the scapula, the lower jaw.Neuralgic pain intensifies with deep inspiration, sneezing and coughing, with an infarction this does not happen. In addition, with intercostal neuralgia, it is possible to determine local soreness by pressing at specific points:
- In the spine in the region of the exit of the affected nerve;
- At the edge of the sternum at the site where the nerve ends;
- In the direction of the nerve in the intercostal space.
Other symptoms should also be considered.With myocardial infarction, there is a change in the rhythm of the heart, heart rate, blood pressure, cold sweat, fear of death.For confirmation or refutation of cardiac pathology, it is necessary to make electrocardiography.
It should be noted that pain is not the only symptom of intercostal neuralgia. In favor of the disease, the following signs also testify:
- Numbness of the skin at the point of exit of the affected nerve from the spinal column;
- Twitching of the intercostal muscles;
- Local pallor or redness of the skin;Local hyperhidrosis;Local cooling of the skin.
Treatment of intercostal neuralgia
Treatment of the disease should be comprehensive.To eliminate pain use non-steroidal anti-inflammatory drugs( Diclofenac, Nimid, Piroxicam).A doctor may prescribe drugs in the form of tablets or injections.With moderate pain, ointments can be useful( Ketonal Gel, Finalgon).Ointments have warming and analgesic effects.With severe pain, therapeutic blockades are performed-the administration of painkillers in the plexus.
Since intercostal neuralgia often develops against a background of muscle spasm, muscle relaxants( Midokalm, Sirdalud) are used.To improve the trophism of nerve tissue, vitamin B( Neurovitan) is prescribed.
To combat intercostal neuralgia apply non-drug methods, in particular massage.This allows you to remove muscle spasm, increase blood circulation in tissues, and therefore increase metabolic processes.
If the compression of the nerve is caused by the displacement of the vertebrae, spinal traction, manual therapy can be performed.In addition, to enhance the effect of treatment will help physiotherapy: magnetotherapy, ultraphoonophoresis, UHF therapy.
Grigorova Valeria, medical reviewer