Intercostal Neuralgia: Causes, Symptoms, Diagnosis, and Treatments

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Intercostal NeuralgiaIf you have never heard of intercostal neuralgia, you are not alone, as this is a rare condition affecting the deeply protected nerves within your rib cage. Straining or damage to one of these nerves can result in breathing difficulties and severe pain upon movement. We will take a closer look at intercostal neuralgia and possible home remedies.

Intercostal Neuralgia Definition

So, what is intercostal neuralgia? It can be better understood through the definition of the medical terms. Intercostal refers to the nerves that run from the spinal cord to in between the ribs within the rib cage. They support the muscles in this region.

Neuralgia is the pain that occurs within nerves, in this case, the intercostal nerves. The pain usually arises from a compression of the nerves, whether it be from trauma or disease. The irregular pain may result in the upper chest, across the underarm, and around the shoulder blades. The pain can be so severe that even the gentle touch of clothing can send shock waves through a person, as well as the simplest acts of sitting or lying down.

The strain or damage to the intercostal nerves may be the result of health conditions such as shingles, or from trauma to the area such as with surgery. We will next learn about the varying causes of intercostal neuralgia.

Intercostal Neuralgia Causes

The most common cause behind an intercostal neuralgia diagnosis is surgery of the thoracic cavity. This procedure requires the ribcage to be widened, which can damage the intercostal nerves.

Other trauma-related causes include:

  • Infections from shingles or the ribs
  • Thinning of the nerves over time
  • Direct trauma to the chest or ribs
  • Nerve entrapment
  • Muscle strain
  • Inflammation of the nerves
  • Pregnancy causing the ribcage to expand
  • Pressure of a localized tumor on the nerve

Intercostal Neuralgia Symptoms

With neuralgia in the name of the condition, pain is obviously the primary symptom. The varying degrees and range of pain help to determine the severity of the trauma to the nerve. The pain will appear in the chest region and could radiate from the back around either side of the ribs. It can range from an aching sensation to a sharp, stabbing pain and may be intermittent or constant. The pain can also worsen with movement and episodes of sneezing, laughing, and even pain with deep breaths.

Other symptoms that may follow can also have a link to other health conditions such as angina or heart disease. The rib pain, if concentrated on the left side, could lead to this type of diagnosis. With intercostal neuralgia, there may be numbness, tingling, fever, and loss of appetite, as well as pain in the abdomen, shoulders, or neck.

The more serious life-threatening symptoms of intercostal neuralgia can be in the form of radiating pain on the left side of the body, affecting the chest, ribs, arm, shoulder, and back region. There also may be a feeling of tightness or pressure in the chest and palpitations. Also, the nerves can cause difficult breathing and may produce a phlegm-filled cough. At this point, the painful muscles can become weak before parallelization sets in, with an overwhelming feeling of dizziness.

Intercostal Neuralgia Diagnosis

For a clinical diagnosis, your doctor will complete a medical history and physical examination. The doctor will then complete a pain questionnaire, as well as a neurological exam. The tests may include an x-ray or a magnetic resonance imaging (MRI) scan.

Intercostal Neuralgia Treatment

Some cases of intercostal neuralgia do not require any treatment as the trauma or damage is minor, and there is little to no pain. However, in other cases, treatment may involve various medical options such as pain relievers and injections. These may include nonsteroidal anti-inflammatory drugs, corticosteroids, antidepressants, antihistamines, and antiviral medications. For those with recurring pain, treatment will focus on removing the nerve ending or by destroying it.

There are natural treatments sufferers of this condition can use alone or with a pain management plan to help with symptoms. Cold therapy, acupuncture, massage therapy, and yoga may prove to be beneficial.

We have outlined two key exercises used for intercostal neuralgia.

1. Stretching

By lifting your arms overhead and to the side, the chest cavity expands, which stretches the intercostal nerves, muscles, and blood vessels. Do the following stretches twice a day.

Raise your arms over your head and clasp your hands while you lean to one side. Hold the position for several minutes. Repeat on the other side.

For the next stretch, stand in a doorway and place your hands on either side with your elbows bent. Place your feet shoulder-width apart as you lean forward slightly. You should feel a comforting stretch in your back, shoulders, and chest.

2. Posture Training

This form of exercise corrects your posture while helping to reduce your intercostal neuralgia symptoms.

Stand straight with your shoulders back and tuck the pelvis underneath. Put your arms down the side with your elbows touching the side of your body. Gently move your hands behind you so that your shoulder blades touch. Press your hands together with small motions for 10 to 20 times before returning to starting position. Repeat at least twice daily.

Intercostal neuralgia is a rare occurrence usually caused by a distinct injury or damage to the intercostal nerves. Although these nerves are well-protected within the ribcage, it is still vital to take precautions to prevent them from being affected. These precautionary measures include the use of protective padding with contact sports, being cautious when driving, and having vaccinations for chicken pox, shingles, and herpes zoster. Any possible damage to the nerves may need to be treated with surgical procedures while most other cases will resolve in time.

Also Read:

Kerkar, P., “What Is Intercostal Neuralgia: Symptoms, Causes, Treatment, Pathophysiology, Diagnosis,” ePain Assist;, last accessed May 30, 2017.
“Intercostal Neuralgia,” Health Grades;, last accessed May 30, 2017.