Intercostal neuralgia: symptoms and treatment
Intercostal neuralgia is a painful condition caused by irritation of the intercostal nerves or by squeezing them. Intercostal neuralgia, the symptoms of which, as a rule, are noted in older people, is explained by age-related changes that are relevant for the condition of their vessels. As for children, they have this disease is extremely rare.
Intercostal neuralgia is a pain syndrome provoked reflexively, which occurs, as we noted above, as a result of a certain effect on the intercostal nerves. Quite often this type of neuralgia arises against the backdrop of a neglected stage of osteochondrosis, which occurs as a result of the compression produced on the roots of the intercostal nerves by intervertebral hernias.
Other possible causes of this disease include a number of diseases, including hormonal spondylopathy, spondylitis, a progressive degree of kyphosis, neoplasms centered in the spine, Bechterew’s disease, etc.
Provoke an attack of a disease may cause colds or hypothermia, poisoning or infection, mental stress or trauma. In addition, the number of factors affecting the appearance of intercostal neuralgia factors also include excessive physical exertion, performed with unaccustomed or without the necessary pre-heating.
Thus, when considering a number of factors, it is possible to determine the main causes leading to the appearance of intercostal neuralgia, namely, intoxication, cooling and infection.
It is noteworthy that often clinical practice indicates the occurrence of intercostal neuralgia as a result of herpetic lesions. Often, it arises as a kind of response to the irritation, carried out in the address of nerve trunks, which occurs as a result of pathological processes in the area of neighboring tissues and organs. In particular, such processes may include diseases of the ribs and spine, pleurisy, deformation of the chest area, etc.
It is also common to distinguish such a cause of intercostal neuralgia (which corresponds to the generalized version of intoxication), as the reception of certain medications, against which the nerves are jammed. Prolonged use of certain medications often provokes the development of complications, which is due to the actual disintegration of their components in the body in this case.
In general, a significant content of toxic substances, as well as the inhalation of metal salts — all this accompanies the defeat of the nervous system, often provoking intercostal neuralgia.
Neuralgia of the intercostal: symptoms
The main symptom of intercostal neuralgia is pain, which focuses on the heart area. This pain, in its essence, differs from the pain that accompanies heart disease, and, above all, the fact that in the case of intercostal neuralgia, this pain has a neuropathic nature. In other words, it provokes certain diseases associated with the nervous system, as well as its elements or actual damage to them.
The appearance of the symptom in the form of pain in the rib area is explained by what happens, as we have already noted, compression or irritation of the intercostal nerves — the essence of the process can be seen below:
Despite the fact that the nature of pain is neuropathic, it can manifest itself in different ways, being burning or aching, acute or dull. In some cases, patients complain of episodic appearance of pain, in others the pain is constant. Naturally, taking into account the appearance of pain due to damage, the pain provoked by the stimulation of nerve fibers increases in the case of increased physical activity. Thus, a sharp movement of the body, loud talk, a usual sneezing or a sharp change in the position of the body — all this with intercostal neuralgia will lead to a significant increase in pain.
Considering the characteristics of pain in intercostal neuralgia, we note that they also appear when palpating certain areas of the body (that is, when they are probed). In particular, such areas can be referred, again, to the intercostal area or spine, the chest region, etc. Incidentally, in that part of the chest in which severe pain is manifested, the nerve segment directly affected is located.
It is noteworthy that the duration of pain can not be constant — subsequently, the necrosis of the nerve root simply occurs. This, in turn, leads to calming the patient who does not experience symptoms of intercostal neuralgia and pain in particular. Meanwhile, this is not the disappearance of the disease. So, the new state is replaced by the new ones — this is a decrease in the respiratory volume, which manifests itself in the form of a superficial breathing of the patient, which is also accompanied by a feeling of heaviness in the chest.
Pain with intercostal neuralgia predominantly, of course, centers in the area between the ribs, but it can also be noted in other areas, for example, giving under the scapula or to the lumbar region. Such a reflection of pain often does not give the right to unequivocally state the primary source of nerve damage.
In addition to pain, intercostal neuralgia is accompanied by some other symptoms. In particular, it can be distinctly palpable jerking or muscle contractions. Also can be observed intense sweating, possibly a discoloration of the skin — it can either blush, or, conversely, have a very pale appearance. Do not rule out tingling of the skin or loss of sensitivity in certain areas.
Emerging pains in the chest area are determined by physicians, as, indeed, by the patients themselves, as the «girdling» pains, which is explained by their occurrence along the course of the intercostal spaces.
There are some external signs that indicate the disease we are considering. So, patients often stay in the «antalgic» pose, which looks like this: the body body bends to the healthy side when making attempts to preserve this position. This is explained by the fact that as a result of such manipulations with his own body, the patient, thereby, produces a stretching of the intercostal spaces. The pressure as a result of this decreases, the nerve endings are irritated much less, which ultimately leads to a reduction in the immediate pain sensations.
An additional role in the described tactics is played by the psychological fear associated with the expectation of pain, as a result of which the patients strive for the maximum possible time to be in a similar position of the body.
Disease differs from heart disease
Considering the features of pain and symptoms in general, you can make some conclusions. In particular, I would like to touch upon the generality of the pain arising in this type of neuralgia in the chest region with certain diseases associated with the work of the cardiovascular system. It is the definition of the exact nature of pain that makes it possible to distinguish diseases from each other, as well as to identify the causes that this pain provoked.
It should be remembered that although pain is the main symptom pointing to both neuralgia and heart disease, the character of this pain varies in both cases.
Intercostal neuralgia is characterized by constant pain, noted during a very long time interval. Naturally, in this case, to eliminate it, using the same, we can say, traditional for heart problems, nitroglycerin, will not succeed. Pain intensification is noted, as was also indicated earlier, in the case of any movement of the body or a change in its position.
If we are talking about the relevance of any disease associated with the cardiovascular system, there is already a periodical and short-term pain suppressed by the use of medications (for example, all the same nitroglycerin). The pain provoked by the disease of the heart does not increase in the case of any body movements.
Also note that for cardiac pain is a violation of the heart rhythm in conjunction with changes in blood pressure (it either rises or falls). If we are talking about intercostal neuralgia, then its symptoms exclude such manifestations, respectively, the pulse and pressure remain within the norm.
Treatment of intercostal neuralgia
As a basis for successful treatment, undoubtedly, measures aimed at eliminating pain are used. To get rid of them it is possible only when the effect exerted by the irritating factor is completely eliminated. As we found out, the pain arises as a result of compression and compression of nerve endings, respectively, the patient, in the first place, prescribes analgesic medications.
If the doctor finds the abnormality in the location of the cervical vertebrae and vertebrae of the thoracic region during the examination, their «return to the place» is required, which implies the need for physiotherapy and massage.
Conducting manual therapy is possible only by a specialist, it is extremely important to remember! Otherwise, you can not only face a number of side effects caused by inept intervention, but also with disabilities.
As an additional measure of treatment, osteopathy is widely used, the procedures of which ensure the restoration of the position of each part of the spine according to the accepted anatomical location. In the end, there is a rapid restoration of blood circulation and normalization of the lymph flow, which, in turn, restores the balance of internal nerve endings, muscles and the body as a whole.
The reflexotherapy is also applicable in the treatment of this disease and in the recovery of the patient. To this is added physical education with a certain set of exercises. Effective treatment can be supplemented with various ointments.
Concluding our article, I would like to note that intercostal neuralgia often turns into a chronic stage, at which systematic pain recurrence occurs. To avoid this, one should revise one’s own way of life, minimizing any type of workload, the same concerns decreasing the intensity of sports. It is strictly forbidden to drink alcohol. Stressful situations and unrest, as you know, have a negative impact on the nervous system, and therefore, if possible, they should also be reduced.
In case of occurrence of a symptomatology relevant for intercostal neuralgia, it is necessary to consult a neurologist, in addition, a manual therapist and physiotherapist may be appointed.