Intercostal neuralgia and cough. We treat intercostal neuralgia in quick and simple ways

Most people associate the feeling of sharp pain in the chest with a heart attack, but don’t think about the worst - perhaps it’s intercostal neuralgia, which develops as a result of irritation, inflammation and pinching nerve endings in the area of ​​the spinal or thoracic roots. In medicine, this disease can often be found under the term “thoracalgia”, which among all neurological diseases is considered the most “cunning” and “insidious” disease, as it often resembles the symptoms of organ diseases chest And abdominal cavity. People over 35 years of age are at risk for developing the disease. The disease rarely occurs in children, adolescents or young adults.

What is intercostal neuralgia?

Intercostal neuralgia – neuropathic pain syndrome, characterized by irritation or compression of the intercostal nerve endings. The symptoms often cause people to panic and think about serious illnesses heart, stomach, lungs, spine. The disease itself is not too dangerous, but only when a person promptly seeks help from a doctor - a vertebrologist.

The mechanism of development of intercostal neuralgia is quite complex, but mainly consists of damage to the intercostal nerves that arise from spinal cord and are located between the ribs. Each of the 12 nerve bundles contains sensory and autonomic nerve fibers, which are capable of reacting sharply to any damage. In addition, when nerve fibers are damaged, intervertebral discs bulge and become severely pinched, which causes acute pain.

It is important to note that intercostal neuralgia is not an independent disease, but develops against the background concomitant diseases or disorders that occur in the human body. Also, before carrying out treatment, it is important to determine the underlying disease, since irritation of the intercostal nerves itself can often be only one of the symptoms indicating the presence of a more serious pathology.

The main causes of intercostal neuralgia

The etiology of the disease is based on musculoskeletal diseases. musculoskeletal system, but besides this there are other provoking factors. There are many reasons that can cause the development of this disease.

Let's look at the most common ones:

• Osteochondrosis (cervical, thoracic).
• Injuries, fractures, bruises of the chest, spine or back.
• Prolonged or periodic hypothermia of the body.
• Radiculopathy (radicular syndrome).
• Infectious diseases: herpes zoster, tuberculosis, influenza.
• Intervertebral hernia.
• Excessive physical activity.
• Excessive increase in muscle tissue.
• Spondylolisthesis.
• Benign or malignant tumors.
• Chronic alcoholism.
• Birth defects are caused by anatomical abnormalities in the vertebrae and ribs.
• Osteoporosis.
• Ankylosing spondylitis.
• Vitamin D hypovitaminosis.
• Hormonal disorders.
• Benign vascular formation in the tissues of the vertebrae (hemangioma).
• Curvature of the spine (kyphosis, lordosis or scoliosis).
• Stress, frequent depression.
• Multiple sclerosis.
• Long-term use of potent medications.
• Sedentary lifestyle.

Based on the above diseases, we can conclude that almost any disease of the musculoskeletal system can provoke the development of pathology.

Types of intercostal neuralgia

Intercostal neuralgia is divided into two main types: radicular and reflex.

1. Radicular - develops as a result of irritation of the roots of the spinal cord. Characterized by this type neuralgia - painful sensations in the spine that radiate to the chest.

2. Reflex – manifests itself with local tension and muscle contraction in the intercostal spaces.

Regardless of the type of intercostal neuralgia, the symptoms of the disease manifest themselves acutely and require immediate treatment.

Clinical signs of intercostal neuralgia

The disease relates to acute conditions, so its symptoms are always intense and pronounced. The main symptom of the disease is severe and acute pain that appears in the damaged area and spreads to other organs, mainly the chest and spine. The location of the pain syndrome can be varied, as well as the nature of the pain. Intercostal neuralgia is characterized by stabbing or It's a dull pain, as well as numbness of the arm and a small area of ​​the chest.

The pain intensifies with sudden movements, deep breath, turning, coughing, and also under the influence of irritating factors: cold or heat. Symptoms often resemble a heart attack, as patients feel pain in the heart area, which can radiate to the shoulder blade, arm, lower back or intestines. The painful condition of intercostal neuralgia can last for several hours and intensify at night and with any movement. In addition to severe pain in the chest area, patients experience:

• increased sweating;
• pale skin;
• reduction of muscle segments;
• pain on palpation or deep inspiration;
• numbness of the skin in the area of ​​the affected nerve;
• general ailments.

It is not uncommon for patients to experience a rise in body temperature to 37.5 degrees, nausea and vomiting. If the patient has all of the above symptoms, then making a diagnosis is not at all difficult, but in most cases, intercostal neuralgia is disguised as other diseases: heart pathologies, renal or intestinal colic.

Therefore, it is very important to distinguish intercostal neuralgia from other diseases that can even lead to death.

How to distinguish intercostal neuralgia from heart pathologies?

It is quite simple to distinguish intercostal neuralgia from other diseases, but to do this you need to know the nature, location and intensity of the pain syndrome. One of the important differences is that with neuralgia, pain in the chest area can continue for for a long time, intensify with any movement. For heart disease, chest pain can be relieved with medications (nitroglycerin) 5 to 10 minutes after its use. Pathologies of the cardiovascular system are not characterized by increased pain during movement, which is observed with neuralgia. Pain in the heart is accompanied by changes in blood pressure, and the rhythm of the pulse is disrupted. With intercostal neuralgia, blood pressure and pulse are normal. The only thing that can provoke their increase is strong worries about one’s health. Often, neuralgic pain can radiate to the lumbar region and remind a person of attacks renal colic. If you doubt or suspect that paroxysmal pain is associated with other diseases, you should seek help from a doctor as soon as possible and do not delay treatment. The earlier the disease is diagnosed, the easier treatment will be.

Diagnosis is often difficult, especially if the patient has a history of chronic diseases of the heart or other internal organs. To make a diagnosis, the doctor does not have enough history from the patient, so he prescribes a number of examinations:

• Clinical blood test - an increase in leukocytes in the blood indicates an inflammatory process in the area of ​​nerve endings.
• Bacteriological blood test - if thoracalgia is caused by a pathogenic pathogen, then it will be visible in this study. In cases where the disease has developed against the background of non-infectious genesis, then the analysis will be unchanged
• Chest X-ray will reveal the presence or absence of abnormalities in the structure of bone tissue.

• Magnetic resonance imaging (MRI) - allows you to accurately determine changes in bone and cartilage tissue, as well as pinching or inflammation in the intercostal nerve tissues.
• Myelography – determines pathological changes in nervous tissue.
• Ultrasound differentiates neuralgia from other pathologies, but with intercostal neuralgia, changes are not visible on ultrasound.
• Electrospondylography – reveals pathology of the intervertebral discs and spine.

The results of the examination allow the doctor to draw up full picture diseases, determine the degree of damage to nerve fibers, make the correct diagnosis and prescribe appropriate treatment. Sometimes it is enough for a patient to undergo an MRI, which is considered the most informative and precise method diagnostics if the development of the disease is suspected.

Methods for treating intercostal neuralgia

Treatment of intercostal neuralgia is carried out comprehensively and only after diagnosis. No less important in treatment is the degree of neglect of the disease and the cause of its occurrence. Knowing all the features of the manifestation of intercostal neuralgia, you can begin treatment. IN acute period illness, when a person is tormented by severe pain, it is recommended to observe bed rest, and it is recommended to lie on a hard and flat surface. Painkillers and anti-inflammatory drugs will help reduce attacks of pain: Ortofen, Diclofenac, Ibuprofen, Tempalgin, Sedalgin, Movalis and others.

In addition to anti-inflammatory drugs, the doctor prescribes muscle relaxants that relieve muscle spasms (Mydocalm), as well as sedatives. Every patient suffering from the disease is recommended to take B vitamins (B1, B6, B12) - restore nerve structures fabrics.

After the acute period of the disease subsides a little and the pain syndrome is not so strong, it is important to go through the entire necessary diagnostics and identify the exact cause of intercostal neuralgia. If the cause of intercostal neuralgia is established, then it is necessary to treat the cause itself. In cases where the disease is of a vertebrogenic nature, that is, developed against the background of diseases of the spine, it is required complex treatment. By eliminating the cause of the disease, the symptoms of intercostal neuralgia will subside or disappear altogether.

If intercostal neuralgia has an advanced form, then recovery will take more than one month, but given the achievements in modern medicine, the prognosis after treatment is always favorable. Only comprehensive treatment will help to completely cope with the disease, which consists of bed rest during an exacerbation, taking medications, following a diet, doing therapeutic exercises, as well as physiotherapeutic procedures. An auxiliary therapy in the treatment of intercostal neuralgia is considered folk remedies, which are effective during the period of remission of the disease or for prevention.

Drug treatment of intercostal neuralgia involves the use of painkillers and anti-inflammatory drugs. Every medicinal product should be selected by the doctor individually, taking into account the patient’s age, the presence or absence of chronic diseases. If the pain syndrome cannot be relieved with painkillers, then the doctor prescribes novocaine blockades.

A special place in treatment is occupied by physiotherapeutic procedures: UV, laser therapy, acupuncture. It is also considered a mandatory point in treatment acupressure and physical therapy.

Treatment of the disease can last from several weeks to several months, it depends on the degree of the disease, its progression and, of course, on the prescribed treatment.

Treatment of intercostal neuralgia with folk remedies

Treatment of intercostal neuralgia is often carried out at home, so many patients, in addition to the treatment prescribed by a doctor, turn to traditional medicine, which over the many years of its existence has accumulated a huge number of recipes for treating the disease. All the recipes recommended by traditional medicine cannot act as the main treatment, but only as adjuvant therapy. Let's look at several recipes for treating intercostal neuralgia at home.

• Recipe 1. Treatment with black radish juice. You will need 1 small black radish, which needs to be chopped (you can grate it on a fine grater). Then you need to squeeze the juice out of it and rub the painful areas or make a compress at night.
• Recipe 2. Chamomile for internal use. To prepare the infusion, you will need 4 tablespoons/liter of chamomile flowers, pour 0.3 liters of boiling water. Bring to a boil, let cool, then strain and take 100 mil 3 times a day. Chamomile decoction has an anti-inflammatory effect.

• Recipe 3. Sea salt to treat illness. You will need 2 tables. l. sea ​​salt, dissolve in 0.5 liters of hot water. Then dip into the prepared solution small piece natural fabric and apply to the sore spot. Warm compress keep for at least 1 – 2 hours.
• Recipe 4. Sage baths. To prepare a bath, you need to take 20 grams of dry sage, pour 2 liters of boiling water, bring to a boil, leave for 1 hour, strain and pour into the bath. You can also add 3 tbsp to the prepared bath. l sea salt and a few drops of essential oil. You need to take such baths for no more than 15 minutes.
• Recipe 5. Juice from onions and potatoes. You will need raw potatoes and 1 large onion. Potatoes and onions need to be grated. The resulting pulp should be placed on a small piece of clean cloth and applied to the sore spot for 1 - 2 hours.

• Recipe 6. Beeswax treats painful condition. Beeswax needs to be melted, add 1 spoon of natural honey and juice from 1 onion. Mix everything well and apply to the sore spot, making a compress at night.

There are other traditional medicine recipes that are effective in treating intercostal neuralgia, but in any case, before using them you need to consult with your doctor and conduct a sensitivity test. Despite the safety of traditional medicine, many components of plant or animal origin can cause allergic reactions.

Complications of intercostal neuralgia

Intercostal neuralgia does not have serious complications, especially when a person promptly seeks help from a doctor. The only one possible complication This disease is considered to be a painful shock that appears during the acute period of the disease. In such cases, the patient needs to take a painkiller and any sedative as quickly as possible.

Prevention of intercostal neuralgia

Prevention of the disease consists of following basic rules, such as:

• Avoid hypothermia.
• Treat internal diseases of the musculoskeletal system in a timely manner.
• Carry out daily physical exercise, especially when your work activity involves sedentary work. Maintain proper posture.
• Watch your diet and lifestyle.
• Stop drinking alcohol.
• Avoid spinal injuries.
• If there is any internal disease infectious or non-infectious origin, seek help from doctors, carry out full course treatment, this will help avoid possible complications.

Intercostal neuralgia is a complex disease that requires qualified medical assistance and timely diagnosis. The sooner the disease is diagnosed, the less time a person will suffer from pain, which can sometimes be so strong that it causes a painful shock and loss of consciousness in a person.

She underwent treatment at the Health Workshop clinic on Nauki from March 1 to March 15, 2019 with neurologist Elena Vladimirovna Khislavskaya and physiotherapist Olga Yuryevna Kiryanova. Contacted with acute pain in the back and weakness in the legs. They prescribed a course of back injections and ozone injections. After the third procedure there was a deterioration, then, while getting into the car, my leg gave out, fell, sprained my already weak leg... But somehow it began to improve, my back straightened, my legs began to walk more confidently. Today was the last procedure and a long necessary conversation with the doctor, new recommendations for treatment. Thanks to the entire team for their sensitivity and teamwork. Now I am on the road to recovery, in three months I will have a new meeting with a wonderful doctor.

Elena Sergeevna

Solodilina A.A.

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They helped me. I came to the clinic with pain in my left shoulder. The pain has decreased. I don't regret coming here. Doctor Elena Arkadyevna is attentive, polite, and explains everything clearly. I'm not breaking up!

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Gratitude and congratulations for the “Health Workshop”! On these holidays, Defender of the Fatherland Day and March 8th, I ask you to congratulate everyone and especially the wonderful doctor V.L. Egorov, the wonderful D.E. Vetrov, Alekhintseva S.E., Stepanov E.A. and all the treatment room staff, Alexandra and her entire team. I wish everyone good health, always Have a good mood, fulfillment of desires, career success and great personal happiness. With gratitude, V.I. Belyaeva

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suffered from chronic pain 8 months, in the clinic and hospital they brushed it off or made vague diagnoses, despite all the information I provided... Viktor Anatolyevich is a doctor who accurately diagnosed my problem in as soon as possible. The professional skills of such a highly qualified specialist are something that I have been critically lacking for a long time. Many thanks to the doctor and all the clinic staff!

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I express my deep gratitude to the attending physician Elena Vladimirovna Khislavskaya! Long and painful trips to the district clinic and the consultation center of the Kalininsky district led to nothing, none of the doctors could make an accurate diagnosis, they found nothing, they just shrugged it off, and some of them were sent to a psychotherapist. I was getting worse and worse. As this clinic was my last hope, I ended up with Elena Vladimirovna. She was so attentive to my problem, correctly diagnosed (Tittze syndrome), prescribed treatment, and little by little I began to get out. I believe that only her sensitive attitude towards people and her desire to understand gave results. Since the disease was advanced, treatment lasted for 2 months and then recovery after discharge. Yes, it costs money, but taking into account the fact that visiting compulsory medical insurance and even paid specialists from other clinics did not bring results, it is definitely worth it. I was returned to normal life How can this be measured? I would like to say a special thank you to orthopedist Rustam Fanilievich, he performed the blockade very carefully and accurately. I also express my deep gratitude to the massage therapist Sergei Nikolaevich Guberniatorov, he has golden hands. And to all the clinic staff for their friendly and sensitive attitude!

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I express my gratitude to the clinic team for their respectful and attentive attitude towards patients. I would like to separately thank such doctors as Soboleva Svetlana Nikolaevna, Kustova Marina Anatolyevna, Akhmadullina Tamara Nurievna, Chernov Andrey Aleksandrovich for their professionalism, kindness of heart and great skill. It is a great blessing that such competent, skillful and talented, caring people work exactly where they are needed most. I wish prosperity and well-being to your clinic and the specialists who work in it.

Kudryavtseva Natalya Pavlovna, 65 years old

She underwent a course of treatment at the Health Workshop and in particular with Stanislav Vladimirovich. I want to express my deep gratitude for the help provided to me, for your golden hands. A very attentive and sensitive doctor, taking into account my diagnosis (hernia, protrusion, etc.), used gentle techniques and after each session my health improved and my life got better, I couldn’t wait to see him so that he could ease my suffering. Stanislav Vladimirovich, thank you very much, I will definitely recommend you to those who need the same help.

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Was treated by Lisina E.A. I'm very pleased. She saved me from a nervous breakdown and healed me. Problems with hip joints. She prescribed plasma therapy. I am very grateful to her. All clinic staff are polite and attentive. All the medical staff are excellent workers. I am very grateful to all the employees of the Health Workshop. I also thank Alexander Sergeevich Kryukov, who immediately understood my condition and handed me over to E.A. Lisina.

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I would like to thank from the bottom of my heart the entire team of the “Health Workshop” at 224B Moskovsky Prospekt. Absolutely everything: both doctors and administrators are very attentive and professional. I received the treatment I wanted. I will definitely contact you again to maintain my current - very good condition - of the musculoskeletal system. I would especially like to thank neurologist E.A. Lisina, hirudotherapist G.V. Lapin, chiropractor Daskovsky S.V. and physiotherapist D.T. Gvirdzhishvili It's just a pleasure to meet and work with them. Thank you!

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Here is my lifeline - “Health Workshop”: my legs can’t walk, my back hurts, my head is ringing. I accidentally heard about this clinic on the radio and this is the second time I have visited it. I enter and find myself in the kingdom of silence, peace and hope, if not cured, then at least improve my condition. Nice, charming girls-consultants greet you with kind greetings. They patiently listen to your questions and fill out Required documents and escorted to the attending physician. During the waiting period, you are offered to watch help videos on TV and drink a cup of coffee or tea. And all fears are behind us! Thank you darlings. Without your well-coordinated work, attentive, friendly attitude the patient would not have the same effect from the visit. And here is the first meeting with the doctor. I was lucky, and I think others were too. I met with a real magician, who with just one word gave me confidence that I needed treatment. This is Egorov Vladimir Leonidovich. Who in our district clinics would talk with a patient for an hour? Nobody! And Vladimir Leonidovich listened to me carefully, explained the essence of the disease - osteoporosis of the spine, and then spent the same amount of time selecting necessary treatment. I am grateful to you, dear doctor, congratulations on the upcoming New Year and wish you health and creative success. I communicated with the same wonderful doctors, professionals in their field, very kind and attentive, while undergoing procedures. This is Alekhintseva Svetlana Evgenievna, Stepanova Elena Anatolyevna, Akhmadullina Tamara Nurievna, exercise therapy doctor and, of course, chiropractor Rakhmatov Tolmas Turaevich. This is a doctor from God. His warm hands do wonders. Thank you all for your conscientious work and respect for ordinary people. I want to say a special thank you to the entire team treatment room. The work of nurses cannot be compared with anything in terms of difficulty and responsibility. And how sensitive, attentive and kind they all are... Forgive me for those I didn’t mention in my message. The whole team works just fine. Happy New Year to the entire clinic team! I wish you health, personal happiness, creative success, grateful patients.

Neuralgia is usually called pain caused not by an organ or part of the body, but directly by the nerve itself. In the case of intercostal neuralgia, pain is caused by damage or compression of the nerves passing between the ribs.

What is intercostal neuralgia

Intercostal neuralgia is a syndrome characterized by intense pain in the chest area, or more precisely, in the intercostal space. The disease occurs mainly in old age, but its occurrence in children is also possible. The incidence of the disease in men and women is approximately the same.

Intercostal nerves come from thoracic spine and contain fibers for various purposes - sensory, motor and sympathetic. There are a total of 12 pairs of intercostal nerves. Passing between the ribs, they innervate the muscles and skin of the chest, abdomen and peritoneum.

It is customary to distinguish two main types of intercostal neuralgia - radicular, caused by pinching of the roots of nerve fibers in the spine, and reflex, caused by muscle spasm in the intercostal space.

Also, depending on whether the pain is felt on one side of the chest or on both, intercostal neuralgia can be unilateral or bilateral. The disease is of a bilateral type, most often caused by herpes. It is worth keeping in mind that damage to the intercostal nerve on one side can lead to pain on both sides of the body - due to the fact that the nerve fibers are partially intertwined.

The disease does not pose an immediate threat to life, although it causes a lot of pain for the patient. discomfort. However, in some cases, the cause of neuralgia may be hidden serious diseases, such as tumors. In addition, pain may worsen general state patient, lead to insomnia, hypertensive crises, etc. It should also be borne in mind that dysfunction of the intercostal nerve can negatively affect the process of supplying blood to tissues.

Intercostal neuralgia: symptoms

The area where pain occurs is the intercostal space. The pain is shooting or burning in nature. The intensity and duration of pain may vary from patient to patient. Sometimes the patient may feel only a slight burning sensation, and sometimes severe pain, intensifying with each breath. Often, the patient can feel a wave of pain spreading along the intercostal nerve. When pressing on the place where the nerve goes, the pain can intensify many times. At night, the pain usually does not decrease, which can lead to insomnia.

But with intercostal neuralgia, the symptoms may not be entirely typical. For example, pain may also radiate to the scapula, epigastric region, lower back, collarbone, in women - into the mammary glands.

Symptoms of intercostal neuralgia also include some indirect signs: increased sweating, muscle twitching, loss of skin sensitivity in the area where the damaged intercostal nerve is located, paleness or redness of the skin, swelling. The symptoms of neuralgia may also be similar in appearance to pain caused by other diseases. For example, when a nerve running in the area of ​​the lower rib is irritated, pain occurs that resembles renal colic.

But first of all, the symptoms and nature of pain in neuralgia should be separated from the signs cardiovascular diseases, in particular, coronary disease. Left-sided neuralgia is especially often disguised as angina.

Features that distinguish neuralgia and its symptoms from heart disease

Here typical characteristics and symptoms that are characteristic of pain with intercostal neuralgia (as opposed to pain with angina):

• The intensity of pain changes with changes in body position - bending, turning. When taking a deep breath, coughing or sneezing, the pain intensifies.
• The pain can be partially or completely relieved by taking sedatives and sedatives - Corvalol, valerian.
• The pain lasts for hours and even days.
• The pain is not relieved by taking vasodilators.
• The nature of the pain is in no way related to physical activity (meaning loads not associated with changes in the position of the body, for example, walking).
• Pain is not accompanied by disturbances heart rate.

It is worth noting that angina pectoris and neuralgia can have a number of similar symptoms, for example, changes in blood pressure or shortness of breath, although the mechanism of their occurrence is different in both cases.

Lichen alba is treated on an outpatient basis. Photo: Andrei_R/Shutterstock.com

Causes of neuralgia

The most common cause of the disease is osteochondrosis. This disease causes compression of the nerve roots in the intervertebral discs.

Hypothermia, working in an uncomfortable position, draft, colds, neurological diseases, diseases of internal organs, intoxication - all this can also provoke the appearance of intercostal neuralgia. The causes of the syndrome may also lie in damage to the nerve sheaths (demyelination). It is possible that intercostal neuralgia may occur as a result of rib fractures and spinal injuries. In children, neuralgia may be associated with birth injuries or disturbances in the formation of the skeleton.

Among infectious causes intercostal neuralgia, herpes zoster should be put in first place in terms of prevalence. Neuralgia can also be caused by diseases such as tuberculosis and influenza.

Factors contributing to neuralgia:

• diabetes
• age-related vascular diseases
• lack of immunity
• deficiency of vitamins, primarily group B
• hypertension
• hormonal changes

In most cases, the immediate cause of intercostal neuralgia is muscle spasm, which leads to compression of the nerves.

Diagnostics

When making a diagnosis, neuralgia must be differentiated from pain caused by diseases of the spine not associated with osteochondrosis or trauma (for example, spondylitis or ankylosing spondylitis), pleurisy, diseases of the gastrointestinal tract, kidneys, cancer, as well as diseases of the cardiovascular system.

To clarify the diagnosis, first of all, analysis of symptoms and visual inspection patient, listening to the heart, lungs and palpating the rib area. However, in some cases it can be difficult to make an accurate diagnosis based on these data, so additional tests may be ordered. Clinical researches may include a cardiogram, radiography, X-ray and magnetic tomography, electroneurography, myelography, ultrasound, blood and urine tests.

Photo: Room's Studio/Shutterstock.com

Treatment of intercostal neuralgia

Intercostal neuralgia - what to do if you have pain in the chest area? First of all, it is necessary to figure out whether this is really intercostal neuralgia or something more dangerous disease. Indeed, with intercostal neuralgia, the symptoms often copy the symptoms of diseases of the internal organs. AND self-treatment, in the event that the diagnosis was made incorrectly by the patient himself, can lead to dire consequences. In addition, neuralgia different people may differ in causes and intensity, and effective treatment may have its own characteristics each time. Therefore, if characteristic signs indicating intercostal neuralgia appear, you should consult a therapist. Only a doctor can correctly recognize the symptoms and prescribe treatment.

The treatment strategy consists of three stages:

1. Relief of pain using painkillers
2. Elimination immediate cause pinched or damaged nerve
3. Treatment of those pathologies that caused nerve irritation

Traditional medicine

IN traditional medicine The following methods of treating intercostal neuralgia are usually used:

• Therapy medications(analgesics, anti-inflammatory drugs, vitamins)
• Physiotherapy
• Limitation of spinal mobility (for example, with the help of corsets)
• Manual and reflex therapy
• Massage
• Physiotherapy

Treatment in most cases is conservative, although in case of advanced disease and ineffectiveness of other methods, it can also be used. surgery. Treatment methods for right-sided and left-sided intercostal neuralgia are not fundamentally different. During exacerbation of the disease, bed rest is usually indicated, but the patient is recommended to lie on a hard surface.

Drugs

Relief of severe pain is usually done with painkiller injections - novocaine blockades. If the pain is moderate, it is preferable to take oral analgesics. Also, for intercostal neuralgia, muscle relaxants are prescribed to help relax muscles, diuretics to relieve swelling, sedatives and antidepressants - to relieve stress. Ointments or patches with anti-inflammatory and analgesic substances can be used locally. In case of intercostal neuralgia caused by herpes, drugs that fight viruses are prescribed.

Treatment methods for intercostal neuralgia caused by osteochondrosis

If the root cause of the disease is osteochondrosis, then the fight against neuralgia should be aimed primarily at its treatment. In this case, methods such as physiotherapy, massage and manual therapy provide great help.

Physiotherapeutic procedures are one of the most effective methods in treating the consequences of osteochondrosis. These may include the use of ultrasound, magnetic fields, electric current, laser, UV and IR radiation.

The massage is designed to strengthen and relax muscles, as well as improve blood flow in tissues. Manual therapy is aimed primarily at restoring the configuration of the spine and eliminating displacements of individual vertebrae.

Folk remedies

Neuralgia is by no means a modern phenomenon. Our great-grandfathers knew very well what kind of scourge this was, but they also knew how to treat it. ethnoscience has developed a lot effective methods, which can be successfully used today. After all, it is not always possible to see a doctor if an attack of illness occurs suddenly.

Rubbing the affected area with alcohol tincture of birch buds or valerian gives a good effect. General warming of the body with warm clothes or a woolen scarf also helps. Local heating of the painful area using heating pads is ineffective and can only worsen the condition.

Among the remedies for internal use, it is worth mentioning a decoction of peppermint. It is prepared like this: 1 tablespoon of dry leaves is infused in 200 g of boiling water. You should drink 100 g of the decoction in the morning and evening.

Prevention

It is well known that any disease is easier to prevent than to treat. This is also true for neuralgia.

• Monitor your diet and lifestyle
• Avoid hypothermia and drafts
• Avoid strenuous physical work
• Avoid injury to the ribs and spine
• Monitor correct posture and do strengthening exercises, especially if your job is sedentary
• Treat in a timely manner infectious diseases and diseases of the musculoskeletal system

Intercostal neuralgia is a painful condition caused by irritation of the intercostal nerves or their compression. Intercostal neuralgia, the symptoms of which are usually observed in older people, is explained by age-related changes, relevant for the condition of their blood vessels. As for children, this disease is extremely rare in them.

general description

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. Often enough of this type neuralgia occurs against the background of an advanced stage, which occurs as a result of compression applied to the roots of the intercostal nerves.

As others possible reasons The occurrence of this disease is also identified by a number of diseases, which in particular include hormonal spondylopathy, progressive degree, neoplasms concentrated in the spine, etc.

An attack of the disease can be triggered by a cold or hypothermia, poisoning or infection, mental stress or trauma. In addition, the factors influencing the appearance of intercostal neuralgia also include excessive physical activity, carried out out of habit or without the necessary pre-warming.

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 quite often clinical practice indicates the occurrence of intercostal neuralgia as a result herpetic lesions. It often occurs as a kind of response to irritation directed at the nerve trunks, which occurs as a result pathological course processes in the area of ​​neighboring tissues and organs. In particular, such processes may include diseases of the ribs and spine, deformation of the chest area, etc.

It is also customary to identify the cause of intercostal neuralgia (which corresponds to a generalized version of intoxication) as taking certain medications, against the background of which pinched nerves occur. Long-term use Some medications often provoke the development of complications, which occurs due to the actual decomposition of their components in the body in this case.

Overall significant content toxic substances, as well as inhalation of metal salts - all this accompanies damage to the nervous system, often provoking intercostal neuralgia.

Intercostal neuralgia: symptoms

The main symptom of intercostal neuralgia is pain, which is concentrated in the heart area. This pain, in its essence, differs from the pain that accompanies heart disease, and, first of all, in that in the case of intercostal neuralgia, this pain is neuropathic in nature. In other words, it is provoked by certain diseases associated with the nervous system, as well as with its elements or damage relevant to them.

The appearance of a symptom in the form of pain in the ribs is explained by the fact that, as we have already noted, compression or irritation of the intercostal nerves occurs - you can see the essence of the process below:

Despite the fact that the nature of pain is neuropathic, it can manifest itself in different ways, being burning or aching, sharp or dull. In some cases, patients complain of episodic pain, in others the pain is constant. Naturally, given the appearance of pain due to damage, pain provoked by irritation of nerve fibers intensifies if the patient increases motor activity. So, flick body, loud talking, normal sneezing or abrupt change body position - all this with intercostal neuralgia will lead to a significant increase in pain.

Considering the characteristics of pain during intercostal neuralgia, we note that they also appear when certain areas of the body are palpated (that is, when they are palpated). In particular, such areas include, again, the intercostal region or spine, the chest area, etc. By the way, in the part of the chest in which sharp pain manifests itself, the segment of the nerve that is directly damaged is located.

It is noteworthy that the duration of pain cannot be constant - subsequently, necrosis of the nerve root simply occurs. This, in turn, leads to a calming of the patient, who does not experience symptoms of intercostal neuralgia and pain in particular. Meanwhile, this does not mean the disappearance of the disease. Thus, the usual state and sensations are replaced by new ones - this is a decrease in tidal volume, which manifests itself in the patient’s shallow breathing, which is also accompanied by a feeling of heaviness in the chest.

Pain with intercostal neuralgia is, of course, predominantly concentrated in the area between the ribs, but it can also be noted in other areas, for example, radiating under the shoulder blade or to 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, these may be clearly noticeable twitching or muscle contractions. Intense sweating may also be observed, and a change in skin color is possible - it may either turn red, or, conversely, have a very pale look. It is possible that the skin may tingle or lose sensitivity in certain areas.

The pain that occurs in the chest area is defined by doctors, as well as by the patients themselves, as “girdling” pain, which is explained by their occurrence along the intercostal spaces.

There are also some external signs, indicating the disease we are considering. Thus, patients are often in an “antalgic” position, which looks like this: the body bends towards the healthy side while trying to maintain this position. This is explained by the fact that as a result of such manipulations with his own body, the patient thereby stretches the intercostal spaces. As a result, the pressure decreases, the nerve endings are irritated much less, which ultimately leads to a decrease in immediate pain.

An additional role in the described tactics is played by psychological fear associated with the expectation of pain, as a result of which patients strive to maximize possible time be in a similar body position.

Difference between the disease and heart disease

Having examined the characteristics of pain and symptoms in general, we can draw some conclusions. In particular, in this regard, I would like to touch upon the commonality of pain in the chest area that occurs with this type of neuralgia with certain diseases associated with the functioning of the cardiovascular system. It is the definition exact nature pain makes it possible to distinguish diseases from each other, as well as to identify the causes that provoked this pain.

It should be remembered that although pain is the main symptom indicating both neuralgia and heart disease, the nature of this pain differs in both cases.

Intercostal neuralgia is characterized by constant pain noted over a very long period of time. Naturally, in this case, it will not be possible to eliminate it using the same, one might say, traditional nitroglycerin for heart problems. Increased pain is noted, as was also stated earlier, in the event of any movement of the body or change in its position.

If we are talking about the relevance of any disease associated with cardiovascular system, then there is already periodic and short-term pain, suppressed by the use of medications (for example, the same nitroglycerin). Pain caused by heart disease does not intensify with any body movements.

We also note that heart pain is characterized by an irregular heart rhythm in combination with a change in blood pressure (it either increases or decreases). If we are talking about intercostal neuralgia, then its symptoms exclude similar manifestations, accordingly, pulse and blood pressure remain within normal limits.

Treatment of intercostal neuralgia

As a basis for successful treatment, undoubtedly, measures aimed at eliminating pain are used. You can get rid of them only when the impact of the irritating factor is completely eliminated. As we found out, pain occurs as a result of squeezing and compression of nerve endings; accordingly, the patient is first prescribed pain medications.

If a doctor discovers during an examination that there is an irregularity in the location of the cervical vertebrae and vertebrae of the thoracic region, they need to be “returned to their place,” which implies the need for physiotherapeutic procedures and massage.

Carrying out manual therapy This can only be done by a specialist, this is extremely important to remember! Otherwise, you may not only encounter a number of side effects caused by inept intervention, but also with disability.

Osteopathy is also widely used as an additional treatment measure, the procedures of which ensure the restoration of the position of each part of the spine in accordance with their accepted anatomical location. Ultimately, there is a rapid restoration of blood circulation and normalization of lymph flow, which, in turn, restores the balance of internal nerve endings, muscles and the body as a whole.

Reflexology is also useful in treating 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 develops into chronic stage, in which there is a systematic recurrence of pain. To avoid this, you should reconsider your lifestyle, minimizing any type of stress, the same applies to reducing the intensity of sports. Drinking alcoholic beverages is strictly prohibited. Stressful situations and unrest, as you know, has a negative impact on nervous system, and therefore, if possible, they should also be reduced.

If symptoms relevant to intercostal neuralgia appear, you should consult a neurologist; in addition, a visit to a chiropractor and physiotherapist may be prescribed.

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Diseases with similar symptoms:

Asthma - chronic illness, which is characterized by short-term attacks of suffocation caused by spasms in the bronchi and swelling of the mucous membrane. A certain risk group and age restrictions this disease does not. But, as it shows medical practice, women suffer from asthma 2 times more often. According to official data, today there are more than 300 million people living with asthma in the world. The first symptoms of the disease most often appear in childhood. Elderly people suffer from the disease much more difficult.

Heart defects are anomalies and deformations of individual functional parts heart: valves, septa, openings between vessels and chambers. Due to their improper functioning, blood circulation is disrupted, and the heart ceases to fully perform its function. main function– oxygen supply to all organs and tissues.

Myocardial dystrophy in medicine is called repeated damage to the heart muscle. The disease is not inflammatory in nature. Often, myocardial dystrophy is a complication of heart disease, which was accompanied by a malnutrition of the heart muscle (myocardium). As the disease progresses, a decrease in muscle tone is observed, which, in turn, is a prerequisite for the development of heart failure. Heart failure, in turn, occurs due to a decrease in blood flow to the myocardium, which is why the cells do not receive the amount of oxygen they need for normal functioning. Because of this, myocardial tissue can atrophy or even become necrotic.

Severe pain in the ribs prompts a person to go to the doctor to find out how to treat intercostal neuralgia and what medications to suppress the symptoms of the disease.

Intercostal neuralgia does not belong to the category of dangerous diseases. But it develops against the background serious pathologies and develops into serious complications. Neuralgia is caused by intervertebral protrusions and hernias, tuberculosis, diabetes, multiple sclerosis, tumors.

The symptoms of neuralgia are such that they can easily be confused with signs of renal colic, cholecystitis, and angina. Only a doctor can make a correct diagnosis and prescribe treatment based on diagnostic studies.

Usage medicines – main way treatment of intercostal neuralgia. To treat the disease and the cause that caused it, the following is prescribed:

• pills;
• injections for intramuscular and intravenous administration;
• ointments, gels or creams.

The form of medication for intercostal neuralgia is chosen by the doctor. Medicines are prescribed taking into account the severity of the disease, the patient’s well-being and contraindications.

Tablets are considered an ineffective treatment for intercostal neuralgia. In addition, they irritate the mucous membranes gastrointestinal tract, cause adverse reactions. Erosive gastritis and gastric ulcer – possible harm from uncontrolled use of tablets.

Pain relievers

The primary goal of drug therapy is to relieve pain – the main symptom of the disease. Pills and injections help get rid of prolonged debilitating pain. For pain relief the following is usually prescribed:

• Spazgan;
• Analgin;
• Baralgin;
• I took it.

To relieve unbearable pain that occurs with swelling of nerve fibers and root compression syndrome, the following is used:

• Ketoprofen;
• Ibuprofen;
• Celebrex;

Analgesics are used to relieve pain and prevent new attacks:

• Panadol;
• Tylenone;
• Pentalgin.

These drugs are available in tablets, injection solutions, ointments and gels. They are taken in tablets. To quickly relieve pain, injections are given and IVs are placed.

The course of treatment with anesthetics is short, it does not exceed 4-5 days. They violate normal functioning gastrointestinal tract.

Local painkillers

Local anesthetics relieve swelling and pain of a neuralgic nature. They are prescribed for temporary relief of acute pain. Reduce pain and eliminate muscle tension with ointments, gels, and injection solutions.

The drugs are applied or injected directly into the lesion. They are used to make blockades. Pain is suppressed with injections of Lidocaine, Novocaine or Xylocaine. The use of local anesthetics is limited in time. They are highly toxic agents that can cause great harm body. Unbearable pain removed with one-time blockades.

Anti-inflammatory medications

Inflammatory processes occurring in nerve fibers lead to swelling and pain. The swollen tissue puts pressure on the nerves. Pinched nerve roots are accompanied by pain. Relieving inflammation, eliminating pain.

Inflammatory processes are suppressed with non-steroidal anti-inflammatory drugs:

• Ortofen;
• Nimesulide;
• Ketoprofen;
• Voltaren;
• Movalis.

The products effectively relieve inflammation. If you use them correctly, according to the regimen given by the doctor, you can get a long-term stable remission. To eliminate inflammation, take a tablet 2 times a day, give an injection, or use rectal suppositories.

The body's susceptibility to drugs is almost the same. But they are best absorbed through the mucous membranes. Long-term treatment anti-inflammatory drugs cause exacerbation of certain ailments (for example, gastritis or ulcers). They should not be used without a doctor's prescription.

Muscle relaxants

IN drug treatment intercostal neuralgia include muscle relaxants - drugs with a sedative effect. They eliminate pain, relax muscles, and improve the patient’s well-being. Which of them can be used for treatment:

• Tizanidine;
• Tolperisone.

The taken muscle relaxant eliminates congestion in muscle tissue and swelling. For treatment, use a drug prescribed by a doctor.

Vitamin therapy

To suppress inflammatory processes, replenish vitamins and minerals, and strengthen the immune system, it is necessary to take special complexes. Medicines with B vitamins are involved in blocking acute inflammatory processes that erupt in nerve tissues. Vitamin complexes relieve muscle spasms, neutralize negative impact medications used.

Sedatives

Painful sensations worsen the well-being of patients, plunge them into a state of prolonged stress, create a feeling of discomfort, and reduce the quality of life. Taking sedatives for intercostal neuralgia helps relieve nervous tension, relax skeletal muscles, and normalize the condition of the sick person.

To this end, in drug therapy you can include a product with a sedative extract medicinal plant. Suitable for treatment:

• Chamomile;
• Mint;
• Motherwort.

Herbs with a sedative effect are used separately or preparations are made from them. It is worth drinking infusions and decoctions from them. Have an effective impact pharmaceutical drugs: syrups, tinctures.

They drink a sedative at night. It promotes good sleep, proper rest, and relieves nervous and muscle tension. Have an excellent relaxing effect essential oils: lavender and mint.

Medicines with bee and snake venom

Eliminate intercostal neuralgia with medicines based on snake oil and bee venom. The effectiveness of ointments and gels with these poisons is quite high. They warm up the skin, accelerate blood circulation, remove metabolic products, and saturate tissues with bioactive substances. The drugs regenerate damaged nerve tissue.

The product with poison is used externally, it is rubbed into the lesions with soft massaging movements, bypassing the heart area. For treatment use:

• Apisatron. Ointment with bee venom suppresses pain and inflammation, restores blood flow.
• Viprosal. Ointment with viper venom eliminates pain and improves blood circulation. Camphor and fir, which the drug contains, have an analgesic effect.

These ointments are used as prescribed by a doctor. They are not always used for treatment of:

• lactation;
• pregnancy;
• allergies;
• heart diseases.

Antiviral agents

Problem: how to treat intercostal neuralgia of a viral nature is easily solved. Antiviral medications are used to suppress it. Effectively fight pathology:

• Amiksin;
• Remantadine.

Ointments and gels

Remedies for neuralgia in the form of ointments and gels quickly relieve pain. They instantly penetrate through the skin pores into the deep tissues, to the lesion, reduce the severity of the pain syndrome and eliminate swelling.

External agents stimulate blood circulation, distract from pain, and remove nervous tension. Thanks to them, blood supply to the sore spot improves, nutrition of damaged tissues, and pain goes away.

To treat intercostal neuralgia use:

• Fastum-gel. The product relieves pain, stimulates blood flow, and eliminates swelling.
• Capsicam. The ointment, due to its effective warming effect, accelerates the supply of blood to tissues. It restores tissue trophism and helps replenish nutrients.
• Finalgon. The ointment warms up. Thanks to her blood vessels are expanding. Blood flow increases. Oxygen and nutrients enter the tissues.
• Indomethacin, Ortofen, Naklofen, Ibuprofen. Ointments fight inflammation, swelling and pain.
• Menovazin. The ointment has a pronounced analgesic effect.
• Chondroxyl. The chondroprotector restores mobility to the spine.

Preference is given to ointments. Their rate of penetration into tissue is higher than that of gels. In the early stages and severe pain use ointments that can relieve muscle spasms and relax muscles.

For patients suffering from severe pain, try not to prescribe ointments with a burning effect. By increasing stimulation at the site of the lesion, it is possible to provoke the development of an ischemic crisis or heart attack due to excessive outflow of blood from the coronary vessels.

Antispasmodics

For neuralgia muscle tissue, surrounding the damaged nerve fibers, spasm, their tone is excessively high. Without eliminating muscle spasms, you cannot get rid of pain. Increased tone relieved with antispasmodics:

• Besalol;
• Halidor;
• No-spy;
• Papazol.

To eliminate spasms, they take pills and give injections.

Intercostal neuralgia requires comprehensive therapeutic treatment. Thanks to it, pain is quickly relieved, the patient’s well-being is improved, and inflammatory processes that caused the disease. Prescription of treatment by the doctor - required condition. Prescribed medications will give maximum healing effect, will not allow complications to develop.