Among nervous diseases, intercostal neuralgia occupies a special place. This is due to the fact that during its course, strong painful sensations are observed, which practically do not occur in other pathologies.
Often the disease occurs in people aged 25-65 years and very rarely affects children. Men and women can suffer from pathology equally. It is worth remembering that any irritation or compression of nerve fibers can lead to symptoms of intercostal neuralgia. Treatment must be comprehensive, as only this will achieve a good result.
Feature of the disease
Intercostal neuralgia is characterized by the fact that the source of pain is not the receptor, but the nerve endings. Attacks of pain in this case are somewhat reminiscent of an electric current discharge. They start suddenly, last for a few seconds, and then just as abruptly disappear. The frequency of such attacks can reach several tens of times a day.
With painful attacks in the back and sternum, swelling of the intercostal nerve is often additionally observed in the area of its exit from the intervertebral foramen. Edema can develop as a result of compression of the nerve endings by the intervertebral hernia, as well as spasmodic back muscles.
According to the ICD 10 code, intercostal neuralgia (M 79.2) refers to diseases of the musculoskeletal tissue, as this is due to the fact that spasmodic muscles are involved in the pathological process.
Causes of occurrence
There are many causes of intercostal neuralgia, which include:
- osteochondrosis;
- injuries;
- infections;
- hypothermia;
- intervertebral hernia;
- new growths;
- spondylolisthesis.
The most common cause is osteochondrosis, since when it occurs, nerve endings are squeezed by sagging vertebrae. It is worth noting the occurrence of inflammation and irritation of the nerve roots. With a sharp movement, there may be a short-term pinching of hematomas and muscles.
Prolonged hypothermia provokes the occurrence of muscle spasms, as well as irritation of the nerve roots. Among infectious lesions, tuberculosis, herpes and influenza can be distinguished. Alcoholism has a great influence, since alcohol toxins, when regularly exposed to nervous tissue, irritate it.
Main symptoms
The main symptom of intercostal neuralgia is paroxysmal acute pain, which is similar to an electric shock. Mostly suffernerve endings are only on one side, and pain is localized only in one intercostal space.
The duration of the symptoms of intercostal neuralgia on the left is calculated in a few seconds, but it seems to the patient that they last for an eternity. Signs are largely provoked by certain behavior of the person himself. In particular, pain may occur when:
- sneeze;
- sudden motion;
- cough;
- laughter;
- deep breath;
- cry.
All this suggests that the pain can be triggered by the defeat of swollen nerve endings. Intercostal neuralgia, the symptoms and treatment of which largely depend on the condition of the affected nerve, is the most striking example of the presence of muscle spasm and the onset of pain.
To prescribe the right treatment, it is imperative to distinguish such a pathological condition from other diseases similar in symptoms. Symptoms of intercostal neuralgia are characterized by the fact that painful sensations occur very sharply, and often a person is not even able to be frightened.
The patient tries to take the most comfortable position and at the same time move as little as possible. During the course of diseases of the cardiovascular system, a person can rush about, since a change in position and a deep breath have absolutely no effect on pain. In addition, there may be blueness of the earlobes, as well as the nasolabial triangle. This occurs as a result of a lackoxygen. In case of heart disease, pain can be stopped with a Nitroglycerin tablet, which must be placed under the tongue. The symptoms of intercostal neuralgia will not be cured by this medicine.
A number of different diseases can stimulate the occurrence of neuralgia, which is why it is quite difficult to make a correct diagnosis at the initial stage of the course of disorders. The doctor must carefully examine the patient's history in order to exclude the occurrence of more complex and dangerous diseases.
Diagnostics
When the first symptoms of intercostal neuralgia occur, you should definitely consult a doctor for a comprehensive diagnosis and correct diagnosis. Initially, the doctor collects the patient's complaints and anamnesis of the development of the disease, and then prescribes a number of additional studies. The most informative of them are:
- blood test;
- bacteriological examination;
- radiography;
- tomography;
- ultrasound diagnostics;
- myelography.
If the symptoms of intercostal neuralgia arose due to an infectious process in the body, then a bacteriological blood test can reveal the causative agent of the disease, and in all other cases the indicators remain unchanged.
X-ray and tomography can detect even the most minor violations in the bone tissue, as well as determine the exact reason for the development of neuralgia. With myelography, nerve endings and the spinal cord are examinedby injecting a contrast agent on an X-ray machine, this allows the changes present in the nervous tissue to be revealed.
Features of treatment
Depending on the provoking cause and symptoms of intercostal neuralgia, treatment on the left side is selected purely individually by a neurologist. However, the therapist can choose the method of treatment. The basic principle is complete rest, elimination of painful sensations, as well as removal of swelling from the muscles and nerves. This leads to a rapid reduction in pain, which eventually disappears completely.
For the treatment of intercostal neuralgia, anti-inflammatory drugs are prescribed, which help to eliminate painful sensations very effectively. On the first day, diuretics can be used to eliminate swelling. Muscle relaxants have a good effect. At the very beginning of treatment, drugs are prescribed intramuscularly, and then you can gradually switch to the tablet form. Drugs should be prescribed by a doctor, taking into account contraindications, as well as the presence of concomitant diseases.
When the first symptoms occur, treatment of intercostal neuralgia at home involves calling a doctor to prescribe medications. After the elimination of an acute pain attack, it is recommended to apply physiotherapy, warming with dry heat, rubbing ointments into the back to normalize blood circulation and eliminate spasm.
In the phase of subsiding exacerbation, massage is shown, as well as physiotherapy exercises. Afterto eliminate pain and as a preventive measure, patients are prescribed swimming and maintaining an active lifestyle.
Medicated treatment
How to treat intercostal neuralgia, only the attending doctor can determine after a comprehensive diagnosis, since in each individual case the drugs are selected individually. When choosing medicines, preference should be given to analgesics. In particular, drugs such as Ortofen, Analgin, Baralgin can be used.
Doctors recommend additional use of ointments that have analgesic and anti-inflammatory effects. They need to be applied to the skin in the area of pain up to 3-4 times a day. Among the local funds, it is necessary to highlight such as Ketonal, Voltaren emulgel, Viprosal, Apizartron, Finalgon.
Ointments containing ibuprofen and diclofenac in their composition help to normalize blood circulation in the place of discomfort and eliminate inflammation, thereby reducing pain. Products made on the basis of bee venom may be popular.
Patches impregnated with creams and gels that help fight pain have good properties. They normalize blood vessels and have an anti-inflammatory effect. They need to be glued directly to the site of pain.
Iodine helps to eliminate puffiness and discomfort. It is necessary to apply a drawing from an iodine grid to the affected area. Vitamins allow you to speed up the process of restoration of nerve fibers,normalize metabolic processes, as well as the transmission of nerve impulses. With significant pain, blockades should be carried out. To do this, use "Lidocaine", "Novocaine", as well as drugs from the group of anesthetics.
Folk techniques
If symptoms of intercostal neuralgia occur, treatment at home should be started immediately, as this will make it much easier and faster to eliminate pathological symptoms. Folk remedies have a very good effect.
You can rub the affected area with alcohol tinctures of birch buds or valerian. The substances that make up these products act similarly to the components of drug gels and ointments. However, applying alcohol-based compresses at night is not recommended, as they can cause skin burns.
Inside you can take a decoction of mint with honey or other sedatives. Treatment of intercostal neuralgia at home is also carried out with the help of heating. The therapeutic effect is provided by warming up with sources of indirect heat. The affected area can be wrapped with a warm woolen scarf.
When treating intercostal neuralgia at home, you can use an ointment prepared on the basis of iodine with glycerin. Freshly squeezed juice of black radish or geranium can be rubbed into the affected area. A bath has a good effect, as it makes it possible to get rid of painful sensations very quickly and effectively. However, it is not recommended to carry out such a procedure in the acute period of the course of the disease.
You should not apply a hot egg or potato to the affected area, as the pain will subside only for a while due to the fact that the hot object somewhat increases blood circulation. However, in the future, swelling of the soft tissues will increase significantly, and the pain will become more intense.
Physiotherapy
Eliminate the symptoms of intercostal neuralgia on the right or left will help physiotherapy techniques, wearing a corset and a sparing regimen. In particular, such means as have a good effect:
- electrophoresis;
- magnetotherapy;
- ultrasound;
- UHF therapy.
The essence of manual therapy is to return the spinal column to its original state. To release the transferred nerve endings, massage is used. The procedure can be carried out only after the elimination of acute pain. Movements should be very careful, do not put too much pressure on the muscles. Acupressure makes it possible to influence certain areas associated with the affected area.
Acupuncture eliminates the imbalance of muscle tissue located in the deepest layers of the skin. With the help of a similar procedure, certain points responsible for muscle tone are affected.
Reduce inflammation, restore blood circulation, expand blood vessels, and normalize metabolism helps laser therapy. UHF therapy helps to reduce swelling of muscles and nerve endings, helps to eliminate infectious agents,and reduce inflammation.
Special exercises help eliminate muscle tone. Classes must be carried out after the main course of therapy. In the acute stage, strict bed rest is recommended, and the surface of the mattress must be firm and even.
Surgical treatment for intercostal neuralgia is not applicable. The only exception is the pathology of the spine, which can provoke the formation of the disease and require surgery.
Treatment during pregnancy
Pain in the intercostal space in women during pregnancy is quite common. The fetus grows in the uterus, which does not pass without a trace for a woman in position. With intercostal neuralgia, you should immediately contact a doctor who will help you choose the most gentle way to get rid of pain.
During the course of therapy, folk remedies and methods or local treatment with moderate dry heat are prescribed. A good effect is provided by therapeutic exercises, but all exercises should be performed in moderation. It is worth noting that after the birth of a child, the problem often disappears on its own without special treatment.
Possible Complications
Complications do not concern intercostal neuralgia itself, but more serious diseases of the cardiovascular system, which are disguised as pinched nerve endings. In some cases, with herpetic infection, persistent and prolonged neuralgiacan lead to insomnia, depression, irritability, and even suicide attempts. Since the pain is very strong, sometimes a painful shock occurs, resulting in a sharp decrease in pressure, up to fainting.
That is why the main emphasis should be placed on disease prevention, this is especially important for those who work in the office. Constant sitting in a position impairs the blood supply to the muscles, and being overweight provokes attacks of acute pain.
Prophylaxis
As a preventive measure for the occurrence of intercostal neuralgia, you need to follow simple rules. It is imperative to avoid hypothermia and drafts, timely treat diseases that can provoke pinched nerve endings, and limit the consumption of alcoholic beverages. When working in a monotonous, uncomfortable position for a long time, it is recommended to take short breaks of several minutes every hour.
If any pathology of the spinal column and other organs and systems occurs, you should immediately consult a doctor for medical help. It is important to maintain correct posture. In addition, you need to adjust your usual diet, nutrition should be correct and balanced. You need to consume as many vegetables and fruits as possible, poultry, dairy products, fish. It is worth giving up hot spices, fried, canned foods.
It is important to do physical exercises to strengthen the muscles of the back and chestcells. In particular, exercises, gymnastics, and exercise equipment have a good effect. It is imperative to avoid injuries, as they adversely affect the state of the muscular corset.
With the right approach, you can not only quickly eliminate pain, but also prevent their occurrence.
