Intercostal neuropathy implies a course of pathology that occurs as a result of squeezing, irritation or inflammation of the intercostal nerves. The disease provokes very strong and painful painful sensations, which in turn provoke painful manifestations.
Often, neuropathy is masked by the symptoms of other diseases that affect the organs of the sternum and abdominal cavity and spine. In this case, the pain syndrome spreads along the nerve, making painful movements of the chest.
Features of the disease
Intercostal neuropathy (ICD-10 code G58.0) is one of the most common diseases in children of middle and older age. The disease is characterized by very severe pain in the sternum. The disease is quite dangerous, because with its sudden onset, signs of angina pectoris or heart attack often appear. The patient is seized with severe panic, and he becomes incapacitated.
Intercostal neuropathy (ICD-10 G58.0) is characterized by the fact that there is a very strong painful pain in the area of the passage of nerve endings. The pains are localized in the intercostal space, along the chest, spine and on the back. They provoke pathology of various kinds of trauma, osteochondrosis, inflammation, curvature, displacement of discs and vertebrae.
Causes of occurrence
Intercostal neuropathy or neuralgia (ICD-10 G58.0) has a completely different origin. A rare, but nevertheless, possible cause is pathological changes in the nerve endings due to damage to their membranes. Among the main provoking factors, it is necessary to distinguish such as:
- intoxication of the body, trauma;
- infectious diseases and pathologies of the spine;
- age and hormonal changes.
Various types of injuries, as well as intoxication of the body, can provoke a pain syndrome, in particular:
- heavy metals;
- bacterial toxins;
- taking certain medications;
- diseases of the internal organs.
Various pathologies of the muscles and spine are the main cause of neuralgia. In particular, these diseases include:
- osteoporosis;
- hernias;
- osteochondrosis;
- scoliosis;
- spondylosis.
Muscle spasm and inflammation of the muscles provokes squeezing of nerve endings and provokes neuropathy. Some infectious diseases can lead to the development of pathology. These include:
- multiple sclerosis;
- polyradiculoneuritis;
- shingles;
- tuberculosis;
- aortic aneurysm.
Crushing nerve endings with tumor-like neoplasms and sclerotic tissues leads to neuralgia. A significant role in the development of pathology is also played by general factors, in particular, such as a decrease in immunity, alcohol abuse, chronic fatigue, and diseases of internal organs.
Women are at a certain risk of developing intercostal neuropathy during menopause, when osteoporosis occurs against the background of ongoing hormonal changes in the body, as well as older people who have age-related changes in tissues and organs. It is worth noting that the disease very rarely develops under the influence of only one factor. Basically, several reasons acting sequentially or simultaneously act as a provocateur.
Left side neuralgia
Intercostal neuropathy or neuralgia (ICD-10 G58.0) is a rather unpleasant and dangerous disease, as it provokes severe pain and leads to the development of various kinds of complications. With the development of neuropathy on the left side, the symptoms appear in the form of severe pain, the nature of which varies depending on the provoking factor. However, with such a lesion, discomfort is given to the region of the heart, so many take neuralgia for a heart attack.
A similar disease is accompanied by various symptoms. In women, pain affects the mammary glands, and attacks in men go much faster and easier. The localization of pain on the left side largely depends on the number of affected nerve endings. In some cases, the discomfort is girdling.
Neuralgia on the right side
With the occurrence of intercostal neuropathy, symptoms on the right side often occur with liver damage and inflammation of appendicitis. This is due to the fact that such conditions are characterized by severe pain in the affected area. In addition, a person may experience symptoms such as:
- temperature rise;
- dark urine;
- enlarged lymph nodes;
- fatigue;
- yellowing of the skin;
- nosebleeds.
The occurrence of neuropathy on the right side in some cases may be associated with the presence of pathologies of the thyroid gland. Women need to consult a mammologist. Pain on the right can be caused by diseases of the kidneys and lungs. If even the slightest discomfort occurs, you must always consult a doctor for diagnosis and subsequent treatment.
Postherpetic neuralgia
Postherpetic intercostal neuropathy (ICD-10 G53.0) develops against the background of activity of herpetic infection. After infection, herpes is introduced into the DNA of the nerve fibers of the spinal cord, which is why intense pain in the affected area is noted after an exacerbation of the pathology.
The development of pathology, its symptoms and treatment do not depend on the type of virus. Often the occurrence of pain in the affected area is caused by exacerbation of shingles. In some cases, discomfort occurs due to a relapse of the virus. This is due to the fact that pathogens mainly affect the face and genitals.
Postherpetic neuropathy can be distinguished from other diseases with similar symptoms by the presence of characteristic vesicle rashes that are localized along the affected nerve. In this case, pain occurs much earlier than skin tumors. Gradually, the intensity of symptoms increases, reaching its maximum during the period when herpetic eruptions disappear.
Main symptoms
Symptoms of intercostal neuropathy are quite pronounced, and they cause a person significant discomfort. There is an intense pain syndrome that spreads along the nerve endings. The pain increases significantly with movements, entry, coughing. Painful sensations do not stop even at rest and can be significantly enhanced even for no apparent reason. The duration of the attack can be different - from several hours to several days.
Among the main symptoms of intercostal neuropathy, it is necessary to highlight such as:
- painful sensations;
- sharp increase in pain during palpation;
- skin over the affected area may completely or partially lose sensitivity.
This is only the main symptomatology of the pathology. In addition, secondary signs of intercostal neuropathy are observed, which include such as:
- increased sweating;
- contraction of individual muscle fibers;
- redness or pallor of the skin.
In the presence of all these symptoms, the diagnosis is not particularly difficult, but the disease can be masked by other pathologies due to the similarity of symptoms. The nature of the pain can be aching or dull, with periodic intensification or permanent.
Diagnostics
If there is a suspicion of neuropathy of the intercostal nerves, you must definitely visit a doctor for a diagnostic examination. Initially, an external examination is carried out, the localization of pain is determined, the change in the sensitivity of the affected area is assessed, and a neurological examination is also required. If necessary, the doctor prescribes laboratory research methods and instrumental diagnostics.
Radiography helps to determine the presence of injuries, bone displacement, the presence of osteophytes and much more. More informative methods are tomography, myelography, contrast discography. After conducting a comprehensive study, the doctor selects the method of therapy.
Treatment features
Treatment of intercostal neuropathy is selected separately for each patient, depending on what exactly provoked the attack of pain. If the nerve endings were pinched by suture after surgery, then it must be removed. With inflammation, painkillers help well.
In some cases, doctors may recommend an epidural injection, and local anesthesia or corticosteroids give good results. Anti-inflammatory drugs will help reduce pain and inflammation.
In addition to medications, you need to use physiotherapy, cold treatment, yoga, acupuncture.
General therapeutic techniques
In the presence of strong painful sensations, the patient is prescribed a strict bed rest with a stay on a hard surface and with maximum immobilization. To reduce pain, physiotherapeutic techniques are recommended, in particular, such as:
- UHF;
- reflexology;
- iontophoresis;
- vacuum therapy;
- acupuncture;
- pharmacopuncture;
- magnetotherapy.
In combination with therapeutic measures, local treatment is important, in particular, the use of creams and ointments with warming, analgesic and anti-inflammatory effects. Well-proven products containing insect poisons, as well as pepper patch.
Drug therapy
When carrying out treatment of intercostal neuropathy, it is necessary to eliminate the pain syndrome and pathology that provoked squeezing or inflammation of the nerve endings. To reduce pain, anti-inflammatory drugs are prescribed, in particular, such as:
- "Riofecoxib";
- Diclofenac
- "Meloxicam."
Painkillers will help suppress inflammation and eliminate discomfort. In such cases, the drugs are used in the form of an injection. To eliminate muscle spasm, the use of muscle relaxants is shown, in particular, such as:
- Sirdalud;
- "Midokalm";
- "Tolperil."
If necessary, treatment is supplemented with sedatives. Usually, herbal medicines are used to restore the nervous system, in particular, such as:
- Persen
- Novo-Passit;
- "Sedasen."
To reduce the intensity of general symptoms, it is recommended to treat the affected area with ointments or gels with an anti-inflammatory effect, in particular, such as:
- "Capsicum";
- "Finalgon";
- Menovazin.
In the event that the transmission of nerve fibers is due to intervertebral hernia or tumors, surgical intervention is prescribed. With shingles, the use of vitamin complexes and antiviral drugs of local and systemic action is indicated.
Folk techniques
With intercostal neuropathy, rubbing with tincture of valerian or birch buds has a good enough result. However, it is better not to apply alcohol compresses for a long time, as this can lead to burns.
Warming helps to eliminate the pain, but the thermal effect should not be direct, therefore, you just need to wrap yourself in a knitted woolen thing or a down scarf. If you strongly heat the affected area, then the pain will go away only for a while, and such an effect will only increase swelling. Baths with sage and sea salt help relieve stress and reduce pain.
To prevent the transition of the disease into a chronic form, it is necessary to exclude the influence of harmful concomitant factors, in particular, such as physical stress, as well as the abuse of alcohol.
Possible complications
With launched intercostal neuralgia, the consequences are determined depending on the reasons that provoked the occurrence of the pathology. In the absence of the required treatment and the progression of the pathology that provoked pinching of the nerve endings, circulatory disorders are possible, which leads to impaired functioning of internal organs and the development of muscle diseases.
In the most extreme and advanced cases, there is a high risk of developing chronic intercostal neuralgia, in which it becomes very difficult for a person to breathe. Persistent pain syndrome causes sleep problems and the development of a depressive state and dysfunction of the heart muscle. Subsequently, the development of a hypertensive crisis is possible.
Prophylaxis
For prevention to be effective, it is important to know how to recognize the course of intercostal neuropathy. It is possible to avoid exacerbation of pain caused by squeezing nerve fibers with the timely treatment of concomitant diseases, and it is also important to lead an active lifestyle.
In addition, it is important to maintain immunity to prevent relapse. If pain occurs in the ribs, you should immediately consult a neurologist.