Among the 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 with 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 the appearance of symptoms of intercostal neuralgia. Treatment must necessarily be comprehensive, as only this will achieve a good result.
Disease feature
Intercostal neuralgia is characterized by the fact that the source of the onset of pain is not the receptor, but the nerve endings. Attacks of pain at the same time somewhat resemble the discharge of an electric current. They begin suddenly, last for several seconds, and then disappear in the same way. The frequency of such attacks can reach several tens of times a day.
With painful attacks in the back and sternum, often there is an additional swelling of the intercostal nerve in the area where it exits from the intervertebral foramen. Edema can develop as a result of squeezing the nerve endings of the intervertebral hernia, as well as spasmodic muscles of the back.
According to ICD code 10, intercostal neuralgia (M 79.2) refers to diseases of the musculoskeletal tissue, since this is due to the fact that spastic muscles are involved in the pathological process.
Causes of occurrence
There are many reasons for intercostal neuralgia, which include:
- osteochondrosis;
- injuries
- infections
- hypothermia;
- intervertebral hernia;
- neoplasms;
- spondylolisthesis.
The most common cause is osteochondrosis, since when it occurs, the 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 short-term pinching by 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 effect, since alcohol toxins with regular exposure to nerve tissue irritate it.
The main symptoms
The main symptom of intercostal neuralgia is paroxysmal acute pain, which is similar to an electric shock. Basically, nerve endings suffer only on one side, and painful sensations are localized in only one intercostal space.
The duration of symptoms of intercostal neuralgia on the left is calculated in a few seconds, but it seems to the patient that they last for ages. Signs are largely triggered by the specific behavior of the person himself. In particular, pain may occur when:
- sneezing
- sudden movement;
- coughing
- laughter
- deep breath
- weeping.
All this suggests that pain can be triggered by a lesion 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 occurrence of painful sensations.
In order to prescribe the correct treatment, it is necessary to distinguish a similar pathological condition from other diseases similar in symptomatology. Symptoms of intercostal neuralgia are characterized by the fact that painful sensations occur very sharply, and often a person is not even able to get scared.
The patient tries to take the most comfortable position and at the same time move as little as possible. With the occurrence of diseases of the cardiovascular system, a person can rush about, since a change in position and a deep breath do not affect the pain at all. In addition, blueness of the earlobes, as well as the nasolabial triangle, may be observed. This is due to a lack of oxygen. For heart diseases, you can stop the pain with a Nitroglycerin tablet, which you need to put under the tongue. Symptoms of intercostal neuralgia this medicine will not help to eliminate.
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 should carefully examine the patient’s current history to exclude the occurrence of more complex and dangerous diseases.
Diagnostics
If you experience the first symptoms of intercostal neuralgia, be sure to consult a doctor for a comprehensive diagnosis and correct diagnosis. Initially, the doctor collects patient complaints and a history of the development of the disease, and then prescribes a series of additional studies. The most informative of these are:
- blood analysis;
- bacteriological examination;
- radiography;
- tomography;
- ultrasound diagnostics;
- myelography.
If symptoms of intercostal neuralgia have arisen due to the occurrence of an infectious process in the body, then when conducting a bacteriological blood test, the causative agent of the disease can be identified, and in all other cases, the indicators remain unchanged.
Radiography and tomography can detect even the most minor violations in the bone tissue, as well as determine for what reason the development of neuralgia occurred. In myelography, the nerve endings and spinal cord are examined by injecting a contrast medium on an X-ray machine, this allows you to identify changes that are present in the nervous tissue.
Treatment features
Depending on the provoking cause and symptoms of intercostal neuralgia, the treatment on the left side is selected 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 the removal of swelling from the muscles and nerves. This leads to a rapid reduction in pain, which over time completely disappears.
Anti-inflammatory drugs are prescribed to treat intercostal neuralgia, which help to eliminate painful sensations very effectively. On the first day, diuretics can be used to eliminate puffiness. 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 implies calling a doctor to prescribe medications. After eliminating an acute pain attack, it is recommended to use physiotherapeutic treatment, warming with dry heat, rubbing ointments in the back to normalize blood circulation and eliminate spasm.
In the phase of abating exacerbation, massage and physiotherapy exercises are indicated. After eliminating pain and as a prophylaxis, patients are prescribed swimming and an active lifestyle.
Drug treatment
How to treat intercostal neuralgia can only be determined by the attending doctor after a comprehensive diagnosis, since in each case the drugs are selected individually. When choosing medicines, preference should be given to analgesics. In particular, such drugs as Ortofen, Analgin, Baralgin can be used.
Doctors recommend additionally applying ointments that have analgesic and anti-inflammatory effects. They need to be applied to the skin in the area of painful sensations up to 3-4 times a day. Among local funds, it is necessary to allocate such as Ketonal, Voltaren Emulgel, Viprosal, Apizartron, and 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. Bee venom based products may be popular.
Patches soaked in creams and gels have good properties that help fight pain. They normalize blood vessels and have anti-inflammatory effects. They need to be glued directly to the site of pain localization.
To eliminate puffiness and discomfort, iodine helps. It is necessary to apply an iodine grid pattern 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, blockade 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 possible to eliminate pathological symptoms much easier and faster. 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 funds act similarly to the components of drug gels and ointments. However, it is not recommended to apply compresses with an alcohol base at night, as they can provoke a burn of the skin.
Inside, you can take a mint broth with honey or other sedatives. Treatment of intercostal neuralgia at home is carried out using warming. The therapeutic effect is provided by heating with sources of indirect heat. The affected area can be wrapped in a warm woolen scarf.
When carrying out therapy of 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. The bath has a good effect, as it makes it possible to quickly and efficiently get rid of painful sensations. However, it is not recommended to carry out a similar procedure in the acute period of the course of the disease.
Do not apply a hot egg or potato to the affected area, since the pain will subside only for a while due to the fact that the hot object slightly increases blood circulation. However, in the future, swelling of the soft tissues will increase significantly, and the pain will become more intense.
Physiotherapy
Physiotherapeutic techniques, wearing a corset and a sparing regimen will help to eliminate the symptoms of intercostal neuralgia on the right or left . In particular, funds such as:
- electrophoresis;
- magnetotherapy;
- ultrasound;
- UHF therapy.
The essence of manual therapy is to return the spinal column to its original state. In order to release the transmitted nerve endings, massage is used. The procedure can only be performed after acute pain has been eliminated. Movements must be very careful, do not put too much pressure on the muscles. Acupressure massage makes it possible to influence certain areas associated with the lesion site.
Acupuncture helps to eliminate 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.
Laser therapy helps to reduce inflammation, restore blood circulation, expand blood vessels, and normalize metabolism. UHF-therapy helps to reduce swelling of the muscles and nerve endings, helps eliminate pathogens of infection, and also reduce the intensity of inflammation.
Special exercises help eliminate muscle tone. Classes must be held after the main course of therapy. In the acute stage, strict bed rest is recommended, and the surface of the mattress must be solid and even.
Surgical treatment for intercostal neuralgia is not used. The exception is only pathology of the spine, which can provoke the formation of a disease and require surgery.
Pregnancy treatment
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 consult a doctor who will help you choose the most gentle way to get rid of pain.
During the treatment, folk remedies and methods are prescribed or local treatment with moderate dry heat. Medical gymnastics provides a good effect, but all exercises must be performed moderately. 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 the intercostal neuralgia itself, but the more serious diseases of the cardiovascular system, which are masked by pinching of the nerve endings. In some cases, with a herpetic infection, persistent and prolonged neuralgia can lead to insomnia, depression, irritability, and even suicide attempts. Since the pain is very strong, sometimes a pain shock occurs, resulting in a sharp decrease in pressure, up to fainting.
That is why the main emphasis should be placed on the prevention of the disease, this is especially important for those who work in the office. Constantly staying in a sitting position worsens the blood supply to the muscles, and excess weight provokes the occurrence of acute pain attacks.
Prophylaxis
As preventive measures for the occurrence of intercostal neuralgia, simple rules must be followed. It is imperative to avoid hypothermia and drafts, timely treat diseases that can provoke pinching of nerve endings, and limit the consumption of alcoholic beverages. With prolonged work in a uniform, uncomfortable position, 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 monitor proper 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 abandoning hot seasonings, fried, canned foods.
It is important to do physical exercises to strengthen the muscles of the back and chest. In particular, exercise, gymnastics, exercise machines have a good effect. It is imperative to avoid injuries, as they adversely affect the state of the muscle corset.
With the right approach, you can not only quickly eliminate painful sensations, but also prevent their occurrence.