Symptoms of intercostal neuralgia

Written by Na Hong Wei
Orthopedics
Updated on September 08, 2024
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Intercostal neuralgia is essentially caused by inherent reasons, or pathological changes in the thoracic vertebrae, ribs, and pleura, leading to an inflammatory symptom involving the intercostal nerves. Therefore, the primary symptom of intercostal neuralgia is pain, but this pain has certain characteristics. First, the pain commonly occurs in the left second rib and the right second, third, and fourth ribs. Second, the range of the pain is usually semicircular; it does not extend beyond the anterior midline at the front or the posterior midline at the back, forming a semicircular pain along the ribs. Third, there are often fixed tender points, which sometimes are located in the costal cartilage or corresponding thoracic vertebrae and paraspinal area; these points, when pressed or tapped, can cause radiating pain. Fourth, many times the examination results are negative, so intercostal neuralgia tends to be a condition where the symptoms are severe, but physical examination often yields very few positive signs.

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Written by Zhang Hui
Neurology
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How to relieve neuralgia

Firstly, symptomatic treatment can be administered to patients. Medications for treating neuralgia mainly include tricyclic antidepressants and anticonvulsants, and serotonin reuptake inhibitors may also be effective. These medications should be taken under the advice of a doctor when necessary to help alleviate pain. Secondly, localized block treatment can also achieve certain clinical effects. Thirdly, it is crucial to identify the cause of the neuralgia and treat it accordingly. For example, if a patient’s neuralgia is caused by optic neuromyelitis, corticosteroids should be used; if it is due to herpes zoster virus infection, antiviral medications are required.

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Written by Zhang Hui
Neurology
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How is neuralgia treated?

Neuralgia can cause severe pain and significantly impact a patient's life. Treatment for neuralgia primarily focuses on the following aspects: First, treatment should be based on the cause of the pain. For instance, if the patient suffers from trigeminal neuralgia, antiepileptic drugs may be prescribed. Surgery may be necessary in some cases. If the neuralgia is caused by a viral infection, active antiviral treatment is required. If tumor cells invade and cause the neuralgia, tumor treatment should be administered. The second type of treatment involves symptomatic management. This mainly includes medications to relieve neuralgia, commonly comprising tricyclic antidepressants and antiepileptic drugs, which can be effective in alleviating the pain and should be taken under the guidance of a doctor.

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Written by Liu Yan Hao
Neurology
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How to treat occipital neuralgia?

Occipital neuralgia is caused by cervical compression of the greater occipital nerve, leading to neuropathic pain. Thus, treatment of occipital neuralgia may involve oral pain relief medications to temporarily alleviate symptoms. Additionally, some nerve-nourishing medications can be used in treatment. Fundamental treatment involves addressing cervical spondylosis, which can include cervical physiotherapy and the use of medications that improve blood circulation and remove blood stasis to treat cervical spondylosis. It is also important to take care of the cervical spine by not sitting for too long; if sitting for extended periods, one should get up and move to stretch the muscles and bones. Performing the "little bird flying" exercise, where the head is leaned back and both arms are extended backwards, can effectively relieve cervical spondylosis and the pain caused by cervical compression of the greater occipital nerve. Additionally, the pillow should not be too high when sleeping at night.

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Written by Li Bao Hua
Dentistry
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What to do with tooth nerve pain?

Common symptoms of dental nerve pain include severe toothache. If teeth are not brushed and rinsed promptly after eating, food residues linger on the teeth, and bacterial fermentation produces acids, leading to symptoms of dental nerve inflammation. This is also due to the further progression of dental caries. In such cases, dental treatment should be sought as early as possible. If the decayed dental tissues are removed and the dental nerve is not exposed, direct filling treatment can be conducted. If infected dental tissues are removed and the dental nerve is exposed, the treatment depends on the development status of the tooth root. If the tooth root is not fully formed, it is advisable to preserve the living dental nerve as much as possible, and direct pulp capping or vital pulpotomy can be performed. If the root apex foramen has already formed, infected purulent dental tissues or the dental nerve can be removed for root canal treatment.

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Written by Wang Cheng Lin
Orthopedics
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How is intercostal neuralgia treated?

In our clinical practice, for intercostal neuralgia, we generally have the following treatment methods: The first type is oral medication, specifically non-steroidal anti-inflammatory drugs, which can alleviate pain. The second type is traditional Chinese medicine, such as drugs that invigorate blood circulation and remove blood stasis, which can also increase local blood circulation to relieve pain. The third method is to use acupuncture, which has comparatively good therapeutic effects on this type of intercostal neuralgia. Generally speaking, most cases of intercostal neuralgia do not last very long. Regardless of which method you choose, you can achieve relatively good results, so the above methods are the most common treatments for intercostal neuralgia. (Medication should be used under the guidance of a doctor based on specific circumstances.)