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 Liu Shi Xiang
Neurology
1min 10sec home-news-image

How to relieve neuralgia

Neuropathic pain can be relieved through treatments such as medication, physical therapy, and surgery. Medications used primarily include antiepileptic drugs and non-steroidal anti-inflammatory analgesics, such as carbamazepine, oxcarbazepine, gabapentin, pregabalin, sodium diclofenac, ibuprofen, and celecoxib. Physical therapy mainly involves localized heat application, massage, manipulation, and acupuncture. Surgical treatment is mainly suitable for patients who do not respond well to medication and physical therapy. Currently, the surgical approach mainly involves minimally invasive surgery to relieve nerve compression, thereby alleviating the symptoms of neuropathic pain. Beyond symptomatic treatment, it is important to identify and treat the underlying cause of the neuropathic pain, such as tumors, trauma, diabetes, etc. These causes can lead to neuropathic symptoms, so it is crucial to actively control these underlying diseases to potentially relieve neuropathic pain at its root. (Medications should be used under the guidance of a doctor.)

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Written by Na Hong Wei
Orthopedics
1min 18sec home-news-image

How to diagnose intercostal neuralgia

The examination for intercostal neuralgia includes two parts. The first part is to confirm whether it is indeed intercostal neuralgia, often based on three reasons. The first is pain that follows a semicircular path along the ribs. Second, there are usually fixed tender points or percussion points, also called trigger points, where pressing will cause pain and lead to a type of pain that radiates along the path of the intercostal nerves. The third is that it is more commonly seen between the fifth and ninth ribs, often causing pain or triggering increased pain during activities like sneezing or deep breathing. With this, it is basically possible to diagnose intercostal neuralgia. However, identifying the cause of intercostal neuralgia is very complex. The usual causes of intercostal neuralgia include five aspects: The first is congenital anomalies, the second is trauma, the third is tumors, the fourth is inflammation, and the fifth is other causes. Therefore, a complete diagnosis of intercostal neuralgia should not only confirm the presence of intercostal neuralgia but also identify the underlying cause. Only by treating the cause of the intercostal neuralgia can there be a very good treatment outcome.

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Written by Cheng Bin
Orthopedics
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Is intercostal neuralgia severe?

First, it should be noted that intercostal neuralgia is not a very serious disease; it is a chronic condition but can be recovered from with long-term treatment as long as treatment is consistently followed. Commonly, treatment for intercostal neuralgia can be supplemented with physiotherapy methods such as acupuncture, massage, and cupping, which are very effective. Additionally, topical application of ointments that invigorate the blood and dispel stasis, or oral administration of non-steroidal anti-inflammatory and neuro-nourishing medications, can be completely adequate. For cases where the symptoms of intercostal neuralgia are particularly severe, local block injections may be performed. Furthermore, it is important to rest and protect the affected area, avoid cold exposure, and minimize irritation to the area to facilitate recovery.

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Written by Zhang Hui
Neurology
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How to deal with occipital neuralgia?

Occipital neuralgia is a relatively common type of neuralgia, and the following recommendations are suggested for its management: Firstly, it is important to identify the cause of the occipital neuralgia. There are many potential causes, such as cervical spondylosis, viral infections, or metastasis of tumors, among others. Actively searching for the cause and addressing it effectively, especially if it stems from cervical spine issues, is crucial. Secondly, medication can be used to alleviate symptoms. This typically includes painkillers, such as non-steroidal anti-inflammatory drugs. If the pain is more pronounced, medications used to treat neuralgia, such as antiepileptic drugs, can also be considered. Thirdly, local physical therapy, acupuncture, and, if necessary, local block treatment in the area most affected by occipital neuralgia, can also be effective.

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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.