How is intercostal neuralgia treated?

Written by Wang Cheng Lin
Orthopedics
Updated on September 26, 2024
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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.)

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Neurology
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Symptoms of neuralgia

Neuralgia comes in many types and is generally quite severe. Patients may experience episodes of intense, short-lasting pain. The common symptoms include: Firstly, a classic type is trigeminal neuralgia, where patients primarily suffer from episodic severe pain in the areas innervated by the trigeminal nerve. This can feel like burning or electric shocks, and is often unbearable. Treatment usually requires antiepileptic drugs. The second major type of neuralgia commonly seen is postherpetic neuralgia, where pain is intense and follows the nerve distribution. Tricyclic antidepressants and antiepileptic drugs can be used for treatment. Additionally, peripheral neuropathy caused by diabetes can also lead to neuralgia. (Please use medication under the guidance of a doctor.)

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Causes of Neuralgia

Neuralgia is extremely painful, with patients often experiencing severe, unbearable pain. The causes of neuralgia mainly include the following types. The first type to note is viral infection, such as herpes zoster virus infection, which can leave postherpetic neuralgia. In such cases, it is crucial to actively use antivirals and employ neuropathic pain medications for treatment. The second scenario may relate to nerve compression, such as trigeminal neuralgia, which may be associated with local vascular compression causing abnormal nerve discharges. Surgical treatment might be necessary to relieve the compression. Sciatica is also caused by compression of the sciatic nerve. The third case might be due to nonspecific inflammatory responses. For example, Guillain-Barre syndrome can also cause neuralgia, and treatment should be directed at the underlying cause.

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Symptoms of tooth nerve pain

Symptoms of tooth nerve pain include pain triggered by cold, hot, sour, sweet stimuli, spontaneous pain, secondary pain, and nighttime pain, as well as unlocalized pain. These are also the main symptoms of pulpitis. Among them, pain triggered by cold, hot, sour, and sweet stimuli is more obvious. Sometimes the pain may intensify with temperature changes, such as cold and hot stimuli. If the pulpitis reaches the acute suppurative stage, there may also be pain that worsens with heat and is relieved by cold. It is common to see patients coming to the clinic holding cold water, indicating that cold water may provide temporary pain relief. In addition, severe nighttime pain might occur, where there is no pain during the day, but intense pain at night, sometimes making it difficult to sleep or waking from sleep due to the pain. Sometimes tooth nerve pain can also be unlocalized, potentially causing pain in the temporal area or affecting both upper and lower jaw teeth.

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Is it sciatica?

It should be noted that the incidence of sciatic nerve pain is still very high in clinical settings, and there are many causes which can lead to severe pain when it occurs. Common causes of sciatic nerve pain include conditions like sciatic neuritis, which can result in patient discomfort, as well as lumbar disc herniation, lumbar spondylolisthesis, lumbar spinal stenosis, and lumbar tumors. Compression of the spinal nerves can also lead to sciatic nerve pain. Additionally, piriformis syndrome can cause sciatic nerve pain in patients. Determining the specific cause requires a physical examination along with some auxiliary tests to make a clear diagnosis, after which active symptomatic treatment can be completely effective.

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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.