What Is an Intercostal Neuralgia?

Intercostal neuralgia is a subjective symptom of a patient. Intercostal nerves are sent from the thoracic spinal cord to the sides through the intercostal space to the anterior chest wall, and dominate the branches of the muscles along the back and chest wall of the thoracic spine and the sensory branches that travel along the intercostal space. Therefore, intercostal neuralgia is pain from the back of the chest along the intercostal obliquely down to the midline band of the anterior wall of the thorax and abdomen.

Basic Information

English name

intercostal neuralgia

Visiting department

Neurology, orthopedics

Common causes

Shingles, spinal degeneration, tumors, etc. can cause

Common symptoms

Chest pain, worsened by coughing, deep breathing or sneezing

Causes of intercostal neuralgia

Thoracic intervertebral disc degeneration, joint capsule and ligament thickening and ossification often lead to narrowing and deforming neural channels, which can cause intercostal nerve inflammation and pain. Other diseases involving intercostal nerves include thoracic spinal tuberculosis, thoracic spine fractures or dislocations, spinal or spinal tumors, ankylosing spondylitis, and rib, mediastinal, and pleural lesions. Herpes zoster intercostal neuralgia is often severe and painful.

Clinical manifestations of intercostal neuralgia

Intercostal neuralgia refers to one or several intercostal areas radiating from the back along the intercostal space to the anterior wall of the thorax and abdomen, which are distributed in a semicircular shape. Most of them are unilaterally involved, or bilaterally. Coughing, deep breathing, or sneezing often make the pain worse. Examination may include thoracic spinous processes, interspinous or paravertebral tenderness and palpitation. A few patients have tenderness along the intercostal area, and there may be paresthesia in the innervated area of the affected nerve. Its painful nature is mostly tingling or burning, and it is characterized by radiation along the intercostal nerve. Herpes zoster shows local lesions.

Intercostal neuralgia diagnosis

To establish a diagnosis, we must first define the intercostal neuralgia according to the distribution of pain characteristics. Then, it is more important to think about and find out the cause of intercostal neuralgia, especially considering tuberculosis, tumors, and osteoporotic compression in the elderly. Fractures, early herpes zoster and other important diseases that are easily overlooked.

Intercostal neuralgia treatment

Treatment should address the cause of intercostal neuralgia, so treatment should be based on the established cause.