MedClinic > Blog > Algology > Intercostal neuralgia


Intercostal neuralgia is the process of squeezing or irritating the roots of the nerve endings of the spinal column, accompanied by bouts of pain, respiratory failure and constant discomfort.

Development reasons

Intercostal neuralgia can occur regardless of age and field of activity. The causes of intercostal neuralgia are associated with the presence of degenerative processes in the spinal column and inflammation of the internal organs of the abdominal cavity:

  • spinal injuries, in particular, a compression fracture of the vertebral body;
  • development of osteochondrosis;
  • presence of osteoporosis;
  • consequence of scoliosis;
  • spinal disc deformities;
  • inflammation of the muscle corset;
  • intervertebral hernia;
  • anomalies in the structure and development of the ribs;
  • intoxication;
  • infectious diseases (including herpes);
  • having had ARVI with complications;
  • development of tuberculosis;
  • reduced immunity;
  • diseases of the gastrointestinal tract;
  • pathology of the liver and kidneys;
  • hormonal changes;

Clinical picture

Symptoms of intercostal neuralgia:

  • sudden onset of pain, accompanied with sudden cessation of pain;
  • increased pain during deep, inhalation or exhalation, bending torso to the side, coughing and sneezing;
  • burning in the chest (simulates clinical picture of myocardial infarction);
  • increased pain with pressure on the ribs and sternum;
  • numbness of the skin at the location of the affected nerve;
  • muscle cramps;
  • pain in the peritoneum, the nature of the pain symptom is piercing, acute;
  • lower back pain (simulates a picture of renal colic);
  • pallor of the skin;
  • increased sweating.

The pain with intercostal neuralgia can be so severe that a person’s breathing becomes clogged. The intensity of the manifestation of the pain symptom and its duration can be different, depending on the stage of development and the causes that provoked the disease.

Symptoms differ based on the location of the damaged nerve ending. Intercostal neuralgia on the left has symptoms similar to heart pains, intercostal neuralgia on the right has signs of hepatic, renal colic, as mentioned above.


Diagnostic methods:

  • examination of the patient, study of his complaints, collection of detailed medical history;
  • X-ray
  • Ultrasound
  • MRI
  • CT


Treatment of intercostal neuralgia is a laborious and lengthy process. The disease proceeds in acute or chronic form, and conservative therapy is aimed at stopping painful symptoms, prolonging remission and reducing the frequency of attacks.

Treatment of intercostal neuralgia is symptomatic, with medication. To release the nerve from pressure, a course of massage is performed, exercises are appointed. Intercostal neuralgia in the acute stage, the development of which is caused by infectious diseases, can be cured only by curing the root cause of its appearance. Regardless of the type of intercostal neuralgia, the patient is prescribed physiotherapy:

  • acupuncture;
  • magnet therapy;
  • reflexology;

Physiotherapy is aimed at stopping the pain syndrome, relieves muscle spasms, with a long course of procedures, the nerve is released from under pressure. During a pain attack, it is recommended to use topical drugs with anaesthetic effect – ointments and gels.

If drug therapy does not give a positive result, the patient will be offered:

  • intercostal blockade – the introduction of a solution of local anaesthetic and glucocorticoid to the site of nerve irritation. It has medical and diagnostic aims. Diagnostic aim lies in the fact that after the blockade the patient immediately feels relief, which means that the cause of the pain is intercostal neuralgia. In the absence of effect, another cause of the pain syndrome should be sought. The treatment effect lies in the fact that due to the injected drugs, inflammation and oedema of the nerve are reduced.
  • radiofrequency neuromodulation of intercostal nerves – high-frequency electric pulses affect the specified nerve, which allows to selectively modify the perception of the pain impulse.

As a rule, the above-listed procedures are enough to stop the pain syndrome, ease the patient’s suffering and help return to normal life.

In some cases, surgical treatment is resorted to:

  • foraminotomy – the expansion of the channel where the damaged nerve passes;
  • kyphoplasty – treatment of compression fractures, as a result of which a nerve is pinched;
  • laminectomy – partial removal of the vertebra, which compresses the nerve root.

The surgery is performed in extreme cases if the disease was neglected and irreversible pathological processes began.