Page Updated on Apr 3, 2020 by Dr. Reyfman (Pain Management Specialist) of Pain Physicians NY

What is Intercostal neuralgia?

Neuralgia is a medical name for pain occurring in the nerves. There are different types of neuralgia, one of which is also Intercostal neuralgia. The pain in neuralgia is usually triggered without any stimulation of the pain receptors.

Intercostal neuralgia as its name says is neuralgia or pain occurring in intercostal nerves. These nerves are located between the ribs in the rib cage. Any damage or dysfunction of these nerves results in Intercostal neuralgia. It is a rare condition.

What causes Intercostal neuralgia?

The causes of Intercostal neuralgia vary from a ruptured abdominal tissue, irregular curvature of vertebrae, abdominal distension, scar tissue which is formed around these nerves, abdominal muscle overuse, etc. Surgeries of the chest wall can also cause intercostal neuralgia, during which these nerves can get damaged. Some other less common causes of intercostal neuralgia include also pregnancy, shingles, tumors, etc.

Many factors increase the risk of suffering from Intercostal neuralgia, like:

  • Varicella-Zoster virus infection,
  • Sports like, football, wrestling, rugby, skiing,
  • Unsafe motor vehicle driving and accidents during which the ribs and intercostal nerves are damaged.

What are the Signs and Symptoms of Intercostal Neuralgia?

The most concerning sign of Intercostal neuralgia is pain. This pain can vary in nature from a stabbing, sharp, aching or a tearing pain. The pain can be unilateral or even bilateral. However, in many cases, the pain is located on either side of the chest wall but also radiates from the back toward the front in a band-like fashion.

Intercostal pain usually gets worse while breathing, laughing, coughing or even sneezing. This is due to the fact that the ribs are on the move while performing the above-mentioned actions. Intercostal neuralgia could be also as a constant and dull pain of the chest wall.

Other signs and symptoms that accompany Intercostal neuralgia include loss of appetite, numbness of the affected area, a tingling sensation, abdominal pain, pain in the shoulders and arms, fever, etc.

How is Intercostal Neuralgia Diagnosed?

If Intercostal neuralgia occurs after a surgical procedure, the diagnosis is very clear. However, in many cases, an extensive neurological examination is necessary to diagnose it.

Diagnostic examinations needed include:

  • X-rays of the chest
  • CT – scan
  • MRI – scan

Intercostal Neuralgia Treatment?

In many cases, Intercostal neuralgia can resolve on its own. However, sometimes treatment is necessary, always depending on the cause.

Painkillers are often prescribed for relieving the pain. Other medications prescribed for treating Intercostal neuralgia include antihistamines, antidepressants, antivirals, corticosteroids, etc.

Other treatment options include intercostal nerve block and intercostal radiofrequency ablation.

What are the most common medications for intercostal neuralgia?

Nerve-related pain can be treated with antidepressants such as amitriptyline, duloxetine, imipramine, venlafaxine and nortriptyline. Intercostal neuralgia doctors might also prescribe anticonvulsant medication including carbamazepine, gabapentin, pregabalin or oxcarbazepine. Severe cases should be treated with opioid-aspiring or opioid-acetaminophen.

When should I visit a pain management doctor in Brooklyn?

You should keep in mind that intercostal neuralgia cannot be left untreated as it might lead to severe complications. These could be insomnia, anxiety, depression and low appetite, leading to weight loss.

If you notice symptoms of this health condition, you should immediately seek medical support. Our pain management doctors will provide you with both effective and safe treatment options for intercostal neuralgia.