Treatment of intercostal neuralgia in children

Pain with neuralgia appears due to compression of the roots of the intercostal nerves. This can happen in chronic osteochondrosis, as the intervertebral hernias begin to put pressure on the roots over time.

Many diseases that affect the spine or are associated with the musculoskeletal system of a person can cause thoracology. This is ankylosing spondylitis, spondylitis, advanced kyphosis.

In cases where the causes of pain in the chest are not at all in the compression of the nerve roots, the etiological factor is hypothermia. Intercostal neuralgia is often found in the season of air conditioning and pleasant drafts.

Also, viral diseases, in particular the herpes simplex virus type 3, which manifests itself in the form of herpes zoster and pain along the nerve fibers. We must not forget about traumatic agents and excessive physical activity, especially with insufficient warm-up.

Intercostal neuralgia can also be psychosomatic and appear as a reaction to stress or nervous shock.

Symptoms of the disease

The main symptom in intercostal neuralgia is acute paroxysmal pain in the chest area. It can be localized clearly in the intercostal space on the right or left or have a spilled character. This is exactly what scares patients the most, since they are primarily thinking about a heart attack. And since the severity of the pain syndrome can increase in a stressful situation, a vicious circle is obtained.

Pain changes in intensity with a change in body position. If you align your back and focus on calm breathing, then the jamming of the roots decreases. The pain is aggravated by coughing, sneezing, taking a deep breath, or compressing the chest. Sometimes it can be burning, pressing or aching.

For such patients a certain posture is characteristic – they bend in the thoracic spine and try to move less.

Patients most often say that it hurtsand in the area of ​​5 intercostal spaces and below. Pain can radiate down to the shoulder blade and left arm or shoulder. Soreness is palpated in places of close proximity of nerve fibers to the skin: near the spine, along the middle axillary line and at the edge of the sternum.

With a viral etiology, the skin over the affected nerve turns red, a slight swelling appears and characteristic rashes along the nerve trunk may occur.

Features of the course of the disease in different population groups

Intercostal neuralgia is often found during pregnancy. This is due to physiological changes that occur in the body of a woman who is preparing to become a mother. With a change in the level of hormones, edema can occur, which leads to compression of the nerve roots and fibers. And with an increase in the size of the fetus, the uterus raises the diaphragm and the excursion of the chest is somewhat reduced, which can also cause pinching of the nerve tissue.

The clinical picture does not change, but the woman reacts more violently, which is natural in her position. Therefore, panic attacks may occur.

In children, intercostal neuralgia occurs after hypothermia or trauma. Among this population, thoracalgia is more common in adolescents and the disease is unremarkable.

Methods of examination

Intercostal neuralgia is characterized by an extremely pronounced pain syndrome. But you need to be able to distinguish thoracology from pain with a heart attack or angina pectoris (if they appear on the left) or from an ulcer attack (if it hurts on the right).

  1. Pain with angina is short-lived and is stopped by taking nitroglycerin. They can radiate to the arm, neck, shoulder and scapular region, but do not change with deep breathing or a change in body position. There are rhythm disturbances or other signs of acute heart failure on the electrocardiogram;
  2. Gastritis or ulcer pain is accompanied by nausea and vomiting, which brings relief. Also, the patient in most cases can associate the occurrence of pain with food intake. Such characteristics are absent in classical intercostal neuralgia.

If examination and differential diagnosis does not allow an accurate diagnosis, additional research methods need to be performed: chest x-ray, computed tomography or magnetic resonance imaging. This is done in order to exclude cancer processes or fractures.

If the pain is given to the lower back, then it will not hurt to do a general urine test to exclude renal pathology. Also, with kidney damage, there will be a positive symptom of striking or Pasternatsky.

Methods of therapy

Before treating intercostal neuralgia, it is necessary to establish the exact cause of its occurrence. Indeed, in addition to symptomatic treatment, etiotropic plays an important role.

If the main disease in the patient is herpes zoster and pain along the intercostal nerves is explained by this, then treatment should be started with antiviral drugs: zovirax, acyclovir. In case of fracture of the ribs, the cause should be eliminated by the traumatologist, and then transfer the patient to a neurologist.

ЛThe treatment should be started when the first attack appears. Assistance to such a patient should be provided by qualified medical personnel.

In the acute period of intercostal neuralgia, the patient is shown bed rest and dry heat to the affected area. To do this, you can wrap a woolen scarf or apply a warm compress. Warming ointments, for example, menovazine, finalgon, or the use of mustard plasters, are also useful. They can be applied to the paravertebral region, avoiding the spine itself and the projection of the heart.

Drug treatment of intercostal neuralgia is aimed at relieving pain, reducing inflammation and speedy recovery of nerve tissue.

Non-steroidal anti-inflammatory drugs in the form of tablets and injectable solutions have been successfully used to relieve pain. During pregnancy, the use of these drugs is possible only with the appointment of a doctor.

PreparationActionPrice
Diclofenac sodiumAvailable in the form of a solution for injection or ointment.
It relieves severe pain and has moderate
antipyretic effect.
From 17 to 36 rub.
MidokalmRelieves muscle hypertonicity in any neurological
pathology. Rapidly absorbed from the gastrointestinal
tract.
Up to 480 rub.
NyzAnti-inflammatory agent that inhibits
COX2 and has an analgesic effect and reduces
temperature. Available as a gel for local
application.
Up to 270 rub.
MovalisA common analgesic based on meloxicam. Reduces not only pain, but also inflammation.From 460 to 656 rub.
IbuprofenPills that are used to reduce pain
syndrome and relieve inflammation.
Up to 80 rub.
NimesilThe drug slows down the synthesis of prostaglandins and has an antipyretic and analgesic effect.803 rubles.

If the use of non-stero />anti-inflammatory drugs does not bring the expected result, then doctors prescribe novocaine blockade. It is produced using a solution of lidocaine or novocaine. Injection is performed towards the spine along the upper edge of the underlying rib. This technique is used so as not to injure the nerves and blood vessels that are located at the bottom of each rib.

Also, to restore the structure of the nerve fiber, B vitamins, the drug milgamma, are prescribed. And in order to relieve muscle spasm muscle relaxants are used.

Shishkevich Vladimir, orthopedic and traumatologistShishkevich Vladimir, orthopedic and traumatologist, project editor-in-chief ExpertNews.

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Physiotherapy

Physiotherapy methods have been successfully used to treat all neurological pathologies.

With intercostal neuralgia, diadynamic and sinusoidal currents are used. They relieve pain, reduce spasm and warm the affected area. Also, electropuncture is used for this purpose – irritation with weak currents of the exit sites of the intercostal nerves.

To improve vitamin D production, patients are prescribed quartz (ultraviolet radiation). This method helps relieve pain and reduce muscle spasm. To improve blood circulation and accelerate tissue regeneration, magnetotherapy should be prescribed.

We should also talk about treated massage. It is first carried out on the back, then transferred to the chest. Active movements in the area of ​​greatest pain are contraindicated, as this can lead to even more muscle spasm. Massage movements begin on the healthy side, and then gently pass on to the patient. If intercostal neuralgia is bilateral, then massage is best to start with the least painful area.

Massage is useful in order to relieve muscle tension and improve blood circulation.

So that intercostal neuralgia from acute does not turn into a chronic doctor, prescribes acupuncture during rehabilitation and sends him to a chiropractor.

Alternative medicine

Treatment of intercostal neuralgia is impossible without the use of folk remedies.

In order to relieve pain at home, there is no better remedy than bee venom. It must be gently rubbed into a painful place and wrapped in a warm scarf.

A pepper patch is also suitable for this purpose. In the market for modern drugs, a good alternative is the Nanoplast patch. It has analgesic, anti-inflammatory and local antipyretic effect.

To a sore spot, you can attach a bag with steamed flax seeds. It must be hot. To relieve pain along the damaged nerve fibers, you can smear radish juice or apply fresh burdock.

For relaxation during the recovery period, a bath or sauna is well suited.

Intercostal neuralgia can become chronic if you do not follow all the doctor’s prescriptions.

To prevent this disease, avoid hypothermia and drafts, as well as not neglect the rest and try to keep the nervous system in balance. Doctors advise doing yoga or exercising daily.

Intercostal neuralgia

L.S. Manvelov
Candidate of Medical Sciences

State Scientific Center of Neurology RAMS

The term “neuralgia” comes from the Greek words “neuron” – “nerve” and “algos” – pain. This pain spreads along the nerves, accompanied by other unpleasant sensations, such as creeping goosebumps, burning or numbness.

The causes of neuralgia are kaleidoscopically diverse: injuries, external (heavy metals, bacterial toxins, some medications) and internal (associated with diseases of internal organs) intoxication; some diseases of the nervous system (multiple sclerosis, polyradiculoneuritis, etc.); infections (herpes zoster, tuberculosis, brucellosis, etc.); decreased immunity; allergy; pathology of the spine (additional ribs, osteochondrosis, deforming spondylosis, disc herniation); squeezing of nerve trunks in the musculoskeletal and musculoskeletal canals. In addition, the occurrence of neuralgia with compression of the nerves by scarred tissues and tumors is possible. Alcohol abuse, diabetes mellitus, metabolic disorders of group B vitamins, which are most often observed with peptic ulcer of the stomach and duodenum, gastritis, hepatitis, colitis, accompanied by metabolic disorders in the nervous tissue, are essential.

Cardiovascular diseases lead to the appearance of neuralgia due to hypoxia of the nerve trunks (insufficient oxygen supply): arterial hypertension, atherosclerosis, rheumatism, etc., as well as anemia (anemia).

Intercostal neuralgia can also occur with changes in the spine in women in menopause due to hormonal disorders, less often with endocrine diseases, for example, with thyrotoxicosis, diseases of the adrenal glands, as well as with prolonged treatment with hormonal drugs. It also occurs in other diseases accompanied by osteoporosis (rarefaction of bone tissue).

As we can see, the number of causes leading to intercostal neuralgia is extremely large, and after all, not all of them were listed here. Therefore, if you experience chest pain, you can not self-medicate, considering “your” diagnosis as error-free – this threatens the development of serious complications. Be sure to seek medical help.

Neuralgia very rarely develops under the influence of only one factor. The disease is mainly observed in older people, when all of the listed causes of its occurrence act on the background of age-related vascular changes. In children, neuralgia practically does not occur.

With neuralgia of the intercostal nerves, changes in both their function and structure can be noted. However, only disturbances in the peripheral nerve fibers cannot explain the attacks of pain that can
to appear without any additional exposure. Formations of the central nervous system take part in the formation of the pain attack, controlling the receipt of impulses from the peripheral nerve trunks. Changes in the central nervous system during pain are confirmed by electroencephalography, which reveals the characteristic “outbursts” of brain electrical activity.

The leading manifestation of intercostal neuralgia is pain along the intercostal nerves of a constant nature, sometimes paroxysmally intensifying, especially with movements and coughing. Intercostal spaces are painful when palpating, their sensitivity is sharply increased. Pain in the chest can be caused by a variety of reasons. Here are just a few examples that help to distinguish pain in intercostal neuralgia from pain in some of the common life-threatening cardiovascular diseases. With angina pectoris, pain quickly occurs and passes quickly (within 3-5 minutes). Its typical location is behind the sternum, in the region of the heart, it can be given to the shoulder, neck, left arm and shoulder blade. The patient may have a cold sweat, a fear of death. The picture of acute myocardial infarction is similar to the signs of angina pectoris, but characteristic pains last longer and are more difficult to relieve. The condition of the patient with a heart attack is more severe, a drop in heart activity, blood pressure, nausea, and vomiting is possible.

To establish the real cause of chest pain help modern diagnostic methods. A truly revolutionary revolution in the diagnosis of diseases was performed by X-ray computed tomography and magnetic resonance imaging, which reveal tumors, vascular, inflammatory and other signs of damage to the brain and spinal cord, spine and internal organs. Currently, these methods are widely used in practical medicine.

Treatment of intercostal neuralgia is primarily aimed at eliminating or correcting the causes that cause it. In the acute period of the disease, bed rest is recommended for 1-3 days. The patient should lie on a firm, even surface, best of all by placing a shield under the mattress. Light, dry heat helps: an electric heating pad, heated sand in bags, mustard plasters, pepper patch for painful places. You should avoid bending and turning the body, prolonged sitting, and even more so sharp movements, lifting weights. Wearing a corset works well for several days, but not for long, so that muscle weakness does not develop.

Medication includes analgesics (analgin, sedalgin, spazgan), non-steroidal anti-inflammatory drugs (ibuprofen, ketoprofen, diclofenac, celebrex, voltaren, indomethacin, piroxicam) inside, in rectal suppositories or intramuscularly. All these drugs should be taken systematically by the hour, prophylactically, without waiting for the intensification of pain. The listed funds are not prescribed for acute gastrointestinal diseases and with very great care – for chronic lesions of the gastrointestinal tract. In this case, Flexen (ketoprofen) can be successfully applied due to the peculiarities of its two forms of release – capsules and injection. In seamless capsules, the active substance is soldered in the form of a lipophilic suspension, contact with the gastric mucosa is completely excluded, as a result of which Flexen’s high safety and tolerance is ensured. As for the injectable form, due to the preparation of the solution immediately before administration, there is no need for stabilizers and preservatives. Two other forms of Flexen release are also effective – gel and rectal suppositories.

Vitamin therapy is carried out, especially vitamins of group B (B1, B6, B12), a combined preparation of milgamma. Muscle relaxants (tizanidine, sirdalud, baclofen, clonazepam), as well as combination drugs, including analgesic and muscle relaxant (myalgin) are prescribed to relax spasmodic muscles. If necessary, sedatives are prescribed.

In severe pain, blockade with solutions of novocaine, lidocaine is indicated. With a prolonged course of the disease, glucocorticosteroids (prednisone and others) are used. The effectiveness of the treatment of patients with lesions of the spine with tissue preparations (rumalon, chondroitin sulfate) has not been proven. Applications with dimexide are also used.

Physiotherapeutic methods of treatment are widely used: diadynamic and sinusoidally modulated currents, electrophoresis and phonophoresis of drugs, ultraviolet irradiation, etc. Reflexotherapy is shown: acupuncture, cauterization, laser therapy.

To prevent the transition of the disease into a chronic form with frequent exacerbations, it is important to exclude or significantly reduce the effect of harmful factors, such as heavy physical exertion, psycho-emotional overstrain, alcohol abuse, diseases of the nervous system, internal organs, etc. We emphasize again that it is absolutely necessary how an earlier visit to the doctor is possible in case of chest pain, which can be one of the symptoms of not only intercostal neuralgia, but also a number of others, including Isla and severe, life-threatening diseases. It is not for nothing that Eastern wisdom says: “Treat a mild illness so that you do not have to treat a serious one.”

Is it possible to completely cure intercostal neuralgia

Intercostal neuralgia (dystonia) is an acute pain syndrome in the zone of innervation of the intercostal nerves. Men and women are prone to the disease with the same frequency. With age, the number of patients increases.

The etiology of the disease is different. Often intercostal dystonia is masked by symptoms of cardiac, gastrointestinal, pulmonary, and renal diseases, which complicates timely diagnosis and treatment, leading to complications. Due to the variety of symptoms, the treatment is carried out by a therapist, vertebrologist, neuropathologist, cardiologist, gastroenterologist, pulmonologist, oncologist.

Causes of pathology

Intercostal neuralgia occurs due to the following reasons:

  • hypothermia;
  • infectious processes in the body;
  • traumatic nerve damage in injuries of the spine and chest;
  • nerve compression by the muscular apparatus of the chest and back, caused by exorbitant physical exertion, prolonged stay in an uncomfortable position, chronic vertebrogenic pain syndrome, malignant processes in the lungs and pleura, aortic aneurysm;
  • irritation of the intercostal nerves due to diseases of the spine – osteochondrosis, spondylosis, intervertebral hernia, scoliosis;
  • dysfunction of the costal vertebral joints due to their deformation (arthrosis, trauma);
  • curvature of the spine, deformation of the chest;
  • pathologies of the nervous system – polyradiculoneuritis, multiple sclerosis;
  • intoxication with certain medicines, alcohol, salts of heavy metals, ionizing radiation;
  • somatic and endocrine diseases, in particular, diseases of the gastrointestinal tract (GIT) and diabetes;
  • weakened immunity;
  • group B hypovitaminosis, anemia;
  • the use of tight underwear in women;
  • intensive growth of the skeleton in children;
  • age-related changes in the elderly.

Forms

According to the pathogenetic factor, 2 main forms of the disease are distinguished:

  • radicular – due to irritation of the roots of the spinal cord, characterized by severe chest pain, similar to heart;
  • reflex – caused by muscle tension in the intercostal spaces.

By the symmetry of the lesion, single and bilateral dystonia is distinguished. Bilateral intercostal neuralgia is often found against a background of herpes infection, radiation intoxication, immunodeficiency.

Depending on the localization, pain occurs:

  1. In the upper chest, around the clavicle, there is irradiation due to irritation or compression of the nerve roots in the lower parts of the spine. Algium is felt during torso, when turning the head, gives to the neck, arm, shoulder on the side of the lesion.
  2. Behind the sternum, between the shoulder blades is neuralgia of the thoracic spine.
  3. Between the shoulder blades, below the axillary fossa, the left side, the area of ​​the nipples – scapular-costal dystonia. Algia can last a long time, be aching or short-term, stitching. It is felt when inhaling and exhaling.
  4. In the front of the chest – near the sternum, in the armpits. The pain is prolonged aching.

Based on the type of damaged nerve fibers, the symptoms of neuralgia are as follows:

  • sensitive bunches – piercing pain;
  • motor – shortness of breath (impaired motor functions of the muscles and diaphragm);
  • autonomic – autonomic symptoms;
  • mixed option.

Evidence

One of the main signs of intercostal neuralgia is intercostal pain (thoracalgia), which has the following features:

  • spreads along the intercostal space from the spine to the sternum;
  • amplified by sudden movements, laughter, coughing, sneezing, turning the body, raising arms, touching the affected area;
  • more often it has a paroxysmal burning, shooting character, “like a shock,” but it can also be aching;
  • during an attack lasting several seconds – 2-3 minutes. the patient freezes, holds his breath on inhalation, tries to avoid any movements;
  • the duration and intensity can vary, does not depend on the time of day (does not decrease at night);
  • the patient is forced to be in a certain position to minimize range of motion;
  • it radiates to different sites depending on localization – to the mammary gland, the region of the heart in women, at the level of the lower ribs on the left side, the scapular, epigastric region in men;
  • it is girdle in nature if it is localized along 1-2 intercostal nerves;
  • there is an increase in intensity as the disease progresses.

Other symptoms of intercostal neuralgia:

  • sleep disturbance (insomnia);
  • in children – convulsions, hyper excitability, speech disorders;
  • muscle cramps and numbness at the site of the lesion;
  • increased sweating;
  • hyperemia or pallor of the skin in the affected area;
  • dyspnea;
  • paresthesia – a feeling of “creeping creeps”, “running electric current”;
  • itching with herpetic etiology, then a rash in the intercostal space, appearing on the 2nd-4th day of pain. The rash is represented by pink spots that turn into vesicles that dry out over time. After vesicles, temporary pigmentation remains on the skin.

Diagnostics

Diagnosis is based on complaints, medical history, objective examination of the patient. During the collection of an anamnesis, the doctor asks about past injuries, operations, the patient’s lifestyle, chronic diseases, takes into account age-related changes.

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An objective examination determines the state of muscle tone, localization of pain, the degree of violation of sensitivity. If you suspect the presence of other pathologies, blurring the clinical picture, additionally apply:

  • magnetic resonance imaging (MRI) and computed tomography (CT) – to exclude hernias, malignant processes, study the condition of muscles, ligaments, nerve tissues;
  • myelography – the study of the roots of the spinal cord through the introduction of contrast medium into the spinal canal. Most informative when combined in CT;
  • X-ray examination of the chest and spine – detection of traumatic, degenerative-dystrophic processes;
  • electrospondylography – assesses the condition of the spine;
  • electroneurography – reveals the consequences of injuries;
  • electrocardiography – with similar symptoms with cardiovascular pathologies;
  • ultrasound examination – the identification of inflammatory processes, diseases of internal organs;
  • contrast discography of the spine, detecting changes in the intervertebral discs;
  • gastroscopy – with a suspected history of gastrointestinal tract pathology;
  • general analysis and stool culture – to identify the bacterial pathogen in infectious etiology;
  • general and biochemical analysis of blood and urine – detection of diseases of internal organs;
  • serological blood test – diagnosis of the state of the immune system, identification of viral pathogens.

Differential diagnostics

It is often difficult to recognize intercostal neuralgia due to the similarity of manifestations with other diseases. It is necessary to diagnose intercostal neuralgia with:

  1. Cardiovascular disease. Thoracalgia often radiates to the left scapula, an area of ​​the heart that resembles heart disease, in particular angina pectoris. Unlike the last pain in dystonia, they do not stop with the drugs of the nitroglycerin series, are aggravated by movements and palpation (with angina pectoris, the provocation of the algium is caused by physical exertion, an attack of a compressive nature). The diagnosis confirms the ECG.
  2. Thoracic radiculitis and intervertebral hernia – algia are episodic in the face of constant dull back pain. Decreased during night sleep. The diagnosis is confirmed by a thoracic spine RG with a suspicion of radiculitis, MRI of the spine with an alleged hernia.
  3. Gastrointestinal episodes of pain in which chest irradiation is possible. In diseases of the stomach (gastritis, ulcer), algias of lower intensity, longer. Pancreatitis is characterized by girdle pain, but it is always bilateral. With gastrointestinal tract disorders, pain is associated with food intake, which is the main difference from intercostal neuralgia. Gastroscopy, laboratory tests confirm the diagnosis.
  4. Renal colic – similar symptoms are observed with neuralgia of the lower ribs – cramping pains in the lumbar region, radiating to the leg, groin. Confirm the diagnosis by ultrasound.
  5. Pleurisy, atypical pneumonia, malignant tumors of the thoracic region – the diagnosis is based on data from RG, CT, MRI.

Treatment

The treatment of intercostal neuralgia is complex and staged. Includes pathogenetic (etiotropic), aimed at eliminating the root cause and symptomatic therapy, stopping thoracalgia attacks, related symptoms. Types of treatment – medication, physiotherapy, physiotherapy, massage, manual therapy, traditional medicine.

The tactics of etiotropic therapy depend on the genesis of neuralgia. Pathogenetic treatment includes:

  • antibiotics, antiviral – for infectious diseases;
  • anti-inflammatory drugs, analgesics, chondroprotectors, immunomodulators, physiotherapy, massage, exercise therapy, folk remedies – for diseases of the spine;
  • detoxification therapy for drug, alcohol, radiation, chemical poisoning;
  • therapy of somatic and endocrine diseases with drugs of the corresponding groups;
  • vitamins, general strengthening, immunostimulants for hypovitaminosis and immunodeficiency states;
  • surgical intervention for malignant processes in the body.

Intercostal neuralgia

With severe pain in the chest, the patient often has panic, since the first thought is a heart attack. A person calls a team of doctors who travel in vain, because the real cause of the pain attack is thoracalgia or intercostal neuralgia. The disease requires careful study and examination, because the cause of the pain is not in the heart, but in the condition of the peripheral nerves.

Causes

Pathology occurs due to pinching of the intercostal nerves. And pinching is the result of pathology of the spine or other problems in the body. Therefore, thoracalgia is a secondary disease. As an independent disease, neuralgia appears only with a pathological change in the nerve sheath. In other cases, pain provokes deformation or displacement of the vertebrae. What diseases of the musculoskeletal system entail neuralgia:

Against the background of what diseases can nerve infringement develop:

mechanical damage to the chest;

infectious diseases: tuberculosis, flu, herpes;

problems with the endocrine system;

congenital malformations of the chest;

Intercostal neurosis rarely develops in young people. This is a disease of the elderly. It begins against the background of age-related changes in the body and taking a large number of drugs.

Types of intercostal neuralgia

Systematize the pathology according to the location of the pain syndrome:

On the right side

Causes less anxiety than pain on the left side. Right-sided neuralgia is diagnosed faster, as it is rarely associated with cardiac pathologies.

From the left side

Needs differential diagnosis – often confused with heart disease. It is more common in women. Incorrect diagnosis is dangerous with improper treatment. Medicines that are taken for heart pain will not help with neuralgia. The pain intensifies with a change in body position or cough.

It is rare, but it brings the patient a lot of discomfort. The pain is localized on both sides, but the intensity of the pain syndrome and treatment methods are similar.

In addition to neuralgia of the intercostal nerves, the following types are distinguished:

occipital (occipital nerve);

inflammation of the sciatic nerve;

What to do with intercostal neuralgia? You should immediately consult a doctor and undergo all necessary examinations.

Clinical signs

Stitching or burning sharp chest pain on one or both sides is the main symptom of thoracalgia. Other signs:

it is difficult to take a deep breath;

back pain with coughing sneezing provokes a pain attack;

numbness at the site of pain;

becomes worse with palpation of the sore spot;

muscles are spasmodic, which worsens the condition of the patient;

pain radiates to other areas: shoulder blades, shoulder;

neuralgia is easily confused with heart pain;

Sometimes neuralgia is dangerous to health. Symptoms of a threat to life and health:

persistent cough with sputum production;

acute pain in the stomach and chest;

The disease may be regular or paroxysmal. During an attack, the patient occupies a body position in which pain is felt to a lesser extent. Intercostal neuralgia in children is a rare phenomenon and is associated, in most cases, with increased spinal growth. In addition to severe pain, children may experience cramps.

Diagnostics

Which doctor should I go to when the first symptoms of intercostal neuralgia appear? First you need to make an appointment with the therapist. He will conduct an external examination and get acquainted with information about the course of the disease. In the future, a neurologist consultation may be required. Diagnosis of intercostal neuralgia without fail includes:

manual (manual) examination;

Lovett test – determination of muscle strength;

neurological examination of the head and cranial nerves, lower and upper extremities, trunk;

examination of reflexes, standing and walking;

localization of pain and the degree of its intensity is determined.

Often there is a need for laboratory research:

contrast study of intervertebral discs;

Based on the results, the doctor makes a diagnosis and prescribes treatment. But there are cases when the causes of intercostal neuralgia remain unknown and it is likely that the disease is psychosomatic. Psychological problems and diseases of the thoracic region are closely interconnected. The opinions of specialists in the psychosomatics of intercostal neuralgia differ:

perhaps the reason lies in the past, a person regularly experiences a difficult moment and cannot forget about it;

neurological disorders – punishment for past actions;

chest pain is the result of hard communication with another person;

the disease is guilt and a hypertrophied conscience.

If neuralgia is a consequence of psychological problems, then the help of a psychologist is needed.

Treatment

Is it possible to solve the problem forever? Often people buy medicines on their own at a pharmacy and try to get rid of the disease with their help. Of course, painkillers help, but the root cause remains. It is important that the treatment of intercostal neuralgia be comprehensive and include various treatment methods and techniques. Therapy also depends on the stage of the disease. If neuralgia was diagnosed at the initial stage, physiotherapeutic procedures are used, and the cause of the disease is simultaneously treated. During the acute stage, bed rest and medication are prescribed. What medicines are used:

Analgin, Neurontin, Spazgan, Sedalgin, Aspirin

Nonsteroidal anti-inflammatory drugs

Anesthetics (for severe pain)

Bee or snake venom preparations

Vipratox, Apizartron, Viramine

Vitamin B Injections

Persen, Novopassit, Glycine

Chondromix, Rumalon, Artrolon

Sometimes the disease can go away on its own, but usually there is a need for treatment. In severe cases, carry out the procedure “cryoablation of nerves”, which involves the removal of part of the affected nerve.

ethnoscience

In addition to taking medications, patients often use traditional medicine recipes. In this case, it is important to observe bed rest and take medication. What methods are used:

For anesthesia, an ointment is used. Glycerin and bee honey should be mixed in a ratio of 1: 1. Apply the resulting ointment to sore spots and leave for 60-120 minutes.

Another ointment with glycerin. Instead of honey, you need to take iodine. Stir and pour into a dark glass dish. Shake the mixture and apply on a cotton swab. Lubricate the entire back with a swab (except for the spine) and wear clothing made from natural fabric. Then you can go to bed. The procedure must be repeated for a month every other day.

In 1 teaspoon of black radish juice add 2 drops of lavender essential oil. Squeeze the juice with honey and sugar. Rub the resulting mixture into the affected area and wrap it with a warm scarf. Juice can be rubbed without lavender, in its pure form.

Wash and chop the yarrow. Pour a tablespoon of the plant with boiling water (150 ml) and leave to infuse for an hour. It is advisable to wrap the dishes in a towel to maintain heat. Take a decoction three times a day for 20 ml.

Prepare a decoction of sage: 4 tablespoons of crushed plants pour 200 ml of boiling water. Close the lid and leave for 2 hours. The resulting broth + sea salt without additives (4 tbsp. Tablespoons) add to a hot bath. Take a bath for 10-15 minutes.

Traditional healers for the treatment of neuralgia also use dry compresses, honey, chamomile, mint, geranium, lemon balm, marshmallow, garlic oil, etc. It is important to remember that these recipes are allowed to be used only as an additional component of the main course of therapy.

Healing procedures

The use of drugs for intercostal neuralgia plays an important role, but physiotherapy should not be forgotten. For example, massage is an integral part of complex therapy. His goal:

elimination of pain syndrome;

restoration of damaged nerves;

relaxation of spasmodic muscles.

In general, the course lasts from 10 short (up to 10 minutes) sessions. In addition to massages, are also used:

Exercises exercise therapy. Gymnastics is aimed at improving the condition of the spine and strengthening muscle tone. Helps relieve pain and cramping. The first classes are best carried out under the supervision of a physical therapy doctor, the following are allowed to perform at home.

Acupuncture. This ancient Chinese technique will help eliminate pain and has a positive effect on the energy forces of the body.

Manual therapy. The specialist will put the ribs in place, which will remove the load from the nerve. The method also improves metabolic processes in tissues, stimulates blood circulation and mobilizes joints.

Pathology lends itself well to the influence of physiotherapy. What procedures do:

Morozov Georgiy

Georgy Morozov, rheumatologist. For more than 20 years, he has been involved in the diagnosis, treatment and prevention of joint diseases.

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