Intercostal neuralgia: symptoms and treatment tablets
Neuralgia is a pain syndrome that occurs in the nerves. There are many types of neuralgias, including intercostal.
Intercostal neuralgia is a rare disease, which is manifested by pain along the intercostal nerves. It can have many different causes, for example:
- chest injuries;
- herniated disc at thoracic level;
- tumors of the thorax;
- operations on organs of the thoracic cavity.
Intercostal nerves start from the spinal cord and placed under the lower edges of respective ribs along with the blood vessels. They Innervate the muscles of the chest, skin and chest cavity. Nerves can be affected as a result of surgery, trauma, infectious process (eg, herpes zoster) or tumour.
The development of acute intercostal neuralgia is due to nerve damage. The development of chronic pain is more complex, including mechanisms that affect the peripheral and Central nervous system and psychological state of the person.
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Signs and symptoms of intercostal neuralgia
The main symptom of intercostal neuralgia is pain in the area of the chest. This pain may be single — or double-sided, stabbing and sharp. It may radiate to the posterior or anterior surface of the chest. Sometimes the pain occurs during breathing, coughing, laughing or sneezing. During exercise it increases. The skin over the area of neuralgia may have increased sensitivity and be painful when touched. In addition to these signs, intercostal neuralgia may be accompanied by:
- pain in the abdomen;
- an increase in temperature;
- rash on the skin along the intercostal interval (symptom of shingles);
- pain in arm, shoulder or back;
- the limitation of motion of the back and shoulder girdle;
- the tingling sensation.
It is very important to distinguish pain in intercostal neuralgia pain with heart disease (angina or myocardial infarction), which can be dangerous for patient’s life.
How to treat intercostal neuralgia?
A treatment plan is developed depending on the reasons for the origin of intercostal neuralgia. Sometimes she walks alone. The treatment of neuralgia, whatever the reasons may include:
- Intercostal nerve blockade is injections of local anesthetic or a corticosteroid around the affected nerve.
- Nonsteroidal anti-inflammatory drugs (NSAIDs) – help to reduce inflammation and relieve pain. These include tablets of Ibuprofen, Naproxen, Indomethacin.
- Antidepressants, which help to ease the pain.
If neuralgia is caused by shingles can be used with the following medications:
- Antihistamines to ease itching.
- Antivirals (Acyclovir and Famciclovir). These drugs for the treatment of shingles can reduce the severity and duration of symptoms of neuralgia.
- Capsaicin alleviates pain.
- Corticosteroid remedies – can reduce the risk of developing postherpetic neuralgia (pain continuing long after shingles).
Treatment of intercostal neuralgia start with the combination of simple painkillers and NSAIDs. If these means do not resolve the symptoms sufficiently, add tricyclic antidepressants or Gabapentin. Tricyclic antidepressants have traditionally been the mainstay of treatment of pain with intercostal neuralgia. Scientific evidence has demonstrated the effectiveness of the use of Amitriptyline, Although Desipramine for this purpose. Unfortunately, the use of this class of medications is associated with side effects such as dry mouth, constipation, sedation and urinary retention. If antidepressants are ineffective or contraindicated, the alternative may be Gabapentin.
To temporarily relieve pain in neuralgia, can be useful for local use of heat and cold, wearing an elastic belt. The ineffectiveness of these methods, carried out the blockade of the intercostal nerves. If the patient is helped blockade, long-term pain relief can be achieved with radiofrequency ablation of the intercostal nerves. This procedure is performed under ultrasound guidance to minimize the risk of pneumothorax. With the help of special equipment intercostal nerve is heated to a temperature of 42°C. Sometimes treatment using transcutaneous electrical nerve stimulation. The influence of weak electrical impulses to nerves and helps relieve pain in neuralgia, without affecting the disease that caused it.
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Some alternative therapies can help patients to get rid of intercostal neuralgia. These methods are used in combination with traditional drug therapy. When intercostal neuralgia apply:
- therapeutic massage;