Intercostal neuralgia is called a pathological condition arising as a result of compression or irritation of the roots or the entire length of the intercostal nerves or their branches. At the same time there are strong pain attacks in the chest that bring suffering to the patient.
Intercostal neuralgia is among the most painful processes. When it occurs often patients think about the pain in the heart, as the localization of the pain is very similar.
However, unlike the heart pains that are caused by circulatory disorders usually in the vessels of the heart, the pain of neuralgia - a process of irritation and hypersensitivity in the region of the intercostal branches nerves. Intercostal neuralgia usually affects people in middle and old age due to age-related degenerative changes in the body, including in the field of nerve trunks.
Causes
The main causes of intercostal neuralgia are degenerative, tumoral or inflammatory changes in the nervous system, particularly peripheral nerve trunks. Predispose to these changes:
- spine problems or ribs, their injury or illness,
- the stomach and intestines,
- diabetes,
- deficiency of vitamins and minerals,
- tumor in the thoracic spine
- excessive strain back muscles or inflammation,
- stress and fatigue,
- progressive osteochondrosis,
- nerve injury on the thorax,
- intoxication with neurotropic poisons, medicines, microbial toxins,
- herpetic nerve damage.
Predispose to the formation of neuralgia:
- weakened immunity,
- heart disease and blood vessels,
- spinal malformations of his injury,
- menopause in women, hormonal shifts,
- alcohol consumption.
As a result of one or more causes formation occurs trauma, inflammatory process or compression of a nerve root or trunk. Thus the nerve endings receive an excessive number of pulses experiencing hypoxia (oxygen deficiency) that transforms into pain impulses as a result.
The symptoms of intercostal neuralgia
The main manifestation of intercostal neuralgia is pain attacks:
- constant severe pain,
- burning,
- tingling,
- recurrent bouts of pain, acute and painful, like a pain in the heart,
- muscle tension in the back,
- increased pain with coughing or sneezing, bends the torso,
- forced body position for pain relief,
- loss of sensation in some parts of the chest.
In this neuralgia may be accompanied by:
- severe sweating,
- abrupt pressure fluctuations,
- low back pain, mimicking pain in the kidneys.
Differences from the pain in his heart
Distinguish pain along the nerve trunks of the pain in my heart to help the following features:
- pain for heart disease are usually non-durable,
- relieves pain by nitroglycerine,
- pain in my heart to give a hand, arm,
- pain does not change with a deep breath,
- have heart rhythm disturbances.
Neuralgia pain:
- long, do not go at night,
- pain intensifies when cornering and body inclined, strongly hurts when probing intercostal spaces,
- no relief from nitroglycerin,
- It helps heat and taking pain.
Diagnostics
First of all, intercostal neuralgia diagnosis based on the main complaints of pain in the chest and examination of the patient with a neat feeling intercostal spaces. Basically, the diagnosis is clear from the survey, but sometimes in difficult cases, use of instrumental methods of diagnostics to identify the cause of neuralgia:
- electroneurogram, especially in the case of suspicion of injury nerve
- CT or MRI of the spine to eliminate the bulk processes in the thoracic (hernia, tumors of the spine and surrounding soft tissues)
- X-rays of the spine and thoracic organs,
- with pain on the left side - an electrocardiogram and heart ultrasound to rule out heart disease.
- general analysis of blood and urine, especially for pain radiating to the back,
- blood for antibodies to herpes viruses, for suspected infection of the nerves.
Treatment of intercostal neuralgia
Intercostal neuralgia is usually treated with neurologists, in some cases, need help neurosurgeons. First of all, the mainstay of treatment - is the elimination of the underlying disease that leads to inflammation or a pinched nerve.
In the period of acute pain is shown:
- bed rest for at least a couple of days, and the surface of the bed must be made smooth and solid, put it under the mattress panel,
- with intercostal neuralgia pain eases warming chest dry heat - woolen shawl, warm compress, towel,
- permissible use of yellow cards in the paravertebral area (but not on the spine itself)
- massage with inflammatory and warming ointments (finalgon, diclofenac gel, voltaren, etc.), pepper patch
- receiving sedatives (valerian, Leonurus, persen, neo-pass), non-steroidal analgesics group - ibuprofen, paracetamol, diclofenac. They can not be abused, over time, they can lose their effectiveness with frequent reception
- on acute now banned physical activity, stress, and alcohol intake.
When severe pain and ineffective analgesics resorted to novocaine blockade.
Later on prescription shall apply:
- Physiotherapy (UVR segment where there is pain, electrophoresis with novocaine, darsonval)
- acupuncture,
- osteopathy,
- laser therapy,
- receiving high doses of B vitamins
The period of rehabilitation shown:
- application of paraffin and ozokerite,
- mud,
- massages,
- baths with radon or hydrogen sulfide.
- shows therapeutic exercise, swimming, massages.
When the volume in the formation of the spine, compresses the nerve roots and giving pain, operative treatment.
prevention
In order to prevent exacerbations intercostal neuralgia shows the methods to strengthen the back muscles, prevention of hypothermia, the normalization of lifestyle, taking vitamins. The prognosis for a favorable intercostal neuralgia.
