Presentation
A 61-year-old woman presented with intermittent pain on her left chest wall with distribution of the pain corresponding to the T10 dermatome. [ncbi.nlm.nih.gov]
Free Case Reports | October 1990 An Unusual Presentation of Intercostal Neuralgia Author Affiliations & Notes Robert F. Haynsworth, M.D. * Carl E. Noe, M.D. * * Associate Attending. [anesthesiology.pubs.asahq.org]
Patients may also present with shallow, apical breathing as deep breaths may also increase pain. [aspecthealth.ca]
Entire Body System
- Epilepsy
McKhann II Florence Irving Associate Professor of Neurological Surgery Director, Epilepsy and Movement Disorder Surgery Director, Adult Hydrocephalus Center Director, Awake Brain Mapping for Tumors and Epilepsy [columbianeurosurgery.org]
Certain physiological factors (such as aging) or pathological ailments (history of epilepsy, Intercostal Neuralgia presents with: Loss of muscle activity Numbness Tingling Pain in back Muscle paralysis The prevalence of thoracic pain in Australian population [motionhealth.com.au]
- Movement Disorder
McKhann II Florence Irving Associate Professor of Neurological Surgery Director, Epilepsy and Movement Disorder Surgery Director, Adult Hydrocephalus Center Director, Awake Brain Mapping for Tumors and Epilepsy [columbianeurosurgery.org]
Respiratoric
- Pleuritic Pain
[…] away from the side may indicate pleuritic pain (distension of pleura).[26] In the case of ACNE syndrome, Carnett’s sign may be positive (increased pain with palpation of the affected area during abdominal muscle engagement [ex: a partial sit up]). [ncbi.nlm.nih.gov]
Musculoskeletal
- Fracture
Fracture can be ruled out with x-rays but if there is a fracture there is not a lot you can do except wear a rib belt and avoid movement. Conservative Intercostal Neuralgia treatment consists of sleeping on your back at all times. [drmikesnyder.com]
History of trauma, ecchymosis, crepitus, and point tenderness over a rib suggests rib fracture. If the trauma was minor, a contusion or intercostal neuralgia may be the source of discomfort. [clinicalgate.com]
She had a fall down some stairs whilst wearing a rucksack and bruised the left side of her chest- rib fractures were excluded on X-ray. [londonpainclinic.com]
- Osteoporosis
In trauma with or without osteoporosis, X-ray is indicated in order to exclude an impression fracture. When there is suspicion of a malignancy, MRI scan and/or referral to a specialist is mandatory. [pijn.com]
Non-traumatic causes, which include a) osteoporosis with vertebral collapse, b) degenerative thoracic disks, c) painful neuropathies, d) rib-joint arthritis, e) spine deformities such as scoliosis, f) infections such as shingles, g) certain intra-thoracic [hannasaadah.com]
[…] thoracalgia right are: mechanical damage to the nerves in the area of the ribs; broken ribs increased muscle tone the curvature of the spine; slouch nerve damage on the background of the tick-borne encephalitis the presence of diseases of the spine (osteoporosis [back.vsebolezni.com]
If we suspect a heart or lung problem, fracture, osteoporosis, rib infection or cancer we will refer you to your GP, medical practitioner or hospital without delay. [sayerclinics.com]
- Contusion
If the trauma was minor, a contusion or intercostal neuralgia may be the source of discomfort. [clinicalgate.com]
Or the body fluid and the phlegm retention or sudden pain and contusion caused the stagnation of the stagnant blood in the collaterals, so that hypochondriac pain happened. [tcmwindow.com]
Trauma can damage visceral organs, and thus aortic dissection, pulmonary contusion, hemo/pneumothorax, or pain referred from cardiac, pulmonary, or other visceral organ damage should be ruled out. [ncbi.nlm.nih.gov]
Workup
Most patients will have had numerous workups and treatments without benefit. Detailed pain and trauma histories plus careful palpation of the spaces beneath the ribs usually provide the necessary clues for diagnosis and effective therapy. [hannasaadah.com]
All other complications were ruled out and all needed workups; imaging and laboratory tests were negative before inclusion in the study. Then, patients were candidates for intercostal PRF. [archtrauma.com]
Other pertinent history and workup include pregnancy and parity, autoimmune disorders, neoplastic process, or metabolic and nutritional derangements. [ncbi.nlm.nih.gov]
Treatment
Treatment Physical Treatments Medication Neuropathic pain medication Capsaicin cream Other Treatments Manual/Musculoskeletal Medicine TENS Interventional Pain Treatments Epidural injections Sleeve injection of a nerve root PRF treatment of a nerve root [pijn.com]
[…] used when other treatments have failed. [living-with-back-pain.org]
CONSERVATIVE TREATMENT FOR AN INTERCOSTAL MUSCLE SPRAIN Conservative treatment starts with a comprehensive assessment by your physiotherapist or osteopath. [forcemedic.com]
In the presence of space-occupying lesions, surgical treatment. Treatment for neuralgia is selected by the doctor (neurologist). Prevention Neuralgia is easier to prevent than to treat. [back.vsebolezni.com]
Prognosis
TABLE OF CONTENT Introduction Chapter 1 Intercostal Neuralgia Chapter 2 Causes Chapter 3 Symptoms Chapter 4 Diagnosis Chapter 5 Treatment Chapter 6 Prognosis Chapter 7 Trigeminal Neuralgia Chapter 8 Shingles Epilogue [chapters.indigo.ca]
Here is my favorite article on costochondritis, http://patient.info/health/costochondritis here is one excerpt: "What is the outlook (prognosis) for costochondritis? The outlook for costochondritis is generally very good. [inspire.com]
The prognosis of neuralgia is favorable. [back.vsebolezni.com]
Prognosis The prognosis of intercostal neuralgia is variable. Some patients achieve resolution of symptoms over time with or without supportive conservative measures, while others develop chronic pain, which can be a significant source of morbidity. [ncbi.nlm.nih.gov]
Etiology
Etiological factors The causes of intercostal thoracalgia different. [back.vsebolezni.com]
Abstract Intercostal nerves were injected with 10 per cent annomium sulfate in 41 patients (52 total sets of injections) for management of intercostal neuralgia from radical mastectomy (six blocks), thoracotomy (20 blocks), or unknown etiology (26 blocks [ncbi.nlm.nih.gov]
[…] neuralgia). glossopharyngeal neuralgia that affecting the petrosal and jugular ganglion of the glossopharyngeal nerve, marked by severe paroxysmal pain originating on the side of the throat and extending to the ear. idiopathic neuralgia neuralgia of unknown etiology [medical-dictionary.thefreedictionary.com]
Its etiological factors include mental irritation, invasion of exogenous pathogen and traumatic injury. The main diseased regions are distribution of liver and the gallbladder meridians. [tcmwindow.com]
In some instances, a structural or inflammatory source can be located, but still there are indeterminate etiologies in many people with primary pain disorders. [epainassist.com]
Epidemiology
Advances in the understanding of the pathogenesis and epidemiology of herpes zoster. J Clin Virol. 2010 May;48 Suppl 1(Suppl 1):S2-7. [PMC free article: PMC5391040] [PubMed: 20510263] 17. [ncbi.nlm.nih.gov]
[…] and the vessels). [8] Marijuana: The American Medical Association stated in Report 3 of the Council on Science and Public Health (I-09) that "...Results of short term controlled trials indicate that smoked cannabis reduces neuropathic pain...". [11] Epidemiology [en.wikipedia.org]
Pathophysiology
The pathophysiology of chronic intercostal neuralgia pain is quite complicated. It involves different mechanisms such as peripheral, central, and psychological. [epainassist.com]
Sources: Kerkar, P., “What Is Intercostal Neuralgia: Symptoms, Causes, Treatment, Pathophysiology, Diagnosis,” ePain Assist; https://www.epainassist.com/nerves/intercostal-neuralgia, last accessed May 30, 2017. [doctorshealthpress.com]
The exact pathophysiology remains unknown, but this is mostly due to chest trauma during physical activities. In addition, athletes may be subjected to sudden large loads of indirect forces or overuse. [archtrauma.com]
Pathophysiology The pathophysiology of intercostal neuralgia is multifactorial and includes various combinations of the peripheral and central nervous system and psychological mechanisms. [ncbi.nlm.nih.gov]
Prevention
Prevention Neuralgia is easier to prevent than to treat. [back.vsebolezni.com]
Vaccination to prevent infection like chickenpox, herpes zoster, and shingles helps to prevent viral infection, which may cause intercostal neuralgia. [epainassist.com]
[…] importance for all interventional pain physicians to perform a thorough pre-use check of the equipment prior to any RFA procedure, with special emphasis on ensuring the integrity of the insulating sheath of the needles which are to be used, in order to prevent [ncbi.nlm.nih.gov]