Intercostal Neuralgia: Symptoms, How the Pain Feels and How Long It Lasts

The pain comes on inhalation: sharp, piercing, as if a red-hot thread had been drawn between the ribs. You can't take a deeper breath, and the first thought is of the heart. Next — what the pain of intercostal neuralgia looks like, how long it lasts, and when it's time to see a doctor.

Intercostal neuralgia: what it is

Intercostal neuralgia, or thoracalgia, is a disease of the peripheral nerves in which chest pain is caused by compression or irritation of the nerve roots of the intercostal nerves. It is not the heart that hurts, but the nerve.

Compression most often occurs where the roots emerge from the spinal column — for example, with osteochondrosis. In most cases, neuralgia is preceded by muscle spasm, which contributes to irritation of nerve endings and, accordingly, to the onset of pronounced pain.

There are many causes of this condition:

• osteochondrosis and other diseases of the thoracic spine — spondylitis, hormonal spondylopathy, ankylosing spondylitis, tumors;
• an awkward sudden movement, working in an uncomfortable position, a draft, chilling, heavy physical exertion;
• stress, colds, chest injury, metabolic disorders;
• excessive tone of the muscles — spinal extensors, shoulder and scapular muscles.

Girdle pain at the level of the chest also occurs with stomach problems: gastritis can cause pain in this area. It mainly affects older people; the condition is practically never seen in children.

How intercostal neuralgia feels

The character of the pain varies — sharp, piercing, aching, burning or dull — and it manifests in attacks or periodically.

The key sign is its connection with movement. With a sudden movement, coughing, sneezing, changing body position and on inhalation, the pain intensifies so much that it interferes with normal breathing. An attack is sometimes accompanied by muscle twitching, sweating, severe tingling in the chest, and the skin reddens or turns pale.

There are also tender points that hurt when pressed: on the back, along the chest, along the spine, in the intercostal spaces. Numbness appears at the very site of damage to the nerve fibers.

Symptoms in women and men: pain in the chest, under the shoulder blade, in the abdomen

The pain of neuralgia manifests in a similar way, and its main variants are described below: in the chest, under the shoulder blade, in the abdomen.

The pain of neuralgia is not felt only in the heart area: pain may occur under the shoulder blade, in the collarbone area and in the lower back.

Chest pain resembling neuralgia occurs with muscle strain after injury or exertion, with herpes zoster with tingling, rash and blisters, with inflammation of the joints of the chest, with anxiety and a panic attack, and with diseases of the lungs and pleura. Pain radiating to the abdomen is a separate reason to be alert: with heart problems it spreads there as well.

How long intercostal neuralgia lasts

No single duration can be given for an attack: the pain may persist both day and night, coming in attacks or with intervals.

For comparison: the pain of angina passes within 5–10 minutes.

How neuralgia differs from heart pain

The difference lies in the behavior of the pain.

With neuralgia, chest pain persists for a long time, both day and night, and intensifies with changes in body position, coughing, sneezing, deep inhalation and exhalation, sudden movements, and when the chest is palpated or pressed. With heart disease, movement and deep breathing do not intensify the pain, but disturbances of the heart rhythm and changes in blood pressure are possible.

A separate scenario is pericarditis: sudden sharp, stabbing pain that intensifies on deep inhalation or in a lying position. To rule out cardiac pathology with pain in the chest or under the left shoulder blade, an electrocardiogram is urgently performed, sometimes an X-ray.

When chest pain requires an urgent doctor

Pain that comes and goes is still a reason to see a doctor and not to guess the cause from sensations.

The doctor assesses the character of the pain, its connection with movement and breathing, and tender points, looks at the cardiogram and, if necessary, prescribes additional examinations.

Intercostal neuralgia by itself is not a reason to call an ambulance. 103/112 — if the chest pain is sudden and does not pass, is felt as squeezing, pressure or burning; if it radiates to the left or right arm, neck, jaw, abdomen or back; if sweating, nausea, dizziness or shortness of breath appear along with it.

This material is for reference and does not replace a doctor's consultation: you can recognize your pain "by sight," but a specialist must assess it.

This content is for reference and does not replace a doctor's consultation. Medical disclaimer