Intercostal neuralgia is a lesion caused by damage to the anterior branch of the thoracic spinal nerve from a variety of causes, with pain predominating in the area of distribution of the damaged spinal nerve. Primary intercostal neuralgia is rare; most intercostal neuralgia is secondary, that is, caused by an acquired cause.
Common causes of intercostal neuralgia.
1, infection: including bacterial and viral secondary infections of the upper respiratory tract, herpes zoster virus infection, etc.
2, trauma: thoracic spine injury, rib fracture, secondary intractable pain after chest surgery.
3, nephritis, diabetes, toxic peripheral nerve damage leading to peripheral neuritis.
4, rheumatism: rheumatoid arthritis, ankylosing spondylitis, etc. cause intercostal nerve damage.
5, thoracic degeneration: degenerative changes in the vertebral body lead to changes in the peri-spinal tissues stimulating the intercostal nerve.
6.Other: inflammation of intercostal soft tissue, tumor, abscess and metastatic cancer, etc. stimulate the thoracic spinal nerve.
Symptoms
The pain is semi-circular and confined from the thoracic spine in the back to the anterior thorax and abdomen along the invaded intercostal nerve.
The nature of the pain is mostly persistent or paroxysmal stabbing or burning pain. The pain increases with deep breathing, coughing, sneezing or physical activity. Most of the pain is limited to a single branch on one side, but several intercostal nerves may be damaged at the same time.
Diagnosis
1. Typical semi-circular limited radiating pain.
2, pressure pain in the spinous process and paraspinal process of the thoracic spine, and skin hypersensitivity or hyperalgesia in the area of the damaged nerve distribution are often present.
3.Take X-ray, CT or MRI to exclude other lesions in the lumbar region and spine.
Treatment principles
Intercostal neuralgia must be treated by finding the cause first. If the cause is unclear and the pain is severe, symptomatic treatment can be used without affecting the diagnosis. Or if the etiology is clear but there is no good treatment plan or the etiology is clear and the pain is severe, a combination of allopathic and symptomatic treatment is often applied in order to reduce the pain.
Treatment
1.Pharmacological treatment: If the pain is severe, anti-inflammatory and analgesic drugs should be applied, and for those who are emotionally unstable, sedative and tranquilizing drugs should be combined.
2.Block therapy For intractable intercostal neuralgia, the application of paravertebral nerve block and intercostal nerve block is more effective.
In short, intercostal neuralgia should first find the cause, the preferred treatment method is blocking, recalcitrant intercostal neuralgia with nerve destruction treatment: radiofrequency temperature-controlled thermal coagulation destruction, freezing, nerve destruction drug blocking.
3, Chinese medicine treatment: the disease is located in the side, belongs to the place of the foot Turk’s Yin liver meridian, can be added in the use of drugs to lead the meridian drugs, such as Chai Hu, Scutellaria baicalensis, Yu Jin, Xiang Shen. Treatment is mainly to regulate the liver. In the acute stage, it is common to see external evil stagnating in the liver veins and liver depression and Qi stagnation, while in the chronic stage, it is common to see blood stasis in the liver meridian and liver Yin deficiency.