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What is an Intercostal Neuralgia?

Mary McMahon
Updated May 17, 2024
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Intercostal neuralgia is a rare pain condition involving the intercostal nerves that supply the muscles between the ribs. In patients with this type of neuralgia, bands of pain around the rib cage are experienced. The pain is usually intermittent and spasmodic. Intensity can vary, depending on a number of factors. This condition is usually treated by a neurologist, which is a physician who specializes in conditions involving the nerves. Treatment usually also involves a pain specialist who helps address the associated pain.

Patients can develop intercostal neuralgia in the wake of an injury that damages the nerves or as a result of a degenerative disease that pinches or otherwise damages the nerves. Typically, people experience pain while breathing, coughing, and laughing. They may also experience pain during exertion. Neuralgia can manifest as tingling, numbness, itchiness, or pain and sometimes all of these sensations are experienced at various times. In some cases, the pain is searing and is sometimes described as being “like a lightning bolt."

Diagnosis of this condition can be complicated. It can mimic other conditions and a physician who does not have experience with intercostal neuralgia may not understand the reports made by the patient. Patients with chronic pain conditions also sometimes encounter resistance from care providers who are concerned about drug-seeking behavior and fear that a patient is claiming to be in pain when this is not the case. The sometimes erratic nature of pain conditions can further complicate matters, as a patient may have varying pain levels that make it hard to narrow down the location and cause of the pain.

Immediate management of intercostal neuralgia includes the administration of analgesic medication to manage pain, along with anti-inflammatory drugs to reduce inflammation around the nerves. A doctor can administer an injection of local anesthetic for a patient experiencing extreme pain. Some other options can include physical therapy and massage, depending on the situation. Some patients also pursue complementary and alternative therapy under the guidance of a care practitioner.

If these measures are not effective, more aggressive treatments for this condition are available. Nerve stimulation sometimes provides benefits for some patients. This option will usually be tested with external stimulation first, and if the patient experiences relief, an internal device may be implanted. Finally, if a nerve does not respond to any treatments, it can be severed in a surgical procedure so that it will stop sending pain signals to the brain.

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Mary McMahon
By Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a WiseGeek researcher and writer. Mary has a liberal arts degree from Goddard College and spends her free time reading, cooking, and exploring the great outdoors.

Discussion Comments
By anon962211 — On Jul 22, 2014

Go to a Chiropractor. It seems so obvious.

By anon356332 — On Nov 24, 2013

I run a Facebook page related to Intercostal Neuralgia. I am a sufferer after having an operation to remove a breast lump. If you would like to join us to discuss treatments/experiences or just for a rant, you are more than welcome.

By anon333383 — On May 05, 2013

Where allopathy fails, the homeopathy starts. It is really a great science. But one wonders as to why the allopathy doctors don't accept it.

It may be this medicine or that. If it saves a life or makes a life better, I don't understand why someone would not follow it or at least try it! I don't know how the man has gone on the moon!

By ihatemeds — On Jan 07, 2013

I was stabbed in the left chest cavity. The wound went in about three inches and was about two inches wide, missing all vital organs.

It got infected once because one of the inner stitches was poking through the skin. They reopened it and drained it and stitched it back up. The second time it got infected they opened it, drained it and packed it daily until it closed. I was in Afghanistan so I didn't exactly have the best medical care.

I've been on 1800 mg of gabipenton for about a year then they tried lididurm patches, steroid shots, and nerve blockers. All had little effect. The doctor said it may be because of the previous infections that I had or the lack of medical treatment I received (after the wound closed I didn't get it looked at until I came stateside about eight months later). Is it possible that this is true and no treatment can help, that I just have to wait it out?

By ddljohn — On Jun 29, 2012

@alisha, @burcidi-- @burcidi gave good suggestions but I think nerve blockers are used when the pain is extreme. I'm not sure your condition would require it. I agree that you should start off with steroid injections and go from there.

I know someone who went to acupuncture as intercostal neuralgia treatment and she was very happy with the results. So I would highly recommend that you try alternative therapies as well.

@anon152548-- Cutting and removing nerves is really a drastic measure and the last resort to this condition as far as I know. Nerves do have the capability to grow back but I think surgeons use precautions to prevent that from happening in this case. But you should definitely discuss the risks and side effects with your doctor if you're considering that procedure.

By burcidi — On Jun 29, 2012

@alisha-- Unfortunately, I don't know about alternative treatments but have you tried steroid treatments? You can have the area injected with steroids which helps relieve the pain. The injections can be kind of painful but hopefully you won't need them on a regular basis.

I'm guessing the nerve medications you took were nerve blockers? That's also another primary treatment for the pain caused by intercostal neuralgia. My husband has had a lot of relief with those in addition to oral sedatives.

You should talk to your doctor about these other treatments that you might have not tried. I guess if nothing works, it wouldn't hurt to talk with a chiropractor or a homeopathy practitioner.

By discographer — On Jun 28, 2012

I've had intercostal neuralgia symptoms for the last ten years or so. It started suddenly after a car accident. I have tried various pain-relievers and nerve medications that my doctor prescribed but the pain is still there. The pain is in my rib area and comes on suddenly. It's usually triggered by a movement but it can last for a couple of minutes. It's hard to even breathe when I get the pain.

I'm starting to consider alternative treatments, like acupuncture and homeopathy. I'm not sure if these will help, but I'm willing to try anything at this point.

Does anyone here have intercostal neuralgia? Have you tried any alternative treatments for it?

By anon152548 — On Feb 14, 2011

If you sever the nerve or nerves which are causing the pain, do these grow back again?

Mary McMahon
Mary McMahon

Ever since she began contributing to the site several years ago, Mary has embraced the exciting challenge of being a...

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