Symptoms of intercostal neuralgia

Written by Na Hong Wei
Orthopedics
Updated on September 08, 2024
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Intercostal neuralgia is essentially caused by inherent reasons, or pathological changes in the thoracic vertebrae, ribs, and pleura, leading to an inflammatory symptom involving the intercostal nerves. Therefore, the primary symptom of intercostal neuralgia is pain, but this pain has certain characteristics. First, the pain commonly occurs in the left second rib and the right second, third, and fourth ribs. Second, the range of the pain is usually semicircular; it does not extend beyond the anterior midline at the front or the posterior midline at the back, forming a semicircular pain along the ribs. Third, there are often fixed tender points, which sometimes are located in the costal cartilage or corresponding thoracic vertebrae and paraspinal area; these points, when pressed or tapped, can cause radiating pain. Fourth, many times the examination results are negative, so intercostal neuralgia tends to be a condition where the symptoms are severe, but physical examination often yields very few positive signs.

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How to deal with occipital neuralgia?

Occipital neuralgia is a relatively common type of neuralgia, and the following recommendations are suggested for its management: Firstly, it is important to identify the cause of the occipital neuralgia. There are many potential causes, such as cervical spondylosis, viral infections, or metastasis of tumors, among others. Actively searching for the cause and addressing it effectively, especially if it stems from cervical spine issues, is crucial. Secondly, medication can be used to alleviate symptoms. This typically includes painkillers, such as non-steroidal anti-inflammatory drugs. If the pain is more pronounced, medications used to treat neuralgia, such as antiepileptic drugs, can also be considered. Thirdly, local physical therapy, acupuncture, and, if necessary, local block treatment in the area most affected by occipital neuralgia, can also be effective.

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Causes of Neuralgia

Neuralgia is extremely painful, with patients often experiencing severe, unbearable pain. The causes of neuralgia mainly include the following types. The first type to note is viral infection, such as herpes zoster virus infection, which can leave postherpetic neuralgia. In such cases, it is crucial to actively use antivirals and employ neuropathic pain medications for treatment. The second scenario may relate to nerve compression, such as trigeminal neuralgia, which may be associated with local vascular compression causing abnormal nerve discharges. Surgical treatment might be necessary to relieve the compression. Sciatica is also caused by compression of the sciatic nerve. The third case might be due to nonspecific inflammatory responses. For example, Guillain-Barre syndrome can also cause neuralgia, and treatment should be directed at the underlying cause.

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How to diagnose occipital neuralgia?

Occipital neuralgia is a very common condition, generally characterized by pain in the back of the head. The nature of the pain is usually dull, but it can radiate to the top of the head. To diagnose occipital neuralgia, the main examination is to see if there are any significant tender points along the course of the greater occipital nerve. If there are obvious tender points, it is likely that occipital neuralgia is a possibility. Additionally, there are some underlying causes of occipital neuralgia, such as cervical spondylosis, osteoarthritis, or inflammation of muscles in the head and neck area, and even some tumors. Therefore, it is necessary to perform comprehensive auxiliary examinations to rule out these related diseases, including MRI of the cervical spine and X-rays. Treatment is relatively simple and may include the administration of nerve-nourishing medications and pain relievers. (The use of medications should be under the guidance of a doctor.)

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Symptoms of tooth nerve pain

Symptoms of tooth nerve pain include pain triggered by cold, hot, sour, sweet stimuli, spontaneous pain, secondary pain, and nighttime pain, as well as unlocalized pain. These are also the main symptoms of pulpitis. Among them, pain triggered by cold, hot, sour, and sweet stimuli is more obvious. Sometimes the pain may intensify with temperature changes, such as cold and hot stimuli. If the pulpitis reaches the acute suppurative stage, there may also be pain that worsens with heat and is relieved by cold. It is common to see patients coming to the clinic holding cold water, indicating that cold water may provide temporary pain relief. In addition, severe nighttime pain might occur, where there is no pain during the day, but intense pain at night, sometimes making it difficult to sleep or waking from sleep due to the pain. Sometimes tooth nerve pain can also be unlocalized, potentially causing pain in the temporal area or affecting both upper and lower jaw teeth.

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How to treat occipital neuralgia?

Occipital neuralgia is caused by cervical compression of the greater occipital nerve, leading to neuropathic pain. Thus, treatment of occipital neuralgia may involve oral pain relief medications to temporarily alleviate symptoms. Additionally, some nerve-nourishing medications can be used in treatment. Fundamental treatment involves addressing cervical spondylosis, which can include cervical physiotherapy and the use of medications that improve blood circulation and remove blood stasis to treat cervical spondylosis. It is also important to take care of the cervical spine by not sitting for too long; if sitting for extended periods, one should get up and move to stretch the muscles and bones. Performing the "little bird flying" exercise, where the head is leaned back and both arms are extended backwards, can effectively relieve cervical spondylosis and the pain caused by cervical compression of the greater occipital nerve. Additionally, the pillow should not be too high when sleeping at night.