Introduction
In medicine, neuralgia refers to a pain that can develop along a nerve and its area of supply. Intercostal neuralgia is therefore a nerve pain that affects the nerves of the intercostal spaces (inter – between; costa – rib). The intercostal spaces extend, as the name suggests, between two ribs.
They are formed by the muscles located there (Musculus intercostalis externus and internus), which in turn are still surrounded by the outer and inner chest wall fasciae, which must be imagined as tight and firm connective tissue sheaths. The blood vessels of the intercostal spaces as well as an associated nerve – the intercostal nerve – run in close proximity, namely on the underside of each rib. This nerve innervates the intercostal muscles and the abdominal muscles. In intercostal neuralgia, these very intercostal nerves are the trigger and cause stabbing, pulling and possibly persistent pain.
Causes
In most cases, intercostal neuralgia is caused by an underlying disease, so that it is in principle not an independent disease. Rather, it can be described as a complaint that occurs in the context of another condition. There can be many different causes of intercostal neuralgia.
Possible origins can be the spinal cord or the spinal column. If the spine is the cause of the disease, degenerative diseases are usually the trigger. These are diseases that are accompanied by a degradation or regression of certain structures of the spinal column and can be traced back to genetic disposition or permanent harmful influences.
Within the scope of these diseases, it is possible that nerve roots become trapped and irritated, which can then lead to intercostal neuralgia. This includes, for example, so-called osteochondrosis, which leads to increased wear and tear of intervertebral discs and vertebral bodies. Herniated intervertebral discs, which occur frequently, but not necessarily, due to excessive strain, can also lead to entrapment of nerve roots.
Thus, a herniated disc can also be a possible cause. Similarly, traumatic (accident-related) changes, such as fractures (bone fractures), especially rib fractures, can in the worst case lead to mechanical pressure on the nerve root and trigger intercostal neuralgia. Myogelosis (hardening of the intercostal muscles caused by overexertion or incorrect loading) resulting from physical work or intensive sporting activity is a conceivable cause.
An operation that involves opening the chest or even removing ribs may also be a possible cause of intercostal neuralgia. This topic may also be of interest to you:
- Nerve root entrapment
Infectious diseases can also be responsible for the occurrence, as they can lead to nerve inflammation or nerve irritation. The most clinically known trigger is infection with the varicella zoster virus, which causes herpes zoster, also known as shingles.
In the course of the disease, nerves can become inflamed, which can lead to intercostal neuralgia. The pain may continue even after shingles has healed. In the course of infectious disease processes that take place in the immediate vicinity of the intercostal nerves, nerve root irritation or damage can occur. It is therefore possible that intercostal neuralgia occurs as a result of diseases such as pneumonia, tuberculosis, pleurisy or pleurisy of the bones.
