Introduction – What is a pinched nerve at the rib?
Colloquially speaking, a pinched nerve often refers to an irritation or inflammation of the nerve. Only rarely can nerves really become trapped. At the ribs, irritation of the intercostal nerves can occur.
These are the nerves that run from the back of the thoracic spine between the ribs to the front towards the sternum (breastbone). If these intercostal nerves are irritated, sudden sharp pain may occur or symptoms may become more severe over time. This is generally called intercostal neuralgia (intercostal neuralgia).
Causes
The causes for irritation or inflammation of the nerves are manifold. An underlying spinal disease such as osteochondrosis (bone and cartilage degeneration), spondylitis (inflammation of the spinal column) or a tumor on the spinal column that builds up (osteoplastic) or breaks down (osteolytic) bone may be possible. Changes in the ribs such as a fracture, pleuritis (inflammation of the pleura) or periostitis (inflammation of the periosteum) can also be considered as causes.
Nerve pain in the area of the ribs can also occur after shingles has been overcome and healed (herpes zoster virus). A slipped disc in the area of the thoracic spine can lead to irritation of the nerve tracts and thus to symptoms. Diseases of the spinal cord or the nerve tracts themselves can also cause symptoms.
Pneumonia or other lung diseases, such as a severe cough, can also cause irritation of the intercostal nerves. In rare cases, organic causes can also be the cause, such as inflammation of the gall bladder (cholecystitis), gallstones, stomach problems or heart disease. If one coughs strongly and/or frequently, a massive movement of the chest takes place.
The intercostal muscles, which are located between the ribs, are tensed and relaxed alternately. Since the intercostal nerves lie directly below the ribs and are therefore in close spatial relationship to the muscle fibers, this can lead to irritation of the nerve fibers. If the cough persists, the intercostal muscles may tense up over time, which additionally irritates the nerves.
The relieving posture, which is taken because of the hardened muscles, also promotes the pain symptomatology of further coughing attacks. Back pain can have many different causes. The most common causes are herniated discs, osteoporosis (bone resorption), osteomalacia (softening of bones), psychosocial factors such as stress at work or in private life, overstraining of the spine and musculature due to, for example, heavy carrying, slipping of the vertebrae (spondylolisthesis), inflammatory arthrosis, narrowing of the spinal canal (spinal stenosis) or inflammation of nerve fibers, discs or vertebrae caused by viruses or bacteria. Depending on where the defect is located, pain can occur there. If, for example, a herniated disc occurs at the level of the 10.11. thoracic vertebra, this can lead to muscle loss of the intercostal muscles associated with the dermatome as well as to loss of sensitivity at the level of the navel.
