Neuralgic disorders in the thoracic region are characterized primarily by a sharp pain syndrome involving nerve nodes located in the intercostal space. Because of its specificity, pathology can often be confused with signs of a cardiovascular or pulmonary disease, so immediate diagnosis and medical assistance is required.
Thoracic neuralgia caused by dozens of reasons that have a different nature of occurrence. In 75% of cases, doctors are faced with a history of spinal abnormalities in a patient. Among them, the most common is spinal hernia: a musculoskeletal disease that causes displacement of the vertebrae and intervertebral discs.
And although they are rarely found in the thoracic region, because of the complex structure of the nervous system, chest pain can also be transmitted from lumbar hernia. Almost as often as with hernias, patients with thoracic neuralgia are treated by patients diagnosed with osteochondrosis with a corresponding impairment of the nerve roots (or other spinal curvatures).
The second category of factors are traumatic injuries. These are any bruises, sprains, cracks or fractures of the ribs that can cause neuralgia to one degree or another. They are considered less complex in terms of treatment of thoracic neuralgia, because they are easily diagnosed and eliminated. To a certain extent, this is also true for penetrating wounds (knife, bullet), affecting the nerve plexus in the thoracic region or the back.
The third most common set of causes that can cause chest pain is inflammation of the muscles caused by an infectious process. Most often, myositis occurs as a result of viral or bacterial infection. Some toxic substances, injuries, parasites and hereditary features can also lead to muscular chest neuralgia.
Read also … What is dangerous intercostal neuralgia in a pregnant woman and what methods can be used to treat it during gestation
With regard to the causes that provoke transient short-term pain in the sternum with neuralgia, most people face such factors in their lives:
- muscle hypertonus;
- cramps in untrained muscles with abrupt loads or sprains;
- long stay of the body in an uncomfortable position (at work or during rest);
- crooked posture;
- stress or overwork;
- hormonal imbalance.
There are a number of pathologies and painful conditions that can also lead to pains and neuralgic sensations in the chest, although they are much less common in medical practice. First, there are salt deposits in the shoulder joints or the spine, as well as a number of disorders in the circulatory system and vitamin B deficiencies. Finally, under certain conditions, chest pain occurs due to neoplasms of a benign or malignant nature in the chest.
The clinical picture of the disease
The main diagnostic symptom is pain syndrome – characteristic in its manifestation, which allows it to be distinguished, for example, from a heart attack or pneumonia. Most often, the pain is acute, but not pulsating, but smooth, aggravated by external factors – turning or bending the body, lifting weights, running, or actively walking with the hands.
For such pain, it is characteristic to subside, if a person is still in a comfortable position, and to be activated during any physical activity, up to coughing or sneezing.
At rest, the patient can reveal discomfort by palpating the proposed areas of neuralgia. In this case, the patient will reflexively seek to change the position of the body or hold the breath in order to get rid of pain. In some cases, there is a local numbness of the muscles and skin in the area of pathology, as well as mild hyperemia and the appearance of subfebrile temperature along with increased respiration and sweating.
The list of specific symptoms indicating the etiology of the disease is as follows:
- visually detectable spinal curvature, characteristic signs of vertebral pathology, including hernias, on X-rays and MRI;
- identification of deviations in the condition of the ribs in various injuries (against the background of partial or complete immobilization of the patient);
- presence of signs of infection or viral infection in the patient’s blood, which caused inflammation and muscle spasms;
- identification of tumors in the breast tissue using scanning, analysis of their nature;
- hormonal disorders, the presence of abnormalities in the function of the endocrine system.
Most of the signs relating to the clinical picture of the disease (except for chest pains with neuralgia) are detected only through additional studies and analyzes. In some cases, the etiology of the disease is combined, and therefore the set of symptoms is mixed.
To understand what to do in case of chest neuralgia, a thorough diagnosis should be made and the cause of the disease should be identified. From this will depend on the choice of therapeutic complex. However, in the most common cases — with spinal curvature, pinching of the nerves, or mechanical back injuries — the most effective are conservative therapies.
First of all, it is a therapeutic physical culture based on kinesitherapy: metered loads aimed at decompression of the nerve roots, correction of the muscular system and straightening posture.
Such methods of treatment as massage, manual therapy, reflexotherapy (acupuncture), spinal traction, necessary for increasing the intervertebral distance, are considered to be equally useful. Separately, a complex of physiotherapeutic measures is considered, which includes exposure to low-frequency currents, ultrasound, laser and magnetic fields.
Medications for intercostal neuralgia are selected individually, depending on the cause of the pathology, but if the disease is infectious in nature, antibacterial or antiviral drugs, as well as anti-inflammatory drugs, will be required. Consequently, for endocrine system disorders that cause intercostal neuralgia of the thoracic region, hormonal preparations will be relevant, and when cancer is detected, a complex of appropriate measures and drugs.
A significant role in the recovery process is played by anesthetic pills for neuralgia that relieve pain syndrome and even eliminate the cause of the pathology. Most often used:
- Ketanol (Ketorolak, Ketanov, Toradol);
- Ketoprofen (Flamaks, Fleksen);
- Ibuprofen (Nurofen, Bonifen);
- Xsefokam, Movalis, Nimesulide;
- Mydocalm, Sirdalud;
- Baralgin, Spazgan, Finalgon.
Some of the listed drugs, produced in the form of ointments and creams, also have relaxing, cooling and regenerating effects. Do not forget about the vitamin complexes, in particular, containing vitamins of group B, thanks to which the bone and muscle tissue will receive the necessary substances for recovery.
As for surgical intervention, it is resorted to only in emergency cases and with the ineffectiveness of conservative therapy. We are talking about fractures or penetrating injuries that require reposition of the ribs and elimination of the consequences of injury.
In some situations, there is a need for surgery in the treatment of intervertebral hernia and oncological pathologies. For example, when the education, squeezing the nerve root, must be removed from the back. Such an operation is always followed by a long recovery period with limited patient mobility.
Home treatment and neuralgia prevention
Home treatment is a great addition to basic therapy. For example, exercise therapy exercises can be supplemented with a warm-up or yoga classes, following medical prescriptions and practicing according to professionally developed techniques. Training will include mainly dilutions and amplitude swinging of the arms, turns and tilts of the body, as well as breathing exercises with maximum opening of the chest.
Having identified the key symptoms, treatment of neuralgia of the thoracic spine can be performed with the help of hot baths with beneficial salts and essential oils added thereto. It will warm up well, relax the muscles of the back and chest, and at the same time soothe the excited nerve endings. In addition, experts in the field of traditional medicine recommend trying to apply compresses from steamed flaxseeds, rubbing tincture of birch buds and oral intake of peppermint decoction in the morning.
In the prevention of both temporary and chronic neuralgia, prevention and elementary precautionary measures play an important role. For example, you should avoid prolonged stay in the same posture, especially at work or during school, and also constantly monitor your own posture. It is equally important to engage in sports for the full strengthening of the muscular system and joints, to maintain a balanced diet and lead a healthy lifestyle.