Intercostal osteochondrosis is a common, but not entirely correct from a medical point of view, concept. When they talk about intercostal osteochondrosis, they most often mean developing neuralgia, which causes very pronounced symptoms. And neuralgia, in turn, in most patients with a characteristic clinical picture of the disease is caused precisely by osteochondrosis of the thoracic spine.
The concept of intercostal osteochondrosis
Intercostal osteochondrosis is manifested by a characteristic clinical picture that occurs in response to irritation of the nerve processes that run between the ribs. The development of such a pathological change, that is, irritation of the nerves, in turn leads to the destruction of the vertebrae and structures of the intervertebral discs, that is, osteochondrosis.
Osteochondrosis of the thoracic spine occurs less frequently in comparison with other parts of the spinal column. This is due to the fact that there is minimal external influence on the thoracic region, and this part of the body itself is inactive. But still, under the influence of metabolic disorders, a constant sedentary lifestyle, stress and other provoking factors, certain changes begin to occur in the vertebrae and adjacent tissues.
Under their influence, the vertebrae gradually collapse, the discs protrude, and this leads to compression of the nerve endings and, therefore, to the appearance of all the symptoms of neuralgia. The nerve trunks passing along the edge of the ribs can also be irritated by osteophytes – bone growths that also form during prolonged osteochondrosis.
Symptoms and Signs
Intercostal neuralgia can be attributed to a symptom indicating the possible development of osteochondrosis. It is the changes in the vertebrae that most often provoke the symptoms of an attack. But do not forget that neuralgia sometimes indicates other diseases.
Therefore, only a qualified specialist can correctly make a diagnosis after examining his patient and diagnostic manipulations.
For intercostal neuralgia, a complex of changes is characteristic, which, to one degree or another, manifests itself in every person suffering from this disease. The main and most common signs of the development of neuralgia in the intercostal spaces include:
- When examining the skin at the site of pain localization, you can also see a changed color of the skin, it can be hyperemic, pale or with spots of some pigmentation.
- At the time of an acute painful attack, a person sweats profusely.
- Sometimes it is observed along the nerve and twitching of the muscle muscles adjacent to this area.
- The patient records atypical sensations. These are crawling creeps on the body, tingling, a feeling of numbness of the skin and deeper tissues.
What are the pains with intercostal neuralgia of the thoracic region?
Painful sensations can be different in nature, that is, stabbing, squeezing, aching. In most cases, the patient describes his pain as diffuse, without a definite localization and somewhat intensifying towards the spinal column.
Painful sensations with neuralgia are almost always aggravated by coughing, changes in body position. It can give pain to the scapula, to the upper part of the chest. Very often, pain in neuralgia in the left half can be confused with an attack of angina pectoris; in general, these two diseases are similar. Angina pectoris is distinguished from neuralgia in several ways:
- Pain during an attack of angina pectoris rarely lasts more than 15 minutes and is successfully relieved with nitroglycerin or validol. With neuralgia, painful sensations can be disturbed for several hours.
- The intensity of all pain at the time of an attack of neuralgia does not change with physical exertion, but intensifies at the time of a deep breath, coughing.
- If you palpate the intercostal spaces at certain points, then with inflammation of the nerves, the patient will notice a pronounced increase in pain.
Pain in neuralgia must be separated from the manifestations of stomach diseases, pleurisy, muscle inflammation.
Some people at the time of acute pain take an antalgic posture. At the same time, they bend in a healthy direction and try to stay in a similar position as long as possible. This position contributes to the fact that the intercostal spaces are stretched and, accordingly, the pressure on the nerves passing nearby decreases, which leads to a decrease in pain.
Temperature with illness
A high rise in temperature and a prolonged febrile syndrome are not typical for nerve inflammation caused by osteochondrosis. Sometimes at the time of acute attacks and with extensive inflammation, the temperature can stay at a level of 37-37.5 degrees, it appears periodically and disappears on its own or under the influence of treatment.
If neuralgia is accompanied by a temperature over 38 degrees, then it is necessary to exclude such a disease as shingles before starting treatment. This disease is caused by the activation of the virus in the body and therefore can manifest itself with all the symptoms of infectious inflammation.
Applicator Kuznetsov: instructions for use, reviews, harm and benefit.
Symptoms and treatment of coccygodynia in women – all the features of therapy.
Read more about what an ultrasound scan is, how it is carried out and what it does, read here.
The main causes of occurrence
The most common cause of intercostal neuralgia in humans is thoracic osteochondrosis. Pathological changes in the vertebral bodies, cartilage and ligaments lead to the fact that the work of the nerve endings passing through the spinal cord begins to be disrupted. The effect on the nerve, and therefore all the unpleasant sensations, is intensified if, against the background of osteochondrosis, there is also:
- Hypothermia of the whole body or specifically the chest.
- Respiratory, bacterial, or viral disease.
- Physical fatigue.
- Psychoemotional stress.
- Various injuries and bruises of the chest.
All these provoking factors affect both the occurrence of the first attack of intercostal neuralgia and its intensification and frequency. In addition to osteochondrosis in the vertebrae of the thoracic region, neuralgia can also occur under the influence of other diseases, these include:
- Neoplasms in the spine and spinal cord.
- Injuries to the chest and vertebral bodies.
- Bechterew’s disease.
- Kyphosis and scoliosis.
- Spondylosis, herniated intervertebral discs.
- Diseases of the nervous system.
When diagnosing, it is necessary to take into account the presence of all these diseases in the patient. Only in this case it will be possible to correctly establish the cause of intercostal neuralgia and choose the correct treatment tactics.
The first stage of diagnosis is consultation with a neurologist or therapist. During the examination, the doctor carefully collects an anamnesis, finds out whether there have been similar attacks in the past, which was accompanied by increased pain – trauma, hypothermia, physical activity or other reasons. It is necessary to conduct an examination, with the help of which the neurologist identifies the localization of pain, studies the muscle tone, and determines the sensitivity in the upper limbs.
All this is important to consider before making a final diagnosis. After the examination, referrals for additional examinations are issued. The main instrumental methods for identifying intercostal neuralgia and its main causes include:
- X-rays of the chest and spine. The pictures will show changes in the vertebral bodies and ribs.
- Ultrasound is prescribed to exclude changes in the digestive organs.
- Computer diagnostics makes it possible to more accurately identify all changes in the spine.
- Electrospondylography is a modern diagnostic method that allows you to identify all the slightest pathological changes in the state of the spinal column. Along the way, when conducting such a diagnosis, violations in the functioning of other organs are also revealed.
- Myelography is an X-ray of the spinal cord using a contrast agent. This examination can reveal narrowing of the holes between the vertebrae, the presence of a hernia or tumor.
- An ECG is prescribed to exclude angina pectoris.
Intercostal neuralgia and the cause of this disease are exposed after all diagnostic measures. Based on the examinations, the doctor selects a treatment regimen.
How to cure
With an attack of intercostal neuralgia in the first days of the disease, it is necessary to remove all the main manifestations. In the future, they begin to treat the identified osteochondrosis. The patient needs to understand that the earlier therapy is started, the more chances are that it is possible to stop the destruction of the vertebrae . Disease therapy begins with the use of the following groups of medicines:
- Non-steroidal anti-inflammatory drugs. This group of drugs relieves swelling and inflammation, which leads to a decrease in pain
- Muscle relaxants relax the muscles and also help reduce the symptoms of a painful attack.
- For severe pain, it is necessary to use analgesics and antispasmodics.
In the first days of an attack of intercostal neuralgia, all drugs should preferably be injected. This increases their availability and the faster the analgesic and anti-inflammatory effect.
In the future, the treatment of osteochondrosis is selected. The restoration of the functioning of the spine will be most complete if, in addition to medications, physiotherapy, massage courses , and special complexes of physical exercises are used. Complexes of vitamins, good nutrition have a positive effect on well-being and restoration of working capacity .
How to relieve an attack
With an acute attack of pain, everyone wants to get rid of these sensations faster. It is possible to eliminate pain on your own only if you are sure that it is really neuralgia in the intercostal spaces. In the early days of illness, you must follow these rules:
- Observe bed rest and rest. Unloading the spine also reduces the impact on the nerve endings.
- Pain relievers and antispasmodics can be used.
- Rubbing in ointments with a distracting, anti-inflammatory and analgesic mechanism of action reduces pain .
- You can take a sedative or sedative. Relief of psycho-emotional stress also helps to reduce painful sensations.