What Causes Intercostal Neuralgia? Symptoms And Treatment Options

‘Intercostal’ is a medical term which means between the ribs. ‘Neuralgia’ refers to sharp shooting pain along the path of the nerve caused due to irritation or damage to the nerve. Intercostal neuralgia is sharp shooting pain which is experienced along the path of nerves situated between the ribs. Though intercostal neuralgia is rare, person who suffers from it finds very difficult to bear the pain.

Several reasons are noted to cause intercostals neuralgia. This includes infection which can be mild or serious. Inflammation, injury, tumor and surgery of chest cavity are few other reasons.

Often during a thoracic (chest) surgery the ribs have to be spread apart, while doing so it is possible to damage the nerves present in the intercostal space. An impact to the chest wall or fracture of ribs can lead to nerve damage.

Another common reason is nerve entrapment in between the two rib space. Herpes zoster or Shingles as it is often called when affects the chest area; it causes radiating pain and burning sensation along the nerve pathway. When the muscle of chest or back gets strained and pulled, it can compress the nerve running between the two ribs.

Infection of rib such as osteomyelitis can also damage the intercostals nerve causing irritation and inflammation. A growing tumor in the thoracic cavity can also compress intercostals nerve. Some women complain of intercostals pain during pregnancy. This is because of the increasing size of the baby which leads to expansion of rib cage.

Risk factors include unsafe driving leading to motor accidents and chest injury. Certain contact and high speed sports such as football, rugby, wrestling, boxing, skiing, can lead to chest injury and nerve damage. Infection such as chickenpox which may precipitate Herpes zoster later on is also considered to be risk factor.

Symptoms Of Intercostal Neuralgia

Pain in chest is the main symptom of intercostal neuralgia. This pain is often described in many terms such as stabbing, sharp and shooting, aching and gnawing, burning etc. The pain may be experienced between the two rib spaces or it can be felt in whole of the chest. In some cases, the pain may radiate from back to front of the chest as if it is wrapped with a band. Pain is experienced more while breathing deeply.

Intercostal neuralgic pain can be constant and dull remaining all the time or there can be acute exacerbation in between. Usually the patient complains of pain aggravated with slightest physical exertion. Activities such as lifting an object, bending, coughing, laughing loudly, and twisting etc can cause pain in the chest and in the intercostals space. Sometime the space between two ribs is tender to touch.

Due to pain there is restricted movement of the chest. Even the patient is not able to breathe properly as inhalation of air leads to expansion of chest wall which may put pressure on the intercostal nerves.

Intercostal Neuralgia Treatment Options

Intercostals neuralgia can prevail for many days, weeks and months. The main aim is to alleviate the incapacitating pain of intercostal neuralgia. Conventional approach is to inject local anesthetic in the affected area. This is done by an experienced and qualified doctor who is aware of human anatomy.

If the nerve is entrapped in the scar tissue of surgical operation, the scar tissue is surgically excised and the nerve is made free.

There are natural and alternative ways for alleviating the pain of Intercostal neuralgia for people who prefer it. Homeopathy offers good relief for such patients. Aconite, Colocynth, Belledona, Mezerium, Arnica, Verbascum, are few important homeopathic medicines for Intercostal neuralgia.

Acupressure and acupuncture are other important alternative treatments for intercostal neuralgia.

At home people have found relief by applying mustard plaster. It acts as a counter irritant. Applying hot pad or hot water bag or a hot sand bag on the affected area helps to alleviate pain. Applying porous adhesive plaster is also proved to be beneficial in treating the condition.


  1. Linda said:

    I had CPR August 5, 2015. After having a hernia surgery the surgeon unknowingly nicked an artery while reinserting my stomach. During recovery the anesthesiologist noticed my blood pressure was dropping and could not get it stabilized. After 25 minutes of CPR they found with ultrasound that my abdomen was full of blood. I was rushed back to surgery room and given 8 units of blood.

    Two years later I still have extreme sternum and rib pain, both are still as sore to touch as when I first had surgery. The doctors say that I’ll always have pain without giving me any explanation. Is it possible that it is due to nerve damage, then what can I do? How do I find the right doctor to give me hope and some kind of relief? I am currently on pain medicines but don’t want to depend on them forever. I would appreciate any advice you would offer.

    April 16, 2017
  2. Naomi said:

    Hope you are feeling a bit better now. I too have injury to my intercostal area post surgery for more than a year. I have been advised to try TENS therapy at home as it is good for pain management and rehabilitation of the muscles affected. It is a frustrating pain and discomfort to live with. Do go back to talk about pain management with your doctor. There is help out there.

    December 29, 2017

Leave a Reply

Your email address will not be published.

This site uses Akismet to reduce spam. Learn how your comment data is processed.