Intercostal neuralgia Symptoms, Causes, Diagnosis in USA

Intercostal neuralgia is a neuropathic pain involving the intercostal nerve. These are nerves that grow from the bottom of the ribs.

Intercostal neuralgia can cause thoracic pain and it can affect your chest pain and upper trunk. It can produce intense pain or spasm episodes of pain. Pain is often described as stabbing, tearing, sharp, spasms like tender, shortness of breath, or convulsions. This pain may be increase during exertion or any kind of sudden movements involving the upper chest, Such as laughing or coughing.

This neuropathic pain is associated with injury or inflammation of the nerves, cartilage, muscles, ligaments in the region of the rib cage and middle spine.



Intercostal neuralgia Symptoms

Intercostal neuralgia

The main symptoms of this neuropathic pain are sharp, shooting, and burning. You may  feel this pain

in the upper chest

in the upper back

around the ribs

some additional symptoms in theses area include



This neuropathic pain may get worse even after doing gentle physicals activities like taking deep breaths or stretching.

In intercostal neuralgia, symptoms include more severe cases

Muscle Atrophy


Loss of appetite

Involuntary Muscle Twitching


Intercostal Neuralgia Causes

Intercostal Neuralgia is mainly caused by inflammation, Irritation or compression of intercostal nerve, it is just below your rib

Nerve entrapment or pressure

Trauma to your chest

Viral infection such as shingles

Sometimes intercoastal neuralgia has no apparent causes, in this case, it can be called idiopathic Neuralgia.

How To Diagnosed?

Depending on your symptoms, you may also need a neurological examination to diagnoses a problem with your nervous system. Your treatment may use an x-ray, ultrasound, CT scan or MRI scan to look for any signs of injury.

How To treated this Neuropathic Pain?

Not only one treatment is available for relieving from Neuralgia.

Medications include

Duloxetine (Cymbalta)



Desipramine (Norpramin)

Imipramine (Tofranil)

Nortriptyline (Pamelor, Aventyl)


Some over the counter options

Lidocaine gels or Skin Patches

Capsaicin Creams or Skin Patches

Your doctors may also give you a suggestion to try anticonvulsant medication

Pregabalin (Lyrica)

Oxcarbazepine (Trileptal)

Carbamazepine (Epitol, Tegretol, Carbatrol, Equetro)


Here we also share a Quora answer which was given by Dr. Poonam Patel (M.B.B.S, MD, Pain specialties). Here is the screenshot

Intercostal neuralgia

Risk Factors of Intercostal Neuralgia

Risk factors include

Participation in high speed or contact sports, Football, Snowboarding, Skiing, Wrestling.

Infections with the Varicella Zoster Virus, the virus known for Causing Shingles and Chickenpox.

Automobile accidents and unsafe driving.

Having a condition that can cause inflammatory arthritis and Systemic inflammation.


Intercostal neuralgia Pregnancy

It is one of the many neurological diseases associated with pregnancy. Women in the 34th week of her fourth pregnancy presented with pain in the right side and hypothermia in the ribs, with progression to the right upper quadrant of the abdomen and the middle thoracic part of her back. With a clinical diagnosis of pregnancy-related intercostal neuralgia. They inserted an epidural catheter at T8 for ambulatory pain management. Bupivacaine had an uninterrupted infusion title by concentration and rate until adequate painkillers were obtained. The final effective dose consisted of 0.125% bupivacaine at 6ml/h with a patient-controlled bolus dose of 2 ml every 30 min as needed. This allows the patient to continue working full time and daily activities with minimal discomfort.

Epidural infusion continued until 28 days after the initial clinical visit until the patient returned to spontaneous labor. A full-term baby was delivered without incident. No major complications such as local anesthetic toxicity, Motor impairment, Hypertension, or infection were observed.

For this patient, a properly placed chronic epidural catheter and a titrated continuous infusion of bupivacaine provide adequate and safe analgesia in pregnancy-related intercostal Neuralgia.


It is possible to get Intercostal Neuralgia as a Result of Gastroscopy?

Intercostal neuralgia

It is very difficult because intercostal nerves are located within a groove on the inside lower border of each rib.

The gastroscope should go through the abdominal muscles rather than the intercostal muscles.


What Causes a Sharp Pain in your chest?

Your chest pain can due to many causes

Lung causes like Pneumonia

Cardiac causes like Ischemic Heart Disease

Some other causes are musculoskeletal like Costosternal arthritis, Tietz Syndrome, Intercostal Neuralgia, Costochondritis.

Pain from Gall bladder stones can also be referred to as the chest.


What could Cause my ribs to feel bruised at the Bottom of them?

Overexertion…like sit-ups. Pneumonia.

Intercostal Neuralgia, which is an infection between the ribs. It is very painful.


For more information, you can visit the


ReadSinus Arrhythmia, Semmes Murphey Clinic