Intercostal neuralgia and osteopathy
What is intercostal neuralgia?
Intercostal neuralgia corresponds to intercostal pain, located in the thorax and linked to the suffering of an intercostal nerve, that is to say of one or several nerves between the ribs. This neuralgia results in a pain that can be very acute in the thorax.
Small summary of anatomy:
The intercostal muscles are located between the ribs under several layers. The muscles are :
- External intercostal
- Internal intercostal
- Intimate intercostal
- Sub-costal muscle
Between the internal and intimate intercostal muscles, pass the vascular and nervous packages: nerves, arteries and intercostal veins (one between each pair of ribs).
What causes intercostal neuralgia?
Be careful, this pain can also be a sign of a heart or lung problem. In case of intercostal pain, it is recommended to consult your doctor!
Once the cardiac and pulmonary causes have been eliminated, intercostal pain can be caused by the ribs themselves, the costo-vertebral joints (between the ribs and the vertebrae) or the muscles:
- Rib fracture: it occurs mainly in cases of trauma but can also occur during a sneeze for example in osteoporotic patients
- Shingles: this is a viral infection. Vesicles, which can be mistaken for small pimples, appear on the skin along the path of the intercostal nerve.
- Costal sprain
- Tietze syndrome
- Intercostal cramp
- Contracture of the intercostal muscles
- Tear of the intercostal muscles
- Thoracic spinal block:
- Post-operatively: during certain cardiac operations, it is necessary to open the thorax. Post-operative pain can be incapacitating and last for a long time.
The clinic / symptoms of intercostal neuralgia:
- Pain located on the thorax which can be in hemi-girdle i.e. all along the rib
- Pain increased at :
- Coughing
- The sneeze
- The push during the saddle
- Inspiration and/or expiration
- Reproduced pain:
- Palpation of the ribs or intercostal muscles
- Compression of the involved rib(s)
Treatment of intercostal neuralgia:
Relative rest
It is necessary to rest because during the activity your muscles (already contracted) will contract even more. However, it is necessary to move to stretch the muscles and drain the area.
To do this, simply move the shoulders in increasingly larger circles to engage the thoracic spine and ribs in one direction and then the other.
Putting on heat
The warmth will help relax the muscles that have contracted to protect the area.
Massage
Place your fingers between the ribs and go along them as much as possible, you will thus act on the intercostal muscles. You can adjust the pressure according to your pain. It doesn't have to hurt very much, but this technique will be sensitive.
Anti-inflammatory ?
In cases of chronic pain and only under the advice of your doctor, taking anti-inflammatory drugs may be appropriate.
The inflammation that occurs when intercostal neuralgia appears is a natural reaction that the body sets up. It is this inflammation that will allow the contribution of elements that will allow recovery.
Taking anti-inflammatory medication can relieve the patient in the short term, but in the long term recovery is longer.
If you can do without anti-inflammatories, we do not recommend its use for this reason of slowing down recovery but also on the deleterious effects shown on the various tissues of the body (muscles, bones, etc.).
The bras
Ladies, our pretty bras are a source of intercostal pain. Indeed, these bras cause a very regular pressure on the ribs and always on the same ones.
Our recommendations are as follows:
- Avoid wearing a bra as soon as possible
- Avoid tight bras
- Choose bras without underwire
- Favour the use of bras
Osteopathy and intercostal neuralgia:
The role of your osteopath in cases of intercostal neuralgia is first to find the cause of this pain.
In cases of suspected heart or lung damage, shingles, or rib fractures, your osteopath will advise you and refer you to your doctor.
In the case of fractures or post surgery, it is recommended to wait 3 months before consulting your osteopath.
Your osteopath trained in strapping and K-taping can nevertheless apply strapping or kinesiotaping bands to give you the best possible relief.
Do you need information? Do not hesitate to contact your practitioner:
In other cases, your osteopath will treat the cause and the repercussions of the problem.
He will work specifically on the thorax with the ribs, thoracic vertebrae, intercostal muscles and all the surrounding structures. He will use a range of techniques, structural, fascial, visceral or muscular to relieve the patient without pain.
Marie Messager
Osteopath
2 rue Alexis de Tocqueville
78000 Versailles
