Chest, shoulders, back pain, poop

Regardless of their living habits or work habits, people should have reasonable exercise to avoid occupational diseases. Especially those who are busy at work and have no time for activities often have various body pains, such as chest, shoulder, and back pains, and they dare not exert force when defecating. These conditions are more common among young people. Pain in different parts of the body should be paid attention to. If there is no improvement after rest, it should be checked in time.

Intercostal neuralgia

Intercostal neuralgia is a group of symptoms that refers to damage to the thoracic nerve roots due to various reasons, such as thoracic spine disease or rib, mediastinum, and pleural lesions, which causes compression and stimulation of the intercostal nerves, resulting in an inflammatory reaction, and a syndrome with band-like pain in the chest, intercostals or abdomen.

Clinical type

Intercostal neuralgia is divided into secondary and primary types. Radicular intercostal neuralgia may be caused by diseases such as thoracic vertebra degeneration, thoracic vertebra tuberculosis, thoracic vertebra injury, thoracic vertebra dura mater, tumors, ankylosing spondylitis, etc.; axial intercostal neuralgia may be caused by lesions of the ribs, mediastinum or pleura. Primary intercostal neuralgia is rare.

When intercostal neuralgia occurs, pain can be seen radiating from back to front along the corresponding intercostal space in a semicircular shape; the pain is stabbing or burning. The pain gets worse when you cough, take a deep breath, or sneeze. The pain is usually in one nerve on one side.

Physical examination revealed obvious tenderness beside the spinous processes of the thoracic vertebrae and in the intercostal spaces; patients with typical radicular intercostal neuralgia had a positive neck flexion test; the distribution area of ​​the affected nerves often showed signs of neurological impairment such as hyperesthesia or hypoesthesia.

Clinical manifestations

The pain often involves 1 to 2 intercostal spaces, but is not necessarily limited to the front chest. It is a stabbing or burning pain and is mostly continuous rather than paroxysmal. Coughing, forceful breathing, and body rotation can aggravate the pain. There is tenderness along the course of the nerve, and local pulling pain when the arm is raised. [1]

1. The pain manifests as paroxysmal stabbing or burning pain along a certain intercostal nerve. The pain worsens with coughing, sneezing, or deep breathing, and is most common on one side.

2. The pain range is limited to the distribution area of ​​the diseased intercostal nerves, mostly between the 5th and 9th intercostal spaces on one side. The affected area has severe arc-shaped pain, with a fixed pain point, which worsens in paroxysmal patterns.

3. There are tender points along the distribution area of ​​the intercostal nerves and the corresponding skin areas, especially at the starting point of the lateral cutaneous nerve. The most common tender points are near the spine, axillary line and sternum.

4. No abnormal physical findings were found in X-ray examination or other examinations.

5. Ultrasound, electrocardiogram and X-ray examinations were performed to rule out liver, gallbladder, cardiovascular, lung diseases and history of trauma.