Pain in the bones next to your chest

Pain in the bones on both sides of the chest is most likely a symptom caused by intercostal neuralgia. Intercostal neuralgia is a common symptom in clinical medicine and is also a disease that can cause great pain to patients. When intercostal neuralgia occurs, it may even cause a person to lose basic mobility, so the earlier the treatment, the better. Below, we will introduce you to the relevant knowledge about intercostal neuralgia.

1. Overview

Intercostal neuralgia is a subjective symptom of the patient. The intercostal nerves extend from the thoracic spinal cord to both sides through the intercostals to the anterior chest wall, innervating the muscles of the back and chest wall beside the corresponding thoracic vertebrae and the sensory branches running along the intercostals. Therefore, intercostal neuralgia is pain in a band-like area that extends from the chest and back along the intercostals diagonally forward and downward to the midline of the anterior wall of the chest and abdomen.

2. Causes

Degenerative protrusion of the thoracic intervertebral disc, thickening and ossification of the joint capsule and ligaments often lead to narrowing and deformation of the nerve channels, which can cause inflammation of the intercostal nerves and produce pain. Other lesions that may affect the intercostal nerves include thoracic tuberculosis, thoracic fracture or dislocation, spinal or spinal cord tumors, ankylosing spondylitis, and rib, mediastinal, and pleural lesions. The pain of herpes zoster intercostal neuralgia is often severe.

3. Clinical manifestations

Intercostal neuralgia refers to pain in one or several intercostal areas that radiates from the back along the intercostals to the anterior wall of the chest and abdomen, in a semi-circular distribution. It is usually unilateral, but can also affect both sides simultaneously. The pain is often made worse by coughing, taking deep breaths, or sneezing. Physical examination may reveal tenderness and percussion pain in the thoracic spinous processes, between the spinous processes or beside the vertebrae. A few patients may have tenderness along the intercostals and paresthesias in the areas innervated by the affected nerves. The pain is usually stabbing or burning, and radiates along the intercostal nerves.

4. Inspection

Various examinations can be performed for intercostal neuralgia caused by various causes, such as chest X-ray, thoracic spine X-ray, lumbar puncture, CT, EKG and other examination items are selected according to the condition of the lesion.

5. Diagnosis

To establish a diagnosis, we must first identify it as intercostal neuralgia based on the characteristic distribution of pain. Then, more importantly, we must think of and find out the cause of the intercostal neuralgia, especially considering important diseases that are easily overlooked, such as tuberculosis, tumors, osteoporotic compression fractures in the elderly, and early herpes zoster.

6. Treatment

Treatment should be directed at the cause of the intercostal neuralgia, so the treatment approach should be tailored to the cause established.