The term "intercostal" refers to the location between two ribs. The intercostal areas of the body contain nerves, muscle and blood vessels. Eleven intercostal nerves inhabit the spaces between the ribs. When these nerves are affected by an injury, disease or condition that causes pain to radiate along the nerve, that pain is called intercostal neuralgia. A number of conditions can cause this symptom.
Pregnancy
In pregnancy, the increasing size of a growing baby alters the structure of the torso and rib cage such that pressure on the nerves between the ribs can occur. Intercostal neuralgia associated with pregnancy has been associated with pain and numbness in the ribs abdomen and back, according to S. Samiaska of the Department of General Anesthesiology at the Cleveland Clinic Foundation.
Surgical Complications
The journal "Surgical Endoscopy" has noted several instances where thoracoscopic spinal surgery, a procedure used to repair lesions on the spine, resulted in post surgery symptoms of intercostal neuralgia. Thoracotomy, in which an opening is made between the ribs to allow surgeons to work on the chest, can cause intercostal neuralgia radiating from the back to the front of the chest. Surgical removal of the kidney, known as nephrectomy, can damage the lower intercostal nerves, resulting in intercostal neuralgia radiating from the back to the upper abdomen.
Tumors
Tumors that impinge on a nerve can cause neuralgia. H.K. Kim of the Department of Thoracic and Cardiovascular Surgery of the Korea University Medical reports that a rare parosteal lipoma, a benign tumor, was found on the rib of a patient who was experiencing intercostal neuralgia. Similarly, intercostal neuralgia was reported as a symptom in patients at the Beijing Institutes for Cancer Research who had inoperable tumors of the chest wall.
Shingles
The virus that causes chickenpox can remain in the body for decades after the initial occurrence of the disease has passed. When the chickenpox virus, known as herpes zoster, remains dormant in the nerve bundles near the spine, the virus sometimes reactivates later in life. The Hall Health Primary Care Center at the University of Washington observes that this reactivation typically occurs after the age of 60, resulting in a painful condition known as shingles. In cases of shingles, the reactivated herpes zoster virus travels along the nerve, causing painful burning sensations in the affected area. When the nerves in question are in the ribcage area, as is most common, the painful symptoms of intercostal neuralgia can result.
References
- "Pain"; Long-term Epidural Analgesia for Pregnancy-induced Intercostal Neuralgia; S. Samlaska and TE Dews; 1995
- University of Washington: Hall Health Primary Center: Protect Yourself from Shingles
- "Chinese Journal of Cancer Research"; High Intensity Focused Ultrasound for the Treatment of Unresectable Tumors Located in the Chest Wall and Abdomen of 10 Patients
- "Annals of Thoracic Surgery"; Intercostal Neuralgia Caused by a Parosteal Lipoma of the Rib; H.K. Kim et al; May 2006
