Table of ContentsView AllTable of ContentsSymptomsCausesDiagnosisTreatmentPrognosisPrevention
Table of ContentsView All
View All
Table of Contents
Symptoms
Causes
Diagnosis
Treatment
Prognosis
Prevention
Intercostal neuralgia isnerve painin the chest and upper trunk that radiates from the upper back. The pain comes from theintercostal nervesalong the ribs, chest, or abdomen. It can feel like a sharp or stabbing pain or like burning or aching pain. It can also cause additional symptoms like numbness and tingling.
Here is what you need to know about intercostal neuralgia, including symptoms, potential causes, diagnosis, treatment, and prevention.
Verywell / Julie Bang
What Does Intercostal Neuralgia Feel Like?
You may feel this pain around your ribs or in your upper chest or back. The pain might cover the entire chest or radiate from the back towards the chest. Sometimes the pain can be felt along the length of the ribs. Pain episodes tend to be sporadic and may intensify with activity, including:
Other symptoms of intercostal neuralgia may include:
Some people may also experience referred pain, which is related pain that appears in an unaffected part of the body.In people with intercostal neuralgia, the shoulder blade and lower pelvis are common sites for this type of pain.
When to Call Your Healthcare Provider
There are times when rib and chest pain may indicate a life-threatening condition. Intercostal neuralgia can cause severe and debilitating pain that makes it hard to breathe. Sometimes, rib cage pain or chest area pain can be a sign of a condition that may require emergency medical treatment. For example, chest pain may indicate a heart attack.
Seek immediate medical attention or call 911 if you or someone you’re with starts to have chest pain that is severe and of an unknown cause.
Other symptoms that may indicate a medical emergency include:
What Is Inflammation of the Lungs?
Sometimes, intercostal neuralgia has no known cause. If your healthcare provider is unable to determine a cause, you may be diagnosed with idiopathic intercostal neuralgia. The term “idiopathic” is used to describe medical conditions that have no identifiable or clear cause.
Why Do My Ribs Hurt? Causes of Rib Cage Pain
Risk Factors
There are a number of risk factors that increase the chance of developing intercostal neuralgia.
Risk factors include:
What Causes Shingles to Activate?
The majority of people with intercostal neuralgia first seek medical care because they think they may be having aheart attackor other cardiac problem.
The physical exam is an important part of the intercostal neuralgia diagnosis. It involves inspecting the area where the intercostal nerves are located.Pain produced from simple light pressure can help to assess the extent of pain.
To rule out other potential causes of chest wall pain, rib pain, or back pain, additional testing will be done. This will help your healthcare provider determine if the intercostal nerves are the source of pain or if there is another reason for your chest pain, such as lung orcardiovascular disease.
Other tests to help evaluate causes of pain related to the intercostal nerves include:
If you have risk factors for heart disease, such as diabetes, high blood pressure, a history of smoking, or a family history of heart disease, your healthcare provider will want to test your heart function.
Testing may include:
Treatment for intercostal neuralgia depends on the underlying cause and may include over-the-counter (OTC) and prescription medications and medical procedures.
OTC Medication
Over-the-counter (OTC) medication may help treat the pain associated with intercostal neuralgia. Some of these medications include:
Prescription Medication
If OTC medication doesn’t help, talk to your healthcare provider about prescription medications such as:
Procedures
Certain medical procedures can also help treat intercostal neuralgia. These procedures involve blocking or destroying the nerves that are causing the pain:
Complementary Therapies
Your healthcare provider may also recommend complementary therapies, such as:
These therapies are to be used in conjunction with traditional treatments, and not as lone therapies or as substitutes for medicinal therapies.
Does Intercostal Neuralgia Go Away?
Depending on the cause, intercostal neuralgia may go away in a few weeks to months with treatment. It is also possible for symptoms to resolve on their own without treatment. Some people, however, will continue to experience chronic pain for the long term.
Intercostal pain from a shingles infection can last for months or even years after the rash goes away.If you develop shingles, taking antiviral medication within 72 hours of the rash’s appearance can help prevent postherpetic neuralgia.
Some healthy lifestyle habits may prevent intercostal neuralgia and reduce your risk of developing the condition.
Things you can do to reduce your risk are:
Summary
Intercostal neuralgia is a type of nerve pain that’s felt in the chest. It occurs when the intercostal nerves are inflamed, irritated, or compressed. The pain can have a number of possible causes, including chest trauma, shingles, or a pulled or strained muscle.
Intercostal neuralgia can sometimes be mistaken for a heart attack. If you’re experiencing this kind of pain, your healthcare provider may want to test your heart function before diagnosing you.
Treatment for intercostal neuralgia may include pain medications, nerve blocks, anti-depressants, and more. It can often be prevented with safety precautions and getting a shingles vaccine.
The Difference Between Bruised and Broken Ribs
22 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.International Pain Foundation.What is intercostal neuralgia?Dallas C.Chapter 29: Intercostal nerve entrapment: Chest wall. In:Peripheral Nerve Entrapments: Clinical Diagnosis and Management. Springer International Publishing; 2016. doi:10.1007/978-3-319-27482-9_29Dureja GP.Intercostal neuralgia: A review.J Neurol Transl Neurosci.2017;5(1):1076. doi:10.47739/2333-7087/1075Huang Y, Mehta N.Intercostal neuralgia and thoracic radiculopathy. In:The Spine Handbook. Oxford University Press; 2018:253.MedlinePlus.When to use the emergency room—adult.Hashemi M, Mohseni G, Ataei MH, Zafari A, Keyhani S, Jazayeri SM.Intercostal nerves pulsed radiofrequency for intractable neuralgia treatment in athletes with sport trauma of the chest: A case‑series study.Arch Trauma Res. 2017;6(3):38. doi:10.4103/atr.atr_26_17Hadley GR, Gayle JA, Ripoll J, et al.Post-herpetic neuralgia: A review.Curr Pain Headache Rep. 2016;20(3):17. doi:10.1007/s11916-016-0548-xEe Chin JW, Valchanov K.Pharmacological management of post-thoracotomy pain.Open Med J. 2016;3(1). doi:10.2174/1874220301603010255Kobayashi H, Shinoda Y, Ohki T, Kawano H.Intercostal neuralgia as a symptom of an osteoblastoma in thoracic spine.BMJ Case Rep. 2015;2015:bcr2015210720. doi:10.1136/bcr-2015-210720Shah S, Banh ET, Koury K, Bhatia G, Nandi R, Gulur P.Pain management in pregnancy: Multimodal approaches.Pain Res Treat. 2015;2015:987483. doi:10.1155/2015/987483Tirlapur SA, Priest L, Daniels JP, et al.How do we define the term idiopathic?Curr Opin Obstet Gynecol. 2013;25(6):468–473. doi:10.1097/GCO.0000000000000025Olamikan S, Gulati A, Trescot AM.Intercostal nerve entrapment: Chest wall. In:Peripheral Nerve Entrapments: Clinical Diagnosis and Management. Springer International Publishing; 2016:279-290.Thomas S, Lopez F.Intercostal pain syndromes. In: Kahn S, Xu R (eds).Musculoskeletal Sports and Spine Disorders. Springer, Cham; 2017.Winzenberg T, Jones, G, Callisaya, M.Musculoskeletal chest wall pain.Thorax. 2015;44(8): 540-544American Heart Association.Exercise stress test.Huang Y, Mehta N.Intercostal neuralgia and thoracic radiculopathy. In: Desai M, O’Brien J, eds.The Spine Handbook. New York, NY: Oxford University Press; 2018.Abd-Elsayed A, Lee S, Jackson M.Radiofrequency ablation for treating resistant intercostal neuralgia.Ochsner J. 2018;18(1):91–93.Fiala KJ, Martens JM, Keith MK, Ghouse A, Abd-Elsayed A.Cooled radiofrequency ablation for intercostal neuralgia.Ochsner J. 2023;23(2):159-163. doi:10.31486/toj.22.0087Hetmann F, Kongsgaard UE, Sandvik L, Schou-Bredal I.Post-thoracotomy pain syndrome and sensory disturbances following thoracotomy at 6- and 12-month follow-ups.J Pain Res. 2017;10:663-668. doi:10.2147/JPR.S126639Curran D, Schmidt-Ott R, Schutter U, Simon J, Anastassopoulou A, Matthews S.Impact of herpes zoster and postherpetic neuralgia on the quality of life of Germans aged 50 or above.BMC Infect Dis. 2018;18(1):496. doi:10.1186/s12879-018-3395-zLe P, Rothberg M.Herpes zoster infection.BMJ. 2019;364:k5095. doi:10.1136/bmj.k5095Centers for Disease Control and Prevention.Get the Shingrix vaccine if you are 50 or older.
22 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.International Pain Foundation.What is intercostal neuralgia?Dallas C.Chapter 29: Intercostal nerve entrapment: Chest wall. In:Peripheral Nerve Entrapments: Clinical Diagnosis and Management. Springer International Publishing; 2016. doi:10.1007/978-3-319-27482-9_29Dureja GP.Intercostal neuralgia: A review.J Neurol Transl Neurosci.2017;5(1):1076. doi:10.47739/2333-7087/1075Huang Y, Mehta N.Intercostal neuralgia and thoracic radiculopathy. In:The Spine Handbook. Oxford University Press; 2018:253.MedlinePlus.When to use the emergency room—adult.Hashemi M, Mohseni G, Ataei MH, Zafari A, Keyhani S, Jazayeri SM.Intercostal nerves pulsed radiofrequency for intractable neuralgia treatment in athletes with sport trauma of the chest: A case‑series study.Arch Trauma Res. 2017;6(3):38. doi:10.4103/atr.atr_26_17Hadley GR, Gayle JA, Ripoll J, et al.Post-herpetic neuralgia: A review.Curr Pain Headache Rep. 2016;20(3):17. doi:10.1007/s11916-016-0548-xEe Chin JW, Valchanov K.Pharmacological management of post-thoracotomy pain.Open Med J. 2016;3(1). doi:10.2174/1874220301603010255Kobayashi H, Shinoda Y, Ohki T, Kawano H.Intercostal neuralgia as a symptom of an osteoblastoma in thoracic spine.BMJ Case Rep. 2015;2015:bcr2015210720. doi:10.1136/bcr-2015-210720Shah S, Banh ET, Koury K, Bhatia G, Nandi R, Gulur P.Pain management in pregnancy: Multimodal approaches.Pain Res Treat. 2015;2015:987483. doi:10.1155/2015/987483Tirlapur SA, Priest L, Daniels JP, et al.How do we define the term idiopathic?Curr Opin Obstet Gynecol. 2013;25(6):468–473. doi:10.1097/GCO.0000000000000025Olamikan S, Gulati A, Trescot AM.Intercostal nerve entrapment: Chest wall. In:Peripheral Nerve Entrapments: Clinical Diagnosis and Management. Springer International Publishing; 2016:279-290.Thomas S, Lopez F.Intercostal pain syndromes. In: Kahn S, Xu R (eds).Musculoskeletal Sports and Spine Disorders. Springer, Cham; 2017.Winzenberg T, Jones, G, Callisaya, M.Musculoskeletal chest wall pain.Thorax. 2015;44(8): 540-544American Heart Association.Exercise stress test.Huang Y, Mehta N.Intercostal neuralgia and thoracic radiculopathy. In: Desai M, O’Brien J, eds.The Spine Handbook. New York, NY: Oxford University Press; 2018.Abd-Elsayed A, Lee S, Jackson M.Radiofrequency ablation for treating resistant intercostal neuralgia.Ochsner J. 2018;18(1):91–93.Fiala KJ, Martens JM, Keith MK, Ghouse A, Abd-Elsayed A.Cooled radiofrequency ablation for intercostal neuralgia.Ochsner J. 2023;23(2):159-163. doi:10.31486/toj.22.0087Hetmann F, Kongsgaard UE, Sandvik L, Schou-Bredal I.Post-thoracotomy pain syndrome and sensory disturbances following thoracotomy at 6- and 12-month follow-ups.J Pain Res. 2017;10:663-668. doi:10.2147/JPR.S126639Curran D, Schmidt-Ott R, Schutter U, Simon J, Anastassopoulou A, Matthews S.Impact of herpes zoster and postherpetic neuralgia on the quality of life of Germans aged 50 or above.BMC Infect Dis. 2018;18(1):496. doi:10.1186/s12879-018-3395-zLe P, Rothberg M.Herpes zoster infection.BMJ. 2019;364:k5095. doi:10.1136/bmj.k5095Centers for Disease Control and Prevention.Get the Shingrix vaccine if you are 50 or older.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
International Pain Foundation.What is intercostal neuralgia?Dallas C.Chapter 29: Intercostal nerve entrapment: Chest wall. In:Peripheral Nerve Entrapments: Clinical Diagnosis and Management. Springer International Publishing; 2016. doi:10.1007/978-3-319-27482-9_29Dureja GP.Intercostal neuralgia: A review.J Neurol Transl Neurosci.2017;5(1):1076. doi:10.47739/2333-7087/1075Huang Y, Mehta N.Intercostal neuralgia and thoracic radiculopathy. In:The Spine Handbook. Oxford University Press; 2018:253.MedlinePlus.When to use the emergency room—adult.Hashemi M, Mohseni G, Ataei MH, Zafari A, Keyhani S, Jazayeri SM.Intercostal nerves pulsed radiofrequency for intractable neuralgia treatment in athletes with sport trauma of the chest: A case‑series study.Arch Trauma Res. 2017;6(3):38. doi:10.4103/atr.atr_26_17Hadley GR, Gayle JA, Ripoll J, et al.Post-herpetic neuralgia: A review.Curr Pain Headache Rep. 2016;20(3):17. doi:10.1007/s11916-016-0548-xEe Chin JW, Valchanov K.Pharmacological management of post-thoracotomy pain.Open Med J. 2016;3(1). doi:10.2174/1874220301603010255Kobayashi H, Shinoda Y, Ohki T, Kawano H.Intercostal neuralgia as a symptom of an osteoblastoma in thoracic spine.BMJ Case Rep. 2015;2015:bcr2015210720. doi:10.1136/bcr-2015-210720Shah S, Banh ET, Koury K, Bhatia G, Nandi R, Gulur P.Pain management in pregnancy: Multimodal approaches.Pain Res Treat. 2015;2015:987483. doi:10.1155/2015/987483Tirlapur SA, Priest L, Daniels JP, et al.How do we define the term idiopathic?Curr Opin Obstet Gynecol. 2013;25(6):468–473. doi:10.1097/GCO.0000000000000025Olamikan S, Gulati A, Trescot AM.Intercostal nerve entrapment: Chest wall. In:Peripheral Nerve Entrapments: Clinical Diagnosis and Management. Springer International Publishing; 2016:279-290.Thomas S, Lopez F.Intercostal pain syndromes. In: Kahn S, Xu R (eds).Musculoskeletal Sports and Spine Disorders. Springer, Cham; 2017.Winzenberg T, Jones, G, Callisaya, M.Musculoskeletal chest wall pain.Thorax. 2015;44(8): 540-544American Heart Association.Exercise stress test.Huang Y, Mehta N.Intercostal neuralgia and thoracic radiculopathy. In: Desai M, O’Brien J, eds.The Spine Handbook. New York, NY: Oxford University Press; 2018.Abd-Elsayed A, Lee S, Jackson M.Radiofrequency ablation for treating resistant intercostal neuralgia.Ochsner J. 2018;18(1):91–93.Fiala KJ, Martens JM, Keith MK, Ghouse A, Abd-Elsayed A.Cooled radiofrequency ablation for intercostal neuralgia.Ochsner J. 2023;23(2):159-163. doi:10.31486/toj.22.0087Hetmann F, Kongsgaard UE, Sandvik L, Schou-Bredal I.Post-thoracotomy pain syndrome and sensory disturbances following thoracotomy at 6- and 12-month follow-ups.J Pain Res. 2017;10:663-668. doi:10.2147/JPR.S126639Curran D, Schmidt-Ott R, Schutter U, Simon J, Anastassopoulou A, Matthews S.Impact of herpes zoster and postherpetic neuralgia on the quality of life of Germans aged 50 or above.BMC Infect Dis. 2018;18(1):496. doi:10.1186/s12879-018-3395-zLe P, Rothberg M.Herpes zoster infection.BMJ. 2019;364:k5095. doi:10.1136/bmj.k5095Centers for Disease Control and Prevention.Get the Shingrix vaccine if you are 50 or older.
International Pain Foundation.What is intercostal neuralgia?
Dallas C.Chapter 29: Intercostal nerve entrapment: Chest wall. In:Peripheral Nerve Entrapments: Clinical Diagnosis and Management. Springer International Publishing; 2016. doi:10.1007/978-3-319-27482-9_29
Dureja GP.Intercostal neuralgia: A review.J Neurol Transl Neurosci.2017;5(1):1076. doi:10.47739/2333-7087/1075
Huang Y, Mehta N.Intercostal neuralgia and thoracic radiculopathy. In:The Spine Handbook. Oxford University Press; 2018:253.
MedlinePlus.When to use the emergency room—adult.
Hashemi M, Mohseni G, Ataei MH, Zafari A, Keyhani S, Jazayeri SM.Intercostal nerves pulsed radiofrequency for intractable neuralgia treatment in athletes with sport trauma of the chest: A case‑series study.Arch Trauma Res. 2017;6(3):38. doi:10.4103/atr.atr_26_17
Hadley GR, Gayle JA, Ripoll J, et al.Post-herpetic neuralgia: A review.Curr Pain Headache Rep. 2016;20(3):17. doi:10.1007/s11916-016-0548-x
Ee Chin JW, Valchanov K.Pharmacological management of post-thoracotomy pain.Open Med J. 2016;3(1). doi:10.2174/1874220301603010255
Kobayashi H, Shinoda Y, Ohki T, Kawano H.Intercostal neuralgia as a symptom of an osteoblastoma in thoracic spine.BMJ Case Rep. 2015;2015:bcr2015210720. doi:10.1136/bcr-2015-210720
Shah S, Banh ET, Koury K, Bhatia G, Nandi R, Gulur P.Pain management in pregnancy: Multimodal approaches.Pain Res Treat. 2015;2015:987483. doi:10.1155/2015/987483
Tirlapur SA, Priest L, Daniels JP, et al.How do we define the term idiopathic?Curr Opin Obstet Gynecol. 2013;25(6):468–473. doi:10.1097/GCO.0000000000000025
Olamikan S, Gulati A, Trescot AM.Intercostal nerve entrapment: Chest wall. In:Peripheral Nerve Entrapments: Clinical Diagnosis and Management. Springer International Publishing; 2016:279-290.
Thomas S, Lopez F.Intercostal pain syndromes. In: Kahn S, Xu R (eds).Musculoskeletal Sports and Spine Disorders. Springer, Cham; 2017.
Winzenberg T, Jones, G, Callisaya, M.Musculoskeletal chest wall pain.Thorax. 2015;44(8): 540-544
American Heart Association.Exercise stress test.
Huang Y, Mehta N.Intercostal neuralgia and thoracic radiculopathy. In: Desai M, O’Brien J, eds.The Spine Handbook. New York, NY: Oxford University Press; 2018.
Abd-Elsayed A, Lee S, Jackson M.Radiofrequency ablation for treating resistant intercostal neuralgia.Ochsner J. 2018;18(1):91–93.
Fiala KJ, Martens JM, Keith MK, Ghouse A, Abd-Elsayed A.Cooled radiofrequency ablation for intercostal neuralgia.Ochsner J. 2023;23(2):159-163. doi:10.31486/toj.22.0087
Hetmann F, Kongsgaard UE, Sandvik L, Schou-Bredal I.Post-thoracotomy pain syndrome and sensory disturbances following thoracotomy at 6- and 12-month follow-ups.J Pain Res. 2017;10:663-668. doi:10.2147/JPR.S126639
Curran D, Schmidt-Ott R, Schutter U, Simon J, Anastassopoulou A, Matthews S.Impact of herpes zoster and postherpetic neuralgia on the quality of life of Germans aged 50 or above.BMC Infect Dis. 2018;18(1):496. doi:10.1186/s12879-018-3395-z
Le P, Rothberg M.Herpes zoster infection.BMJ. 2019;364:k5095. doi:10.1136/bmj.k5095
Centers for Disease Control and Prevention.Get the Shingrix vaccine if you are 50 or older.
Meet Our Medical Expert Board
Share Feedback
Was this page helpful?Thanks for your feedback!What is your feedback?OtherHelpfulReport an ErrorSubmit
Was this page helpful?
Thanks for your feedback!
What is your feedback?OtherHelpfulReport an ErrorSubmit
What is your feedback?
