The intercostal muscles surround the ribcage and are responsible for comprising the chest wall, as well as expanding and contracting this wall as necessary for proper breathing. Intercostal neuralgia refers to real or perceived nerve pain originating from this region. Nerve pain in the ribcage may be caused by illness, physical injuries, pressure on the nerves, abnormal growths that are crowding the nerve channels, or damage to the intercostal nerves themselves. Here are some of the most common symptoms of this painful condition, along with the most effective treatments and pain management techniques indicated for intercostal neuralgia. As always, consult your primary care provider before starting or stopping any medical treatment regimen. 

Symptoms of Intercostal Neuralgia

The symptoms experienced by patients suffering from intercostal neuralgia can include: 

-Steady or Intermittent Pain (Sharp or dull, severe or mild, stabbing or shooting, burning or aching.) 

-Sensitivity (It may hurt to perform activities that use the intercostal muscles. Unfortunately, this most directly includes breathing. Patients may also experience tenderness, sensitivity or pain while performing actions within a normal range of motion that engages the intercostals, such as lifting one's arms above one's head while getting dressed. )

-Weakness (Patients may feel as though their torso or trunk are weak or that they are having to strain more forcefully than usual in order to obtain a full satisfying breath.)

Likely Causes of Intercostal Neuralgia

Again, it is imperative that you consult a doctor and obtain a proper medical diagnosis if you are experiencing discomfort, sensitivity, weakness or pain around your rib-cage or torso. However, some common causes of intercostal neuralgia include: 

-Recent injuries to the torso or rib-cage itself. Contact sports like football, rugby or martial arts may result in rib-cage-rattling hits directly to this sensitive area. Bruising or inflammation may result and this can in-turn lead to intercostal nerve pain or symptoms that mimic the condition. If you have recently sustained any hard hits as a result of participating in contact sports or other kinds of strenuous exercise, see a doctor immediately for a thorough check-up. Other common sources of injury are improper lifting techniques while moving heavy objects, or over-zealous weight-lifting routines that are not properly supported by a spotter. 

-Herpetic Illness. Patients that are susceptible to herpes-based diseases such as Shingles may experience intercostal neuralgia as a direct result of one of these illnesses. Shingles can cause pain, inflammation and sensitivity in the upper chest. 

-Recent Surgeries or Invasive Procedures. Patients who have recently undergone invasive surgeries may experience nerve pain in their torsos or surrounding their ribcages due to to tissue damage or inflammation sustained in the course of the surgery. Contact your surgeon and physician for recommendations to reduce the inflammation and manage your pain with medications or physical therapy. 

Effective Treatments for Upper Torso and Chest Nerve Pain

-Direct Nerve Intervention. Should your doctor determine that the pain your are experiencing in your upper chest and torso are the cause of direct damage to your intercostal nerves, and your discomfort does not respond to alternative therapies or medications, it may be necessary to undergo an intercostal nerve block. 

An intercostal nerve block involves an injection of local anesthetic into the affected tissues, muscles or nerves as deemed necessary by your health care provider. In some cases, a combination of pain medication and corticosterioids will be used to help manage your pain while encouraging nearby strained and stressed muscles stop pressuring your nerves. 

-Non-Steroidal Anti-Inflammatory Drugs for Intercostal Nerve Pain. These over-the-counter and relatively safe drugs that are more commonly known as Ibuprofin , Advil and Motrin, are often effective in reducing swelling and localized inflammation in the case of mild to moderate instances of intercostal neuralgia caused by strained muscles. By reducing inflammation in the immediate area, pressure upon the intercostal family of nerves is also reduced, which leads to lessened discomfort for the patient. 

-Capsaicin Creams. The active ingredient in hot peppers can provide relief when applied to the inflammed or irritated areas in cream form. It helps to relax muscles, provide the sensation of soothing warmth and reduce inflammation. 

-Medicinal Treatments for Herpetic Based Nerve Pain.  Should the root cause of your intercostal nerve pain be determined to be viral in nature, there are a number of compounds that may be successful in reducing irritation and discomfort. In the past few years, doctors have been prescribing common anti-depressant medications in the treatment of herpetic neuralgia for their ability to effectively reduce nerve pain. 

Shingles often bring intense itching alongside actual pain, for which antihistamine medications can be an effective answer. The combination of topical antiviral creams or ingested antiviral medications can further improve the patient's prognosis by lessening the severity and duration of the herpetic outbreak responsible for the nerve pain.