Intercostal neuralgia is a type of nerve pain that affects the intercostal nerves, which run between the ribs and help control the muscles of the chest wall and provide sensation to the skin. When these nerves become irritated, inflamed, or injured, patients may experience sharp, burning, or stabbing pain that wraps around the chest or upper abdomen.
This condition can be sudden and severe or chronic and persistent, and it may be aggravated by movement, deep breathing, or touch.
Common Causes of Intercostal Neuralgia
Surgical procedures (e.g., thoracotomy, mastectomy, chest tube placement)
Trauma or rib fractures
Herpes zoster (shingles) or postherpetic neuralgia
Spinal conditions, such as thoracic disc herniation or degenerative changes
Muscle strain or repetitive twisting motions
Entrapment or compression of the intercostal nerve from scar tissue or inflammation
Idiopathic cases, where no clear cause is identified
Symptoms of Intercostal Neuralgia
Sharp, burning, or shooting pain along the rib cage or chest wall
Pain that wraps around from the back to the front of the chest or abdomen
Increased sensitivity to touch, clothing, or temperature changes
Pain with deep breaths, coughing, sneezing, or movement
Muscle spasms or tightness in the chest or back
Tingling or numbness in the affected area
Conservative Treatment Options
Medications
NSAIDs (e.g., ibuprofen, naproxen) for inflammation and mild pain
Neuropathic pain agents (e.g., gabapentin, pregabalin, amitriptyline)
Muscle relaxants for associated muscle tension
Topical medications, such as lidocaine patches or capsaicin cream
Physical Therapy
Focuses on postural correction, stretching, and mobility
Gentle exercises can help relieve nerve compression and reduce referred pain
Lifestyle Modifications
Avoiding aggravating movements, heavy lifting, or twisting
Supportive bracing or cushions for rib or post-surgical support
Interventional Pain Management Options
When symptoms persist or are severe, interventional procedures can provide targeted and lasting relief:
Intercostal Nerve Block
Injection of a local anesthetic and corticosteroid around the affected intercostal nerve
Helps reduce nerve inflammation and confirm the diagnosis
Often performed under ultrasound or fluoroscopic guidance
Pulsed or Thermal Radiofrequency Ablation (RFA)
Destroys or modulates the affected nerve’s ability to transmit pain
Used after a successful diagnostic nerve block
Offers longer-lasting pain relief, typically 6–12 months or more
Paravertebral Nerve Block
Targets the nerve roots as they exit the spine
Can be helpful if the pain is traced back to spinal compression or inflammation
Spinal Cord Stimulation (SCS)
An implantable device used in chronic or refractory intercostal neuralgia
Helps modulate nerve pain signals and reduce dependency on medications
When to Seek Help
You should consult a pain specialist if you:
Experience persistent chest wall pain that worsens with breathing or movement
Have pain that does not respond to medications or physical therapy
Develop symptoms following surgery, injury, or shingles
Have numbness, hypersensitivity, or muscle spasm in the ribs or upper abdomen
Find Relief with Expert Intercostal Nerve Care
At Parkview Spine & Pain, we offer advanced diagnostics and image-guided treatments for intercostal neuralgia. Whether your pain is from trauma, surgery, or nerve irritation, our team will create a personalized care plan to relieve your symptoms and restore your quality of life.
👉 Schedule a consultation today to explore your options for intercostal nerve pain relief.