Intercostal Neuralgia

Posted by karenann01 @karenann01, Aug 24, 2022

For the past 3 years I've had pain, basically under my upper rib cage & breastbone area & around to my back. It's very hard to explain. It started out hurting when I bent over & lifted something heavy. I went to a Dr & ended up having every heart test you can imagine. Then to the GI, where I had everything there tested. I've had blood work & chest xray. No one could seem to explain it. This year it's been worse, doesn't take much to make it hurt. I went to the pain Dr & had him look at my back MRIs to see if there was anything there causing it. When I explained everything to him, he reached around me & started pressing on certain areas of my ribs, some were very painful. He's of the opinion I have Intercostal Neuralgia. He suggested physical therapy & gabapentin. Since I was also going to PT for knee replacement, I took my order to them & asked what they could do. My therapist said there really isn't any special treatment for it, but he did have a few exercises that might help. Those exercises certainly pull on those muscles, but I'm not sure it's helping. So far, I don't see any benefits from the gabapentin, except weird dreams at night & it's been over 2 weeks. Has anyone else had any experience with this. I really don't know what else to do

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Hello @karenann01, Welcome to Connect. I don't have any experience with intercostal neuralgia but did search Connect and found that @sjrohde1 and @funk24 have mentioned intercostal neuralgia in a post in other discussions and may have some suggestions or information to share with you.

I found a YouTube video that seems like it is discussing the same type of symptoms you mentioned and might be helpful. Our full 5 minute guided routine for helping with INTERCOSTAL MUSCLE PAIN!: https://youtu.be/4cVWtiRV0wY.

I also found an article with some suggestions that may be helpful.
-- At-Home Treatments for Intercostal Neuralgia: https://www.painscale.com/article/at-home-treatments-for-intercostal-neuralgia

PT can sometimes awhile before you see any benefit. Are the exercises your therapist showed you similar or the same as the ones in the article or video above?

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Thank you for your reply. I did look up the discussions by the 2 people you mentioned. The first kind of hijacked someone else's discussion I sort of thought. However, I did reply to his comment. The other person just said, his Dr said it might be that. I did look at the youtube & I will try adding those to the ones I'm doing now. They aren't the same, but the ones my therapist gave me are definitely stretching those muscles. I guess after 3 years of this, I'm a little frustrated. Of course I will continue with the meds & the exercises & hope they help at some point.

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@karenann01 I just read your post. This may have nothing to do with your pain but I have some very small bruising in the same area with pain. It comes and goes with how I move. Like you, I wondered what was wrong back behind the pain. It started a year ago but now I have figured out the cause. When I had my mammogram done, the tech had a terrible time trying to get me positioned right. She pulled and pushed, then finally got someone else to assist. Both of them struggled to push me harder on the platform. The pain was terrible, it could not get done fast enough. So the platform that I was pushed into left my ribs sore and marks in a line right under my rib cage. The soreness in that area is becoming less but still there.
As I said this probably had nothing to do with your pain. I thought I would just throw this incident out. I hope you find the source of your pain. In the meantime stay healthy and send an update if you figure the cause out. KLH

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Thank you for your comments & thoughts. I have thought long & hard as to what could have caused it in the first place & have not been able to come up with any answer. My biggest concern is that it seems to be getting worse rather than better. I'm retired & really don't do a lot of things that could have caused it. The only thing I can think of is, we go to the Dominican Repbublic every winter, for the winter & pack 4 suitcases filled to capacity. I lift them & weigh them several times, which really makes it bad. Maybe that's what started it, I don't know. Now all I have to do is bend over, or lift a couple bags of groceries & it hurts. I'm hoping the stretching exercises & the gabapentin do their job soon.

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@karenann01

Thank you for your comments & thoughts. I have thought long & hard as to what could have caused it in the first place & have not been able to come up with any answer. My biggest concern is that it seems to be getting worse rather than better. I'm retired & really don't do a lot of things that could have caused it. The only thing I can think of is, we go to the Dominican Repbublic every winter, for the winter & pack 4 suitcases filled to capacity. I lift them & weigh them several times, which really makes it bad. Maybe that's what started it, I don't know. Now all I have to do is bend over, or lift a couple bags of groceries & it hurts. I'm hoping the stretching exercises & the gabapentin do their job soon.

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Karenann01 - I think that may be the cause … repetitive stress injury. Sometimes these pains take months to subside or go away and with you hoisting suitcases to weigh them every year … sounds like repetitive stress injury. Is there anyone else who could weigh your luggage for you?

It could be costochondritis exacerbated by this yearly “weigh-in” perhaps …?

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You may very well be correct. I guess I never really thought about it just aggravating it over & over again. I can get my husband to do it, but he has a bad back. Of course, his pain goes away after a day or two. I think I'll try that this year & see if it makes a difference. When I had all the heart tests done I asked the DR if she thought it might be costochondritis & she said no. Thanks for the suggestion.

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Your post resonated with me. My husband was experiencing the pain as you describe for 4 months.
He was misdiagnosed as costrochondritis and sent to PT . Turns out he has multiple myeloma with a tumor compromising his spinal cord
As I write this he is here at Mayo (he was not misdiagnosed here) having his 1st of 5 radiation therapy treatments.
I'm sending you lots of healing vibes and hoping that you get relief from your pain quickly.

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@lizbetor22

Your post resonated with me. My husband was experiencing the pain as you describe for 4 months.
He was misdiagnosed as costrochondritis and sent to PT . Turns out he has multiple myeloma with a tumor compromising his spinal cord
As I write this he is here at Mayo (he was not misdiagnosed here) having his 1st of 5 radiation therapy treatments.
I'm sending you lots of healing vibes and hoping that you get relief from your pain quickly.

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Thank you for the healing vibes. I've had serveral back mris, so I don't think it's anything like that. I hope all goes well with your husband's radiation. That must be a worry for you both. I hope all goes well & he is out of pain soon.

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Thank you and I surely hope your pain goes away.
It's been quite the experience. After what happened to my husband I am trying to prevent anyone else from going through the same misdiagnosis. Anyone with unexplained back/ rib pain hears his story.

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I just came across this post and responses 6-8 months after posting. However, I do want to add some information to help others with similar pain. I am a 61-year old male. I had a quintuple CABG surgery in August 2009, at the age of 48. I didn't have a heart attack—caught the coronary artery blockages before an attack or muscle damage. I was described as a walking "time bomb.” I was also diagnosed with Hyperlipidemia (cholesterol above 200). In 2010, I had to have a pacemaker implanted due to sick sinus syndrome. In 2011, I had a cardiac ablation to reduce/eliminate my A-Fib after the CABG.
For "years" after my CABG, I complained of a constant left chest pain at a pain-level of 7-8+ at times to a constant 5-6 out of 10, discomfort, and chest tightness. (This was different from the cardiac rehab-level chest pain!) It was hard for me take in deep breadths. The pain became intense enough that it masked itself as a potential heart attack. I went to the ER numerous times, and of course with a CABG and pacemaker history, I was immediately taken in, numerous tests were conducted, but the outcomes were all similar--no issues with my heart or arteries! They may give nitro pills to reduce the chest pain--again thinking cardiac. I became totally frustrated and stopped going to the ER--I lived with the constant pain, but I did mention it to my primary care and cardiologist during my office visits. Okay, you may be saying why. If I had other pain requiring emergency assistance, I would go.
Jumping ahead to December 29, 2022, I had extreme chest pain that would not stop. I was still in a state of mind not to go to the ER. I did go to my cardiologist and an EKG done and a couple of other tests--same result, not your heart. However, the next few words were the first time I heard the following from any doctor, including my previous primary care and cardiologist--your pain is "Neurological."
My cardiologist sent me to the ER since I presented indications of a stroke or TIA. At the ER, several more tests were conducted regarding the potential stroke. In the end, no stroke, a potential TIA.
I followed up with a Neurologist a week after the ER visit. Yes, she was treating me as minor stroke/TIA. In the discussions, I complained about the chest pain and described the pain to her. We did additional tests, and she came to the conclusion that I was suffering from "Intercostal Neuralgia" and probably have been for the past 9-10 years. My life is now with an additional medication, just add it to the pile of pills I take. I have been on gabapentin now for the last 3 weeks and now am increasing to 900mg/day (taken 300mg x3/day). I do hope this works to mask this chest pain.
The moral of my story for all that reads this, continue to discuss with your doctors if you have chest pain described here and other posts.

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