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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@gunnera

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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@gunnera, your story is most welcome. I appreciate your adding it. It's another testament to the need of being one's own advocate and working with your doctors when something isn't right.

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I learned over time to accept the constant pain. I became upset/angered that no Dr would help me. I described the pain as a constant phantom pain that hurt worst when I did heavier breathing. But now I am under pain management, that creates issues itself. However, I am thankful each day that I am alive, breathing, and kicking.

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@karenann01: May I ask how you are doing regarding Gabapentin and your pain?

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@gunnera

@karenann01: May I ask how you are doing regarding Gabapentin and your pain?

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I'm still taking 600mg at night. Usually wake up with pain, I think bc I sleep on my stomach. It goes away quickly. Overall, I'm doing ok unless I lift things or do stretching. It seems to be mostly on my right side & around into my back. We've been traveling, so haven't seen a DR for awhile. I'm going to make an appointment for this summer for a pain Dr. when I'm in 1 place for awhile. Hopefully, he/she'll be at least willing to continue the gabapentin, unless they have a better idea. What are you doing for yours.

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@karenann01

I'm still taking 600mg at night. Usually wake up with pain, I think bc I sleep on my stomach. It goes away quickly. Overall, I'm doing ok unless I lift things or do stretching. It seems to be mostly on my right side & around into my back. We've been traveling, so haven't seen a DR for awhile. I'm going to make an appointment for this summer for a pain Dr. when I'm in 1 place for awhile. Hopefully, he/she'll be at least willing to continue the gabapentin, unless they have a better idea. What are you doing for yours.

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I am still taking 900mg (3 x 300mg) per day. Neurologist wanted to increase the dosage until I mentioned the side effect of brain fog at times. I'm getting used to it, but I know that the dosage needs to increase; my left side of my chest still hurts more than I would like.

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My Dr had me on 900 mg, one in the morning & 2 at night. I didn't really notice any difference with the 1 in the morning, so I quit taking it. does your chest hurt all the time or do certain activities cause it to hurt. I have also found being on my feet for a long period of time will also cause it to hurt.

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@kilh

@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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@1942marilyne Thanks for the reply. I still have pain now and then. I have not had a screen since but I need to. KLH

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@karenann01

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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I have multiple myeloma resulting in T6 and T7 suffering compression fractures. I now have intercostal neuropathy due to the vertebrae pressing on the nerve. The pain and discomfort is hard to live with.

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@swansm50

I have multiple myeloma resulting in T6 and T7 suffering compression fractures. I now have intercostal neuropathy due to the vertebrae pressing on the nerve. The pain and discomfort is hard to live with.

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The hardest thing for me was finding a Dr who actually acknowledged my pain & diagnosed it. I finally found that person about a year ago. Hardly anyone really knows what it is. I even talked to a physical therapist about it. He didn't really have specific exercises, but gave me a few to try. They just aggravated it. Since taking the gabapentin for almost a year now, my pain is greatly reduced. It used to get so bad, it would sometimes take my breath away. I haven't had that in a long time. I've lived with this for over 4 years. I hope your Dr finds a medication that will help you.

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@karenann01

The hardest thing for me was finding a Dr who actually acknowledged my pain & diagnosed it. I finally found that person about a year ago. Hardly anyone really knows what it is. I even talked to a physical therapist about it. He didn't really have specific exercises, but gave me a few to try. They just aggravated it. Since taking the gabapentin for almost a year now, my pain is greatly reduced. It used to get so bad, it would sometimes take my breath away. I haven't had that in a long time. I've lived with this for over 4 years. I hope your Dr finds a medication that will help you.

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Hi,

I am sorry that you are in pain for so long and haven't found a good Dr yet for treatment.

I happen to stumble upon this post by chance and couldn't help but wonder how many more patients still need to suffer.

I was clueless and had no diagnosis done and was suffering from debilitating pain for close to 2 years post a major car accident. Due to pandemic I couldn't get timely treatment in the country I live currently however luckily I could fly to India for better and faster treatment.

In India , I was diagnosed with intercostal neuralgia and was treated with nerve blocks , lidiacaine patch and duvanta (previously I was on gabapentin, pregablin, amitriptyline but all had bad side effects on me). This really put me on a path to recovery finally.

Its been over 1.5 years now since the nerve blocks, and I have had significant and dramatic improvement in my condition.

In the country I live currently, unfortunately its not a treatment easily provided due to different protocol and restrictions however the pain specialist here also have agreed I did the right thing by choosing to help myself by privately funding my treatment in India.

I am not sure where in the world you are located, however I would suggest you to visit a pain specialist or a neurologist to check if these can be an option for you.

Good luck with your treatment and I really wish that you come out of this pain cycle soon.

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