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Chest wall pain/Intercostal neuralgia

Intercostal neuralgia, also known as chest wall pain, is a condition that causes pain along the intercostal nerves between your ribs. It is caused by nerve compression in the area by the ribcage.

Warning Signs & Symptoms

Symptoms usually include pain that is dull and constant. The pain also may be described as sharp, stabbing, tearing, spasmodic, tender, aching or gnawing. Many patients report feeling as though the pain has wrapped around their upper chest like a band.

Those suffering from intercostal neuralgia may experience pain during sudden movements involving the upper chest, such as breathing, sneezing and laughing. Other symptoms include pain in the back, and pain in the side of the ribs, as well as numbness, tingling and shooting pain that extends to the back. In some patients, neuralgia can cause severe, debilitating pain that makes it difficult to move and breathe. If you are experiencing unexplained, severe pain in your rib cage, chest pain, difficulty breathing, or severe shortness of breath, it is important to seek immediate medical care.

Possible Risk Factors

Injury and inflammation of the nerves, muscles, cartilage and ligaments in the rib cage and middle spine area can cause this condition. Other causes may include pregnancy, chest or rib injury, surgery and viral infections such as shingles.

Tests to Diagnose Chest Wall Pain/Intercostal Neuralgia

Any chest wall pain, whether experienced by itself or with other symptoms, should be evaluated by your healthcare provider.

Treatment Options

Thoracic procedures such as intercostal nerve blocks can be used. During the treatment, a local anesthetic or corticosteroid is injected around the affected nerves. This blocks the nerve, which in turn relieves pain.

Non-steroidal anti-inflammatory drugs (NSAIDs) may be used to help reduce inflammation and pain. These include over-the-counter medications such as ibuprofen and naproxen.

Radiofrequency Lesioning is also a good option if the nerve blocks are helpful, but are not long-lasting.


Neuralgia is easier to prevent than to treat. The prevention of this condition includes:

  • Maintaining an active lifestyle
  • Preventing herpes infection
  • Proper nutrition
  • Limiting smoking and alcohol
  • Strengthening the back muscles
  • Exercise