What injections to give for intercostal neuralgia

Types of procedures

In the process of treating osteochondrosis, the following types of manipulations are practiced:

• Intramuscular injections.
• Intravenous injections.

• Subcutaneous injections.
• Drug blockades.

Intramuscular injections

Through intramuscular injections, medications are injected into any of the large muscles of the body: buttock, thigh, shoulder. This type of procedure is in demand for administering a substance in small quantities. In addition to the muscle fibers themselves, muscles also contain elements of the circulatory and lymphatic systems of the human body. Therefore, the active substance administered intramuscularly enters the bloodstream in a short time, beginning to act. The duration of exposure is ensured by the gradual entry of the drug into the blood. For the best result of the manipulation, the patient should relax tense muscles.

Rehabilitation doctor Sergei Nikolaevich Agapkin will teach you how to give injections to yourself:

httpv://www.youtube.com/watch?v=embed/vQvBzRT3Ajk

Intravenous injections

Intravenous injections, which are given for osteochondrosis, are characterized by the fact that the drug is injected into the blood vessel itself - the vein, i.e. it immediately enters the bloodstream and is quickly delivered to the affected area

When carrying out this manipulation, special attention is required to comply with hygienic measures for treating the hands of medical staff, as well as the place where the medicine is administered. Typically, injections for osteochondrosis are placed in a vein located in the cubital fossa, i.e.

the middle vein, formed at the junction of the ulnar saphenous and radial vessels.

Subcutaneous injections

Directly under the skin of a person there is a layer of fat, which is penetrated by a large number of small blood vessels. When the drug enters them, it almost immediately enters the bloodstream and begins to act. Subcutaneous manipulation in the treatment of osteochondrosis can be performed in the following areas.

1. Upper shoulder region.
2. Axillary part.

1. Subscapular region.
2. Side of the abdomen.
3. The anterior surface of the femoral region of the leg.

The preparatory stage for a subcutaneous injection does not differ from the preparation when other injections are given for osteochondrosis of the lumbar spine, as well as the thoracic and cervical spine. However, the injection itself should be fundamentally different. In any of the places indicated above, a small amount of skin is grabbed in the form of a fold and the drug is injected. At the same time, the nurse is faced with the task of minimizing the possibility of damaging blood vessels and nerve roots. Manipulations cannot be carried out in a place where there is swelling of the subcutaneous fatty tissue or a compacted area of ​​tissue that is formed due to incompletely absorbed medication from a previously performed procedure.

Drug blockades

With the help of medicinal blockades used to treat osteochondrosis, excessive muscle strain is relieved, spasms of blood vessels are eliminated, swelling is reduced, inflammatory processes are stopped, and pain is relieved. Two types of blockades are practiced:

• Paravertebral blockade means that with the help of several injections, active substances are introduced into the area where the nerve roots of the spinal column exit. As a result of the manipulations, the receipt of nerve signals that arrive due to compression of the roots is prevented. In this way, a sick person is relieved of pain.
• An epidural block is characterized by the fact that an injection is placed in the epidural space, which surrounds the spinal cord. Whether the procedure will be effective depends on what kind of substance is administered.

Neurologist Konstantin Sergeevich Susorov shows how paravertebral blockade is done:

httpv://www.youtube.com/watch?v=embed/LUjft1L3O6A

Blocking injections are given using combinations with NSAIDs, glucocorticosteroids (Dexamethasone, Hydrocortisone), antispasmodics, or one anesthetic drug (Novocaine, Lidocaine).

In the following cases, treatment with blockades cannot be carried out:

• The presence of pustules on the human body.
• The patient has a significant change in the anatomical structure of the spine, which makes the blockade impossible from a technical point of view.
• The patient has an individual intolerance to anesthetic drugs.

Spine pathologies

Complex and related drugs

In addition to eliminating pronounced symptoms, treatment aims to restore nutrition to nerve receptors, ensure motor activity, and eliminate the cause of the disease.

Vitamin therapy

B vitamins have a good effect on nerve fibers. Most often they are taken as injections (Milgama). Medicines work comprehensively: they relieve pain, relieve spasms, and restore the penetrating ability of nerve fibers. Eliminate numbness and restore sensitivity.

Sedatives

Severe painful attacks with intercostal neuralgia are often accompanied by nervous breakdowns, emotional disturbances, insomnia, and unmotivated anxiety. To restore psycho-emotional balance, you can take sedatives.

The disease can be treated with various ointments:

• analgesics are contained in Fastum gel, Voltaren, Ketonal, Finalgon, Traumeel;
• improve regeneration and blood circulation with the help of Capsicam, Fenalgon, Apizatron, Viproxal;
• The chondroprotector Chondroxil restores the mobility of the spine.

All ointments are applied to the painful area and rubbed in gently.

When are injections prescribed?

Injections for the treatment of osteochondrosis are used during an attack of pain during the first days of the acute period. The doctor may recommend injections if signs of osteochondrosis of the lumbar, cervical or thoracic spine appear. The patient should understand that this treatment method aims to relieve the severe symptoms of the disease, but does not affect or eliminate the cause of its occurrence. Therefore, after several procedures, the doctor usually prescribes medications to the patient in the form of tablets and external use to continue treatment.

Drug treatment

Treatment of pathology begins with the elimination of pain and other pronounced symptoms.

Anesthesia

1. Non-steroidal anti-inflammatory drugs will help to anesthetize and reduce the inflammatory process that inevitably accompanies neuralgia: Ketoprofen, Ibuprofen, Diclofenac, Nice, Naproxan, Celebrex. These drugs are a modern and practically safe medicine for intercostal neuralgia. But taking these drugs for a long time is not recommended due to side effects.
2. You can take analgesics to relieve pain. Taking Sedalgin, Panadol, Tylenon, Pentalgin tablets helps prevent the occurrence of new attacks.

Some drugs can be taken in tablet form; injections or droppers are prescribed to enhance the effect.

1. For sufficiently severe pain, paravertebral blockades are effective. They are carried out only in medical institutions. Lidocaine, Diclofenac, Hydrocortisone, Novocaine show good results.
2. Ointments containing bee or snake venoms cope quite well with pain. These drugs have a number of contraindications; people who are intolerant to poisons especially need to be careful.

Relieving muscle spasm

During the disease, the muscles located next to the damaged nerve spasm and are in good shape. Without eliminating this pathology, it is impossible to reduce inflammation and completely get rid of pain. The following groups of medications cope with this task:

1. The muscle relaxants Tizanidine, Clonazepam, Mydocalm quickly solve this problem. Since this group of drugs affects the nervous system, Mydocalm can only be taken under medical supervision.
2. Antispasmodics are safer. Besalol, Halidor, No-shpa, Papazol can be taken without fear of severe complications. Both tablets and injections are effective.

What injection medications exist to relieve back pain?

Today, in the treatment of acute pain in the lumbar region and back, medicine finds new principles and algorithms than 50 years ago. The main emphasis in the fight against pain is on eliminating pain with the help of NSAIDs - non-steroidal anti-inflammatory drugs that suppress inflammation and reduce pain, as well as muscle blockades.

And after the removal of severe spasms, it is recommended to refuse to immobilize the patient, that is, to conduct physical therapy exercises and perform massage. Most doctors insist that a person during back pain syndromes should not limit his activity as much as possible.

It has also become popular and effective to prescribe combined vitamin complexes that can have a moderate analgesic effect, these are vitamins B12, B6, and B1. It is believed that vitamin B12 has a more significant analgesic property. Why these particular vitamins?

Recently, these drugs have begun to be considered in medicine as moderate analgesics, since they are neurotropic - they normalize the innervation of muscles, participate in the transmission of excitation, in the metabolism of mediators, influence metabolism, processes in the nervous system, and promote the restoration of damaged nerves.

Over 90 different studies have proven that the use of B vitamins in clinical practice led to a significant reduction in pain in the acute phases of inflammation in complex treatment. Therefore, they can be used either individually or in the form of complex preparations of B vitamins.

Most complex drugs in this group contain the anesthetic lidocaine, which enhances the local analgesic effect. However, it should be remembered that the use of this group of vitamins makes sense only for acute pain in the back, joints, alcoholic polyneuropathy, myasthenia gravis B12 for 10-14 days, and for chronic recurrent diseases they become ineffective.

In cases where painkillers do not help, specialists can offer the patient a method of injections and stretching. It is as follows: after the patient lies on his stomach, the most painful seals or points where the pain is most intense are found in the muscles, and an injection with a novocaine solution is made exactly perpendicularly.

Immediately after the injection, passive stretching of the muscle is performed, after which a hot compress is placed on this place. Then, when the compress is removed, the patient should make active movements, exposing the painful muscle to maximum movement.

The purpose of the novocaine blockade is to “turn off” the nerve. Therefore, the injection points should be as close as possible to the exit points of the nerves, for example, sciatic - at the greater trochanter of the femur, for intercostal neuralgia - in the corresponding intercostal space, for osteochondrosis - at the outer edge of the extensor of the back, etc. It is also advisable to carry out epidural blockades for chronic pain syndrome, for example, for herniated intervertebral discs.

Below is a list of medications prescribed by your doctor according to indications. Only a doctor determines the advisability of using B vitamins, NSAIDs, muscle relaxants, and chondoprotectors. The information below is for informational purposes only; the course of treatment and dosage is determined by a specialist.

Myoton

Some pain-relieving ointments for neuralgia, containing poisons or synthetic chemical components, can cause allergic reactions in the body. Therefore, patients with hypersensitivity to the use of the drug Myoton, which contains only plant substances, are recommended. This ointment is also highly effective and eliminates pain in a short time. Myoton increases blood circulation in the area of ​​application, relaxes muscles and warms up tissues.

The use of external agents for neuralgia should be agreed with the attending physician. Some ointments have contraindications and can cause side effects, so before applying you should carefully read the instructions included with the drugs.

What ointment to use for intercostal neuralgia? This question is often asked by those who are faced with such an unpleasant and painful illness. Intercostal neuralgia is a very unpleasant pathology that develops along the intercostal nerve, as a result of its irritation or compression. Most often, older people experience this disease, but it is rare in children and young people. For this problem, treatment involves eliminating the cause that provoked the disease, for which ointments and tablets are used. Which ointments are more effective for intercostal neuralgia?

When your back or joints hurt, injections of B vitamins should help

B vitamins can also be taken in tablet form, but naturally, intramuscular administration of drugs is considered more effective. Let's consider what drugs of this group exist on the modern pharmaceutical market, their general indications, contraindications, side effects, methods of use and comparative prices in pharmacies:

Features of the use of ointments for intercostal neuralgia

Treatment of intercostal neuralgia with ointments, gels, and creams has a number of positive aspects. These include simplicity and ease of use, economical consumption of the drug, achieving the expected result in the shortest possible time, accessibility to all segments of the population, elimination of disease symptoms and pain.

An important point in the treatment of neurological pathology is strict adherence to the instructions from the manufacturer attached to the drug, recommendations, prescriptions of the attending physician, bed rest during an exacerbation of the disease on a sufficiently elastic and hard mattress, and the mandatory exclusion of drafts. Also, after applying ointments, it is recommended to wrap the inflamed areas of the back and chest with warm items of clothing, accessories in the form of shawls, scarves. Proper treatment with external agents for intercostal neuralgia is the key to achieving a positive result, returning to a normal lifestyle as soon as possible, and also helps prevent the risk of relapses. The timing of use of ointments is determined by the attending physician.

Immunostimulants

Intercostal neuralgia can be caused by viral diseases. In this case, therapy is carried out with drugs that increase immunity:

Timalin . Stimulates the growth of lymphocytes, strengthens the immune system. Contraindications: pregnancy, asthma, hypersensitivity to the drug. Cost: liof. for standard solution 10 mg – 440 RUR/pack.

Cycloferon .
Effective against viral and bacterial infections, prevents tumor growth. Contraindications: liver cirrhosis, pregnancy, breastfeeding, age under 4 years, hypersensitivity to the drug. Cost: solution for 12.5% ​​2 ml – 357 RUR/pack. Article on the topic: All about the treatment of thoracic chondrosis

Non-drug treatment

After relieving attacks with medications, it is recommended to use physiotherapy and various types of massage in complex therapy. Non-traditional methods such as acupuncture, hirudotherapy, and apitherapy are very popular. Various baths with herbs, salt, turpentine, and extracts of various plants are used in home and spa treatment.

Massage

httpv://www.youtube.com/watch?v=embed/oNx6LZMi2JQ

The procedure should be carried out by experienced specialists who know how to influence muscles and joints. A properly performed massage relaxes muscles, increases blood flow and tissue nutrition, releases pinched nerves, and has an analgesic and relaxation effect. Classic, acupressure, cupping hardware massage is used. At home, minor rubbing of tissues is allowed, without affecting the spine.

Physiotherapy

They are carried out during the period of remission. Contraindicated for people with heart problems, who have had a heart attack, diabetes and tuberculosis. Intercostal neuralgia can be treated using electrical muscle stimulation, electrophoresis, phonoresis, magnetic therapy, and darsonvalization. Many procedures are enhanced by the use of medications.

Treatment of intercostal neuralgia is a rather lengthy process. Without eliminating the causes of the pathology, it is impossible to guarantee stable remission. Therefore, further treatment combines preventive measures to prevent exacerbations and an impact on the underlying disease.

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Intercostal neuralgia is effectively eliminated with the help of heat and medicinal baths. Baths using oils with extracts of fir, rose or camphor are effective. The temperature of such a bath should not exceed 38 degrees; 4 drops of the selected oil are dissolved in milk. After a bath, it is not recommended to dry yourself so as not to reduce the therapeutic effect. Water procedures help with exacerbations or are used for prevention.

You can take a bath with the addition of sage and sea salt infusions. Such ingredients also help reduce pain and inflammation. The course of such therapy is 10-11 days. With such procedures, it should be taken into account that the bath is taken no longer than 15 minutes. If cooled water is diluted with hot water, the therapeutic effect may be neutralized. After the procedures, you need to immediately go to bed and dress warmly.

It is useful to perform acupressure after bath procedures. This does not require a medical specialty. You can use “Star” ointment. Massage procedures are carried out with minimal effort: soft circular movements are performed without pressure.

Rub the product in with both hands, with the thumbs positioned on the axis of the spine. If the patient feels a rush of blood, you need to perform such body movements with your palms, as if the blood is being driven to the legs. This indicates that during the massage it was possible to accelerate the blood flow.

You need to do gymnastic exercises during the day and morning. They should strengthen muscles and supply the spine with oxygen. A specialist helps you choose the most harmless exercises. During such exercises, the patient should not feel pain.

Diclofenac for intercostal neuralgia injections All about joints

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Among the many medications that have analgesic, antipyretic and anti-inflammatory effects on the human body, Diclofenac is especially popular among doctors and patients.

This drug, which is available in the form of tablets, rectal suppositories, syrup for oral administration, solution for intramuscular injection, patch and ointment for topical use, is widely used for the treatment of diseases of the musculoskeletal system.

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Diclofenac is also used in the complex treatment of diseases that are accompanied by fever and discomfort in the joints and muscles.

Features of injections - how to give Diclofenac injections, dosage

When a patient begins treatment with Diclofenac, in the first days of therapy this drug is often prescribed intramuscularly.

When performing an injection, it is important to choose the right place for administering the drug - injections can only be given into large areas of muscle tissue

httpv://www.youtube.com/watch?v=embed/qUOWTDOkvGg

Most often, the injection is performed in the outer upper quadrant of the buttock - a syringe with a volume of 5 ml or more with a long needle is suitable for the injection. When performing an injection, you need to insert the needle into the muscle and pull the syringe plunger towards you - this will help make sure that the needle does not enter a blood vessel.

It is advisable to change the direction of administration of the drug daily - inject alternately into the right and left buttock.

For an adult, it is recommended, regardless of the method of administration of the drug, not to exceed the daily dose of Diclofenac of 150 mg. If you calculate how many maximum injections can be given per day, then you need to rely on this figure.

The dose of the drug for children depends on the age and body weight of the patient (depending on the child’s condition, the drug is prescribed at a dose of 2 mg/kg of body weight), and the daily dose is divided into several equal doses.

The duration of drug treatment in each case is determined individually.

What injections are given?

Injections not only help relieve pain, but also have an anti-inflammatory and calming effect. They are popular due to the possibility of administering the drug directly to the site of inflammation and its rapid blockade. There are several options for injections, which differ in the way they affect the body. But in order to achieve maximum effect, it is recommended to combine all groups of drugs and combine them with local agents. The following names of injections for intercostal neuralgia are distinguished:

• anti-inflammatory;
• multivitamins;
• muscle relaxants;
• hormonal;
• painkillers;
• immunostimulating.

Each type is selected based on the situation and condition of the patient. For the first few days, only injection treatment is used, and after the pain has subsided, the drugs are administered through a dropper.

Nonsteroidal anti-inflammatory substances are used as symptomatic medications for intercostal neuralgia, because they are not able to eliminate the cause of the disease, but are effective antipyretics and analgesics. They suppress and stop the inflammation process, eliminate the accompanying symptoms.

Injections for intercostal neuralgia are given only under the strict supervision of the attending physician, since they have a wide range of possible side effects.

For example, treatment with NSAIDs may cause problems with the gastrointestinal mucosa, but even with severe damage they are not felt due to the action of the drug.

Side effects also appear in the form of:

• skin allergic reactions;
• slowing down hematopoiesis;
• nephrotoxicity;
• vascular disorders.

Such drugs are selected based on the physiological characteristics of the patient’s body.

A strong spasm causes an increase in muscle tone and leads to painful sensations not only during movement, but also in a calm state.

Therefore, to eliminate it, agents with an antispasmodic effect are used, aimed at relaxing the muscle fiber. Contraindications to their use are: pregnancy, lactation, childhood and allergies to the components of the drug.

The drugs are based on a derivative of the natural hormone - cortisol, the action of which is aimed at relieving inflammation and reducing tissue swelling. This hormonal drug is recommended for use for a short time (up to 14 days), because a longer period of use can cause complications:

• decreased immune system resistance;
• development of stomach ulcers;
• swelling of the limbs;
• increased blood clotting.

Neuralgia is a pathological condition in which peripheral nerves are affected, which causes severe pain in the area of ​​their innervation. Injections for neuralgia can eliminate pain and thereby improve the patient’s quality of life. Another method of treating the disease is taking pills. However, when an injection is performed, the active substance begins to act faster and relieve discomfort. This is the most popular parenteral method in medical practice (in this case, the medicine enters the body bypassing the gastrointestinal tract, which is an additional advantage of this approach to treatment).

Viprosal

This drug, presented in the form of an ointment, according to patients, very quickly copes with pain, and it is this that causes the greatest inconvenience to the patient in neuralgia. Thanks to the unique composition of the ointment, it has several effects on the body at once and easily copes with attacks of neuralgia. It contains viper venom, camphor oil, turpentine and salicylic acid. Each of these substances has its own effect, but together they are aimed at eliminating pain, activating the body’s protective functions and removing the causes that caused the malaise. But it is worth remembering that only complex therapy will help cope with such a diagnosis as “intercostal neuralgia.” Treatment at home with ointments is allowed only after consultation with a doctor, because Viprosal has a number of serious contraindications for use: pathologies of the kidneys and liver, exhaustion of the body, brain and coronary insufficiency, and others.

This is only a small fraction of those ointments that will help get rid of the pain and inflammation that accompany neuralgia. But it is better if the doctor selects the ointment, focusing on the causes of the pathology.

Indications and contraindications for injections

If a patient has any chronic diseases, this does not exclude the use of an injection method of treatment - either with a single drug or as part of complex drug therapy. For example, when sodium channel blockers are administered, anti-inflammatory and pain medications are prescribed. And for cervical neuralgia (cervical osteochondrosis), painkillers are prescribed, then anti-inflammatory and antispasmodic drugs.

Injections for intercostal neuralgia are recommended if the following symptoms occur:

• muscle spasms that make breathing difficult;
• restrictions on motor activity caused by pain;
• disturbances in the functioning of the cardiovascular system;
• painful sensations that occur during breathing.

Injection manipulation is indicated for symptoms of diseases of the cardiovascular system, high blood pressure, and bluish skin from muscle spasms.

Despite the effectiveness of the described method, it is not always possible to treat neuralgia with injections. They cannot be performed for the following diseases and conditions:

• infectious diseases;
• allergic reactions to certain medications;
• diseases of the hematopoietic system;
• chronic kidney and liver diseases;
• problems with the functioning of the gastrointestinal tract;
• treatment with drugs that prevent blood clotting.

In addition, there are contraindications that are caused by the drug directly used. Therefore, before using medications, you must read the list of contraindications in the instructions.

Efficacy, contraindications and side effects of NSAIDs

Painkillers, of course, are used only as symptomatic therapy; they help eliminate pain in the joints and back, but do not eliminate the cause of its occurrence; in addition, 50% of patients may experience various side effects.

In more than 50 studies aimed at identifying the best pain reliever, researchers found that not a single NSAID drug was more effective than other pain relievers, and some of them are very expensive drugs.

The only thing to pay attention to when choosing is that some generics (Russian diclofenac, for example) are significantly inferior in effectiveness to original drugs (European Diclofenac)

Also, these studies were aimed at identifying a drug with the least side effects. As a result, it was found that Ibuprofen is the least toxic of all NSAIDs.

The manufacturers of the new Cox-2 inhibitor, Celebrex, claimed that it had the least side effects, but studies did not find convincing evidence of this fact.

Therefore, when choosing a non-steroidal anti-inflammatory drug, you should remember that they have almost the same anesthetic properties, the same side effects, but different frequency, intensity, severity of side effects, harmful effects, and, not least important, different prices. For example, Meloxicam has less effect on the stomach and intestines than aceclofenac (Aertal)

Indomethacin gives a pronounced analgesic effect, but destroys cartilage with prolonged use and is now used less and less.

Moreover, doubling the dose does not reduce the intensity of pain, and in the case when one non-steroidal drug does not help (if it is not a fake), replacing it with another does not make sense. Moreover, based on research, we can also conclude that they are not much more effective than regular paracetamol. You can learn more about all ointments for back pain from our article.

Advantages and disadvantages

Advantages:

1. The speed of action of the drug due to its direct delivery to the affected area.
2. The effectiveness of the medicine, because it is not absorbed in the gastrointestinal tract and liver.
3. Duration of action of drugs when used in the form of a suspension or oil solution.

Flaws:

1. Pain and swelling at the injection site.
2. Possibility of infection at the injection site.
3. Injections are quite complex in their preparation and administration.

How does intercostal neuralgia manifest?

The main symptoms are severe pain along the nerve, extending into the chest. The pain can be aching, constant or sharp, causing an attack.

The pain may radiate to the sternum, under the shoulder blade. Neuralgia on the left causes pain in the heart area. Symptoms of nerve disease are often confused with manifestations of pathologies of the heart, stomach, and lungs. False diagnosis delays the treatment process.

The symptoms appear too pronounced, the attack may be accompanied by psycho-emotional disorders, stress, and as a result, increased blood pressure and angina. Since pain symptoms increase during inspiration, patients begin to breathe shallowly. Impaired ventilation of the lungs provokes congestion and cough. Sneezing and coughing cause a new attack, the symptoms become much worse.

Increased back muscle tone and inflammation are typical symptoms of radicular syndrome, which causes an attack of neuralgia. Along the course of the inflamed nerve, a burning sensation, coldness of the skin, and numbness may be felt. Redness of the tissues is observed.

In search of a cure for neuralgia, patients try to take an unnatural position in order to reduce the attack. Staying in a static position for too long increases the pain.

What is neuralgia disease?

Intercostal neuralgia is considered one of the most common diseases of the human nervous system.
It is characterized by constant or paroxysmal pain in the chest, more precisely, in the intercostal area. This disease has two characteristic features:

• neuralgia, as a rule, is accompanied by pain, which is felt along the affected nerves in the intercostal area, usually one or two, so the pain can acquire a girdling character;
• pain syndrome with intercostal neuralgia differs only in one-sided nature: symptoms appear only on the right or left side.

Despite the unilateral pain syndrome, the entire chest is nevertheless completely involved in the pathological process. Moreover, there is a direct connection between a person’s physical activity and the appearance of pain: the slightest movement intensifies the pain.

Painful sensations can also occur against the background of laughter or a strong cough, when breathing deeply or turning the body. Moreover, a protective spasm is formed in the muscles located in the chest, which in turn only intensifies the pain.

Consultation with a doctor is the very first stage of diagnosis when the first symptoms of intercostal neuralgia appear. The specialist, after carefully studying the images, prescribes tests and refers you to specific medical examinations. After this, treatment for neuralgia is prescribed. The patient is referred for consultation to specialists. Usually this is a neurologist or therapist.

Painful changes occurring in nerve fibers may appear for the following reasons:

• as a result of injury;
• after an infectious disease;
• from hypothermia;
• from a tumor;
• as a result of diabetes mellitus;
• with osteochondrosis;
• with atherosclerosis.

Depending on the affected areas, neuralgia occurs:

• intercostal - pain radiates to the heart area, under the shoulder blade, into the chest;
• neuralgia of the shoulder joint;
• postherpetic neuritis;
• lumbar;
• in the form of inflammation of the trigeminal sensory nerve of the face, which is called trigeminal neuritis;
• neuritis of the sciatic, ulnar or occipital nerve;
• femoral;
• neuritis of the pterygopalatine ganglion - in this case, the pain affects the neck, temples, and sometimes it spreads to the hands;
• foot neuroma or Morton's disease.

Intercostal neuralgia is nothing more than a pathology of the intercostal nerves of the thoracic region, associated with their damage or irritation as a result of compression or inflammatory processes. Compression can be a consequence of injuries or be of a compressive nature (for example, with excess weight, intervertebral hernia). Less commonly, the causes of the disease can be poisoning, disorders in the immune system or oncology.

There are cases when even children suffer from this disease, although the disease mainly affects older people. To prevent further development of the pathology and not suffer from attacks, it is recommended to consult a doctor. The specialist will prescribe a set of treatment procedures that effectively eliminate intercostal neuralgia. Treatment at home (subject to doctor's recommendations) is, as a rule, the main type of fight against the disease.

Choice of pain medications

For chronic pain, before prescribing an anesthetic, the doctor determines the causes and nature of chronic pain - referred, neuropathic or central, and prescribes appropriate treatment.

If the pain is acute, then the doctor determines the risk of side effects on the gastrointestinal tract, cardiovascular complications, if the risks are not great, and:

• no dyspepsia - then any NSAID
• If you have dyspepsia, it is better to use ibuprofen (or diclofenac, naproxen), nimesulide (or miloxicam)

If the risk of cardiovascular complications is high, then NSAIDs should be avoided and Paracetamol and opioids should be used. With a moderate risk, it is possible to prescribe nimesulide, subject to adequate correction of blood pressure (amlodipine, see drugs for lowering blood pressure).

If the risk of gastrointestinal bleeding is high, NSAIDs + definitely proton pump inhibitors (omeprazole). It is understood that taking NSAIDs in itself is a sufficient risk even with a single dose, so the standard is that all NSAIDs are taken in combination with proton pump blockers, regardless of the risks of gastroduodenal bleeding.

When the risks of gastrointestinal side effects and cardiovascular complications are combined - Nimesulide + acetylsalicylic acid + omeprazole.

If the pain subsides within 5-7 days, then continue treatment until it is completely relieved. If acute pain does not subside within a week, then muscle relaxants and local anesthetics are prescribed. Local administration of corticosteroids is possible if the diagnosis of tuberculosis of the joints or spine is excluded. If the pain is very severe and there is no effect from painkillers, the infectious nature of the pain should be excluded (tuberculosis pathology - consultation and examination at an anti-tuberculosis dispensary), joint pain due to gonorrhea, syphilis or other infection.

Nonsteroidal anti-inflammatory drugs (NSAIDs)

These drugs are widely used due to their wide range of applications in orthopedics, traumatology, rheumatology and other industries.

Indications for prescribing NSAIDs are the following diseases:

• radiculitis;
• intervertebral hernia;
• injuries and sprains;
• osteochondrosis;
• intercostal neuralgia.

Important! Double doses of these drugs do not reduce pain. Therefore, if there is no effect, you should choose a medicine from another group of drugs.

NSAIDs have many side effects, so be sure to consult a specialist (neurologist) before use.

Ketorol (Ketanov, Ketonal, Ketorolac)

The drugs have the same active substance – tromethamine ketorolac. The difference between these medications is the dosage. They should be used especially carefully by elderly people and people prone to allergic reactions to the components of the drugs.

Ketorol

Application: one dose of Ketorol is 10-30 mg, which is administered intramuscularly. The amount of substance administered depends on the weight, age, and condition of the patient. The maximum daily dose is 40-90 mg. The course of treatment should not exceed five days.

Contraindications:

• prohibited for persons suffering from asthma and cholecystitis;
• for disorders of the renal and excretory systems;
• stomach ulcer;
• pregnancy, lactation;
• children under 16 years of age.

Take with caution to people with liver and kidney problems, and nervous diseases.

Side effects:

• stomach diseases;
• nausea;
• diarrhea;
• headache;
• dizziness;
• drowsiness.

Price of drugs: Ketorolac – from 70 rubles, Ketorol – from 100 rubles, Ketanov – from 110 rubles, Ketonal – from 240 rubles.

Ketoprofen

The active substance Ketoprofen is contained in the following drugs: Ketoprofen, Flexen, Flamax, Artrosilene.

Ketoprofen

These are nonsteroidal anti-inflammatory drugs (NSAIDs) that effectively suppress pain in radiculitis, arthritis, ankylosing spondylitis, and osteoarthritis.

Application: intramuscular injections of 100 mg 1-2 times a day.

It is not recommended to use:

• children under 18 years of age;
• pregnant and lactating women;
• for kidney diseases;
• for gastrointestinal diseases.

Side effects:

• nausea, vomiting;
• headache;
• itchy skin;
• drowsiness.

Use with caution for diabetics, with edema and long-term treatment with NSAIDs.

Price of medicines: Ketoprofen - from 60 rubles, Flamax - from 120 rubles, Artrosilene - from 180 rubles, Flexen - from 190 rubles.

Diclofenac

The following types of drugs contain the active component: Diclofenac, Voltaren, Ortofen, Naklofen.

Diclofenac

It eliminates joint and muscle pain very well, but, unfortunately, the drug is not suitable for people with diseases of the stomach, kidneys, liver, or asthma.

Application: deep intramuscular injection 3-5 mg. Even one injection is enough to eliminate back pain. For serious diseases, the course of treatment is from 5 to 7 days, 1 injection per day.

Contraindications:

• children under 6 years old;
• peptic ulcers;
• pregnancy;
• kidney and liver diseases;
• asthma.

Before use, be sure to administer a small amount of medication to check the patient’s body for allergies.

Side effects:

• drowsiness;
• dizziness;
• irritability;
• digestive problems;
• nausea.

The cost of Diclofenac is from 11 rubles, which makes this drug accessible to all segments of the population.

Price of analogues: Ortofen - from 34 rubles, Naklofen - from 130 rubles, Voltaren - from 250 rubles.

Meloxicam

The following drugs contain the active substance Meloxicam: Meloxicam, Movalis, Revmoxicam, Amelotex, Artrosan, Mesipol.

Meloxicam

Meloxicam is a new generation NSAID. Therefore, it has few side effects. This is a very strong anti-inflammatory drug, it eliminates inflammation and pain. It is not recommended to use together with other types of non-steroidal drugs.

The medicine is effective for:

• Bekhterev's disease;
• arthritis;
• osteoarthritis;
• various back pains.

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Application: intramuscular injections are administered only for the first 3 days, 8 mg per day. The maximum dosage is no more than 15 mg per day.

Contraindications for use:

• asthma;
• stomach ulcer;
• age up to 15 years;
• pregnancy, lactation.

Side effects:

• nausea;
• constipation;
• dizziness and headaches;
• drowsiness.

Cost: Meloxicam – from 150 rubles, Arthrozan – from 270 rubles, Amelotex – from 370 rubles, Mesipol – from 400 rubles, Movalis – from 600 rubles, Revmoxicam – from 700 rubles.

Dexalgin

This popular painkiller contains the active ingredient Dexketoprofen. The medicine begins to act within half an hour, the pain goes away within 4-6 hours. The drug is prescribed for osteochondrosis, arthritis, toothache.

Dexalgin

Application: deep intramuscular injection, one injection - 2 ml by slow injection. Dexalgin is used for no more than two days.

Contraindications:

• stomach ulcer;
• Crohn's disease;
• asthma;
• kidney and liver diseases.

Side effects:

• heartburn;
• headaches, insomnia.

The drug is well tolerated when taken in the correct dosage.

Cost: Dexalgin – from 550 rub.

Xefocam

The active ingredient is Lornoxicam. It has a powerful analgesic effect. Helps with arthritis, arthrosis, headaches, post-operative and toothaches.

Xefocam

Application: intravenously or intramuscularly. The ampoule is diluted in sterile water for injections. The first dose is administered twice to relieve pain, and in the following days - one bottle 2 times a day. The maximum dose is 16 mg (2 bottles).

Contraindications:

• drug intolerance;
• kidney and liver diseases;
• asthma;
• stomach ulcer;
• age under 18 years;
• pregnancy and lactation.

Side effects:

• nausea, vomiting;
• stomach ache;
• allergy.

Cost: Ksefokam – from 720 rub.

Texamen

Tenoxicam is the active ingredient found in this medication.

Texamen

It effectively copes with inflammation and pain in the following diseases:

• osteoarthritis;
• injuries;
• myositis;
• rheumatoid arthritis.

Application: intravenously or intramuscularly. The dose is selected individually, but not more than 20 mg per day. Inflammation disappears by the end of the first week of treatment.

Contraindications:

• stomach ulcer;
• gastritis;
• liver and acute renal failure;
• age under 18 years;
• pregnancy and lactation.

Side effects:

• vomiting, nausea, flatulence;
• increased blood pressure;
• drowsiness;
• dizziness;
• noise in ears.

Cost: Texamen – from 300 rub.

Muscle relaxants

Most of the pain is based on muscle spasm, which itself tightens the nerve root and causes secondary radicular syndrome, so in many cases muscle relaxants are prescribed as an anesthetic:

• Tolperisone - peripheral action, Mydocalm (instructions for use, tablets, injections 30 tablets of 50 and 150 mg 300-400 rubles), Tolperisone 30 pcs. 150-200 rub.
• Hydroxyzine - central with inhibition of the central nervous system, suitable for severe pain, Atarax 25 pcs. 300 RUR, Hydroxyzine 25 pcs. 200 rub.
• Baclofen is also centrally acting, Baklosan.
• Tizanidine - central action, Sirdalud (2 mg. 30 pcs. 230 rub., 4 mg. 30 pcs. 330 rub.), Tizanil (2 mg. 30 pcs. 170 rub., 4 mg. 30 pcs. 250 rub.), Tizalud (2 mg. 30 pcs. 140 rubles), Tizanidine 4 mg. 30 pcs. 150-200 rub.

Chondroprotectors

Special preparations intended for the treatment of degenerative-dystrophic diseases of the musculoskeletal system. They slow down the process of cartilage destruction, start the regeneration process, and reduce pain levels. Chondroprotectors are divided into several generations: first, second and third generation drugs.

• "Rumalon" is a first-generation chondroprotector, which contains glycosaminoglycan - a peptide complex that is synthesized from the bone marrow and cartilage of young calves. Indications for the use of Rumalon are various dystrophic pathologies of the joints: arthrosis, spondyloarthritis, trauma, as well as the rehabilitation period after surgery. The drug enhances the production of the synovial membrane of the joint, thereby improving lubrication and gliding of articular structures and improving metabolism in cartilage.
• "Alflutop" is a drug containing a bioactive concentrate obtained from small marine organisms. This medicine contains the active ingredient chondroitin sulfate, a mineral complex, amino acids and peptides. It has a restorative effect on the cartilage tissue of the joint.
• "Artradol" is a medicine containing the active substance chondroitin sodium sulfate. Used for arthrosis, osteoarthrosis of large joints, osteochondrosis. Artradol has a pronounced anti-inflammatory and analgesic effect, helps improve the mobility of the joint capsule, normalizes calcium-phosphorus metabolism in cartilage tissue and starts the process of its regeneration.
• "Dona" is an injection solution that is used for osteoarthritis, osteochondrosis, and osteoarthritis. The drug has an analgesic and anti-inflammatory effect, enhances the production of hyaluronic acid in the joint membrane, regulates calcium metabolism, and stops the process of cartilage destruction.
• "Chondroxide" - contains sodium chondroitin sulfate, has a pronounced anti-inflammatory, analgesic and regenerating effect on the joint, helps improve the mobility of the patella, eliminate stiffness and swelling.
• “Chondrolone” is a medication that helps improve metabolism in cartilage tissue, enhances cartilage regeneration, and stops destructive processes. Chondrolon also improves lubrication of the articular surface, which helps eliminate stiffness and crunching in the joint.

Treatment of intercostal neuralgia at home

If the patient is diagnosed with “intercostal neuralgia” and has already received all the necessary assistance in the hospital, then he is sent for home treatment. Neuralgia takes a long time and is difficult to treat, therefore, while following all the doctor’s recommendations, it is also necessary to visit him regularly in order to make adjustments to the therapy. At home, having previously agreed on all procedures with the doctor, you can carry out therapy using the following methods:

• use warming and pain-relieving ointments;
• traditional medicine;
• use home devices for physiotherapeutic procedures, for example, Darsonval or magnetic therapy devices;
• massage.

In combination, such treatment will give good results, and pain will not bother you.