When a patient is experiencing rib pain (pain along the rib cage), discomfort when breathing and/or coughing, and torso pain interfering with their day-to-day activities, they may have the rare condition intercostal neuralgia.

Some of the causes of intercostal neuralgia include:

  • Chest or rib injury, such as a broken rib or bruised chest
  • Intercostal nerve entrapment
  • Nerve degeneration
  • Neuritis, which is inflammation of a nerve or group of nerves
  • Pregnancy, which can cause the rib cage to expand
  • Pulled or strained muscle in the chest wall, shoulders, back or arm
  • Rib infection
  • Shingles (reactivation of the varicella zoster virus)
  • Surgery on organs, bones and tissues in the thoracic cavity, such as kidneys, ribs and spine
  • Tumors in the chest and abdomen, which can press on the intercostal nerves

It is very important that a patient informs their primary care physician of their torso pain so that cardiac disease, chest malignancies, or pulmonary conditions may be ruled out.

Intercostal neuralgia may resolve on its own or it may require treatment. There are two treatment approaches that Dr. Lipson recommends for this condition:

  • Nonsteroidal anti-inflammatory drugs, such as ibuprofen, naproxen, and indomethacin. NSAIDS help reduce inflammation and rib pain.
  • Intercostal nerve blocks, which are injections of a local anesthetic or a corticosteroid around the affected intercostal nerve

Some patients may experience relief from pain for 6-12 months, and in some cases indefinite relief is possible.


Dr. Ana Lipson
Lipson Pain Institute
210 1st Street South
Winter Haven, Florida 33880
(863) 293-4800


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