Intercostal pain syndromes involve pain emanating from the chest wall, ribs, muscles, joints, and commonly intercostal and subcostal nerves. A thorough history is vital as physical exam may not be very revealing. The history should include any history of trauma to the region, surgery (cardiac, pulmonary, thoracic), and medical conditions such as diabetes mellitus, herpes zoster, and arthritis. In patients where there is no significant medical history and who have complaints of burning-type pain, one should consider the diagnosis of intercostal neuralgia. Intercostal neuralgia is usually a diagnosis of exclusion. A majority of patients who have intercostal neuralgia first seek medical attention because they think they are having cardiac issues such as a heart attack. Any of the intercostal nerves may be involved presenting with pain that is constant and burning in nature.
Keywords
- Rib pain
- Chest wall pain
- Herpes zoster
- Radiating pain
- Burning pain