The period of bearing a baby is very difficult for a woman’s body. All possible resources are used, which does not always have a beneficial effect on the health of the expectant mother. Intercostal neuralgia during pregnancy is a common occurrence, as a temporary transformation of the spinal column occurs with a change in posture.
To ensure that intercostal neuralgia during pregnancy does not become a reason for loss of performance in the future, it is necessary to take timely measures to treat this condition. Read about which doctor to consult, how to prevent damage to the autonomic nervous system, and what should be done if pain occurs. The article provides reliable information about the symptoms and treatment of intercostal neuralgia during pregnancy, talks about the potential causes of the development of this pathology and possible complications in the future.
It is important to understand that all changes occurring in a pregnant woman’s body can be harmful to her health. Therefore, it is important to constantly be under the supervision of a doctor and strictly follow all his instructions. If any unpleasant sensations appear in the musculoskeletal system, you should immediately make an appointment with a vertebrologist, neurologist or orthopedist. Only these doctors will be able to develop an individual treatment plan for the identified pathology.
In Moscow, if you have chest pain, you can make an appointment with a vertebrologist or neurologist at our manual therapy clinic. Experienced doctors work here. We accept women after the 30th week of pregnancy. We develop individual courses of therapy and preparation for childbirth.
Causes of intercostal neuralgia during pregnancy
Intercostal neuralgia during pregnancy develops for a number of reasons. In the first place is a gradual but permanent deformation of the spine. Normally, by the end of the first year of life, a person has fully formed 4 main physiological curves of the spinal column. They are necessary to ensure uniform distribution of shock-absorbing and mechanical loads. Also, lordosis and kyphosis provide balance to the body when walking upright.
During the development of pregnancy, due to the growth of the uterus, a gradual straightening of the lumbar lordosis occurs. The physiological curvature is smoothed out and, to compensate, the thoracic kyphosis is strengthened and the cervical lordosis is smoothed. Thus, by approximately 25–28 weeks of pregnancy, a woman’s spinal column takes on the appearance of an almost even structure. Physical activity is largely compensated by the increased tone of the muscular frame of the body. But gradually this becomes insufficient and pathological changes begin.
The main reason for the development of intercostal neuralgia during pregnancy is a woman’s refusal to use a prenatal bandage. In second place is the physical unpreparedness of the body to bear an unborn child. This is expressed in the weakness of the muscular frame, the presence of problems with degeneration of the cartilage tissue of the intervertebral discs, and insufficient performance of the circulatory and cardiovascular systems.
The human spinal column is not only a supporting structure that provides mobility of the body and attachment of the upper and lower extremities. Inside the spinal column is the spinal canal. There is the most important part of the autonomic nervous system - the spinal cord. It ensures the performance of the whole body, all internal organs, sensitivity, muscle contractility, etc. With pathologies of the spinal cord and the radicular nerves extending from it, not only paresis and paralysis develop, but also difficulties arise in the functioning of the internal organs of the abdominal cavity and chest. Arrhythmia, breathing problems, spasms in the intestines and biliary tract, etc. may occur.
The spinal canal is formed by the vertebral bodies and their arcuate processes. The stability of the position of the vertebral bodies is ensured by the intervertebral cartilaginous discs separating the vertebral bodies. The natural curves of the spinal column are necessary to ensure that the intervertebral discs are not subject to excessive shock-absorbing load and that they do not lose their elasticity and normal height.
The radicular nerves extend from the structures of the spinal cord. They are paired and are responsible for a specific segment of the body. In the thoracic region of the spinal column, radicular nerves arise, the branches of which are responsible for the innervation of the intercostal muscles.
This is part of the respiratory muscles, due to the contraction and relaxation of which inhalation and exhalation occur. Impulses pass through the structures of the spinal cord from the respiratory center in the brain. They give commands to the intercostal muscles depending on the concentration of carbon dioxide and oxygen in the circulating blood.
Intercostal neuralgia is a pathology in which the process of transmission of nerve impulses through the respiratory intercostal muscles is disrupted. The main reasons for its development during pregnancy can be:
- poor posture and displacement of the vertebral bodies, resulting in compression of the dural membranes of the spinal cord and radicular nerves;
- the height of the intervertebral discs decreases and their shock-absorbing ability is lost due to the high level of female sex hormones in the blood;
- gradual deformation of the chest occurs, including due to an increase in the vital volume of the lungs;
- the load on the costovertebral joints increases due to an increase in the total weight of the pregnant woman;
- There is a deficiency of microelements and vitamins responsible for the functioning of the nerve fiber.
Potential risk factors may include:
- excess body weight of a pregnant woman, including that associated with fluid retention and the development of edema syndrome;
- violation of metabolic processes;
- hard physical labor;
- refusal to use a prenatal bandage;
- back injuries;
- viral infections (including herpetic form);
- improper organization of sleeping and working spaces;
- wearing high-heeled shoes;
- multiple and polyhydramnios pregnancy.
An experienced physician should rule out all potential causes and risk factors at the time of making an accurate diagnosis. The success of future treatment depends on this.
Symptoms of intercostal neuralgia during pregnancy
The clinical picture usually develops very quickly. When making any movement of the body, a woman feels a lumbago in the intercostal space. Further mobility becomes difficult.
Gradually, the clinical symptoms of intercostal neuralgia during pregnancy subside, but they reappear when making any movement. Characteristic signs of the disease are:
- pain in the intercostal space (increases when turning the body or palpating the muscle);
- difficulty taking a deep breath;
- stiffness of movement, inability to tilt to the side or turn to the side;
- lag of the chest on the affected side during breathing.
If symptoms of intercostal neuralgia appear during pregnancy, then you need to make an appointment with a neurologist or vertebrologist as soon as possible. The doctor will conduct an examination and make a preliminary diagnosis. While carrying a baby, exposure to X-rays, MRI examinations, etc. should be avoided whenever possible. Therefore, you should carefully choose a doctor. The specialist must have extensive practical experience in order to make the correct diagnosis without additional examination methods.
Diagnostics
With classic manifestations, the diagnosis of intercostal neuralgia is not difficult (for example, with the consequences of herpes zoster). But given the possibility of pain in the rib area due to numerous diseases, it is often necessary to conduct a thorough examination. The diagnosis of intercostal neuralgia can be made based on the patient’s history of complaints (nature of pain, localization, intensity, duration of pain, presence of irradiation, increased pain with body movements), external examination (presence of spinal deformities), presence of pain on palpation in the area of attachment of the ribs to the sternum or paravertebral points in the thoracic spine. If it is necessary to differentiate with the cardiac nature of pain, an ECG is necessary. To identify degenerative changes in the spine, instrumental research methods such as radiography, CT, and MRI are used. In addition, densitometry is necessary to diagnose osteoporosis. EMG can be used to determine the extent of nerve fiber damage. Laboratory tests and ultrasound may be ordered to diagnose both rheumatological diseases and endocrine disorders or kidney diseases. The approach to diagnosing intercostal neuralgia should be based on the exclusion, first of all, of somatic causes of pain (heart disease, kidney disease, endocrine diseases).
What to do for intercostal neuralgia during pregnancy
If intercostal neuralgia appears during pregnancy, the first thing to do is to give up the idea of using medications. The pain syndrome can be quite severe. But you need to understand that almost all painkillers are contraindicated during pregnancy. Moreover, they do not have any therapeutic effect, but only relieve pain for a while. Therefore, you should not risk your health and your future baby. Do not self-diagnose or treat. If you experience chest pain, consult a neurologist.
If your period is more than 30 weeks, then you can find a manual therapy clinic and seek help there. At this stage, it is already possible to use various methods of manual therapy to restore the normal state of the spinal column.
At home, you should try to rid yourself of any physical activity. If pain occurs, lie on your back on a flat, hard surface.
It is advisable to use a prenatal bandage. It partially relieves the load on the thoracic spine and compensates for the insufficient performance of the muscular frame of the back.
How to determine that it is neuralgia?
It may take some time from the moment a pregnant woman feels severe pain in the sternum until she consults a neurologist. It is, of course, in the patient’s interests to reduce this period as much as possible, but this is not always possible. The first thing to do is to rule out pain of cardiac origin. It is necessary to remember that heart pain most often occurs suddenly and passes quickly. In addition, it can be easily relieved (removed) with a validol tablet dissolved in the mouth.
An attack of intercostal neuralgia lasts much longer. Sometimes the pain does not leave a woman during the day and increases significantly with physical activity. Often with neuralgia, you can find a body position in which the pain will go away, however, it is not always possible to stay in it for a long time.
Treatment of intercostal neuralgia during pregnancy
Before treating intercostal neuralgia during pregnancy, it is necessary to conduct a thorough differential diagnosis. Then the doctor must eliminate the negative impact of all potential causes of the development of this pathology.
Treatment of intercostal neuralgia during pregnancy is carried out without the use of drugs. Our manual therapy clinic uses a variety of safe and effective techniques for this purpose. Most of them can only be used after a woman reaches 30 weeks of pregnancy. A preliminary consultation with a doctor is required.
We develop an individual course for each woman, which may include the following types of influence:
- manual traction of the spinal column – helps restore the normal height of the intervertebral discs and ensure reliable protection of the radicular nerves and their branches;
- osteopathy - to improve the processes of microcirculation of blood and lymphatic fluid in places where nerve fibers are damaged, this starts the process of tissue restoration;
- massage – reduces the increased tone of the intercostal muscles, improves its condition and the degree of nerve impulse conduction;
- physiotherapy - helps speed up the healing process, improves metabolic processes at the cellular level;
- laser exposure helps normalize the condition of damaged tissues;
- Therapeutic gymnastics and kinesiotherapy improve the condition of all tissues, allow the woman’s body to prepare for childbirth, etc.
- The course of treatment for intercostal neuralgia during pregnancy can only be developed individually. The doctor takes into account the general condition of the patient, her age, and the presence of concomitant pathologies.
If you are concerned about such a disease, then we suggest you make an initial free appointment with a vertebrologist or neurologist in our manual therapy clinic right now. Fill out the doctor appointment form (located further down the page). The administrator will call you back and agree on a time convenient for your visit.
Consequences of intercostal neuralgia
Complications of poorly controlled symptoms vary depending on the severity of the disease. In any form, the disease must be examined by a doctor. Once the cause of neuralgia is identified, the doctor will prescribe treatment that minimizes the risk of complications. Here is the main list of consequences:
- Chronic chest pain, weakness and stiffness
- Low oxygen levels
- Pneumonia
- Postherpetic neuralgia
- Stopping breathing
- Spread of cancer
See also: Healing of bones after a fracture
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