Intercostal neuralgia

Intercostal neuralgia is a neuropathic pain which affects the area under your ribs and may be caused by a number of different conditions. Patients experience strong pain in the ribs, breast or upper abdomen.

Pain is the main symptom of intercostal neuralgia and is usually experienced as a ribbon wrapped around your breast or abdomen. The pain may be constant or episodic and you may experience numbness and tingling along with it. It may last long after the condition itself has subsided and be:

  • Sharp
  • Blunt
  • Irradiating (spreading out)
  • Burning
  • Stabbing

Pain caused by intercostal neuralgia may get worse during things like jumping, coughing or sneezing. You may also feel it when breathing in or out or as a localised pain in your shoulder blade, back or groin.

Intercostal neuralgia is caused by injury and inflammation of the nerves between the ribs, which spread out from the spinal cord and pass under your ribs.

Post-thoracotomy pain syndrome (PTPS) occurs following a thoracotomy, which is a surgical incision between your ribs, usually during a procedure to gain access to your lungs or heart. The cut may cause injury to the nerve in between the ribs, which may be the cause of the pain.

Around 50% of people who have a thoracotomy get PTPS. About 30% still have pain four to five years after the operation. In most people, the pain is slight and doesn’t get in the way of their everyday lives.

Postherpetic neuralgia. This is a complication of herpes zoster if you’ve ever had chickenpox. Once you’ve had it, the virus stays in your body for the rest of your life. It may become active again and cause herpes zoster if your immune system gets weaker. This may happen due to ageing or if you take medication to suppress your immune system.

Postherpetic neuralgia is a chronic condition which may continue on long after the herpes zoster has cleared up. Between 30% and 60% of people aged 60 and over with herpes zoster will get postherpetic neuralgia.


Traumatic injuries may cause damage to the nerves between your ribs, which may lead to intercostal neuralgia.

Medical procedures

You may get intercostal neuralgia following medical procedures such as placement of a chest type, mastectomy or other chest operation.

Other causes

Other conditions may also cause intercostal neuralgia, such as:

  • Pregnancy
  • Abnormal growths
  • Compression of the nerves (pinched nerve)
  • Infections
  • Swelling