What is Intercostal Neuralgia(ICN)?

Intercostal neuralgia can develop for a variety of reasons.  Finding an effective treatment will depend on exactly what is causing your pain.  Is the nerve being squeezed by bones or scar tissue?  Has the nerve been injured?  These are all questions that must be answered.






First the Anatomy

In human anatomy "costal" refers to the ribs and "neuralgia" refers to nerve pain.

Intercostal neuralgia refers to nerve pain that is felt between the ribs.

The Intercostal nerves are a set of nerves that run along the bottom edge of each rib. Each one is a branch off of the thoracic spinal nerves near where they exit the spinal canal.

Intercostal Nerve Branches

Each of the Intercostal nerves divides into branches that innervate different areas within the chest and abdomen.

Pain from the intercostal nerves is generally felt on only one side, and may wrap around your chest along the rib or ribs on that side.

The intercostal nerves run along the bottom edge of each rib.

Image thanks to Gray's Anatomy, via Wikimedia Commons


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May be worse with Rib Motion

The pain may be worse with motions or activities that cause the ribs to move.Things like deep breathing, laughing, or coughing may cause sudden sharp pain.

ICN Causes

Anything that irritates or inflames the intercostal nerves may cause intercostal nerve pain. This is not a common condition but may be caused by pregnancy, trauma, tumors within the chest, and surgery.

The intercostal nerves are normally well protected and ICN is not a common condition. However, anything that affects the chest wall may irritate the nerves and cause this type of neuralgia.

During Pregnancy

When you are pregnant if the baby is positioned so that it pushes up against your rib cage this may cause pressure and irritation of the nerves between the ribs.


Any injury to the chest wall may also injure the intercostal nerves. This may occur during contact sports such as rugby or football.

Also, with any type of accident such as a fall or motor vehicle accident, or during medical procedures such as CPR or the insertion of a chest tube. 

Rib Fractures

During traumatic events you may also fracture ribs which can be more painful than the intercostal nerve pain.

However, after the ribs heal you may notice the nerve pain if the intercostal nerves are damaged. 

Contact sports may cause
intercostal neuralgia.

Image thanks to Fabienkhan, via Wikimedia Commons


Tumors within the chest cavity may put pressure on the intercostal nerves that run along the bottom edge of each of your ribs. These tumors may be malignant or benign, but pressure on these nerves will cause pain. 

These growths may be from organs within your chest such as your kidneys or lungs or they may be within the chest wall itself, originating from the bones or muscles that form the chest wall.


Chest surgery is a common cause of ICN. Any surgery that requires the cutting of ribs risks injuring the intercostal nerves. 

ICN is an uncommon cause of pain but when it does occur it can be very severe and distressing.

It can be difficult to treat and most cases result in chronic pain that does not go away.

What is Intercostal Neuralgia? Ch 2
ICN Treatments



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