Psychosomatics of intercostal neuralgia
Intercostal neuralgia is often the name for a sharp, stabbing pain between the ribs that gets worse when you breathe in, turn or press on it. Most often the cause is in the muscles, rib cartilage or nerves, not the heart. But you cannot check chest pain yourself: with pressing pain, breathlessness and a cold sweat, call an ambulance. The Ladder method adds questions about what you hold inside, and it does not replace a doctor.
Updated
When to see a doctor
A GP is the first to check chest pain: they listen to your heart and lungs, do an ECG and, if needed, blood tests and an X-ray to rule out the heart and lungs. Then they may refer you to a neurologist. Do not give yourself a "neuralgia" label and treat chest pain at home.
In the Ladder method
In the Ladder method intercostal neuralgia is not explained as "you wound yourself up" or "it is just nerves". You are not to blame. A doctor checks chest pain first, and only a doctor can rule out the heart. Questions to yourself belong next to the check-up, not instead of it.
Read more
In the method the ribs fit the image of "a frame that takes the blow": where you tense up to survive a loss or a hurt, and do not let yourself breathe fully. It is an image, not the cause, and it does not replace treatment.
On the ladder this shows up as the steps "I have to hold on, I cannot fall apart" and "I am angry but I stay silent". You can work through them at your own pace alongside treatment.
These are questions for reflection, not an explanation of what causes the condition and not a treatment.
More: signs, medicine, sources, questions
How it shows up
Book a doctor’s appointment if you notice:
- Sharp, stabbing or burning pain between the ribs
- Pain worse when breathing in, coughing or turning
- Pain gets worse when you press on the spot
- Usually on one side
- Tingling or numb skin along a rib
- Pain started after exertion, a cold or stress
What medicine knows
The NHS says most chest pain is not related to the heart. A stabbing pain between the ribs can come from tense muscles, inflammation of the cartilage that joins the ribs to the breastbone (costochondritis), or irritated nerves between the ribs. The pain often gets worse with a deep breath, coughing, turning your body or pressing on the sore spot.
Other causes give a similar pain. If there is tingling or burning skin near the pain and a rash in a band appears a few days later, it may be shingles. Chest pain also happens with a panic attack and with severe stress.
Costochondritis, according to the NHS, usually goes away by itself in a few weeks. Painkillers from a pharmacy, warmth and resting from movements that make it worse help. It is important not to confuse it with the heart, so the first time you get such pain, show it to a doctor.
Heart pain cannot be told apart "by feel". Pressing, squeezing pain that spreads to your arm, neck, jaw or back, with breathlessness, sweating or feeling sick, is a reason to call an ambulance straight away, not to wait.
Sources
Frequently asked questions
How can I tell intercostal neuralgia from heart pain?
You cannot do it reliably yourself. Pain that gets worse when you breathe in, turn or press on it more often comes from muscles and ribs, but pressing pain with breathlessness, sweating or spreading to the arm and jaw needs an ambulance (NHS). Always show chest pain to a doctor the first time.
What does intercostal neuralgia mean in psychosomatics?
There is no proven "meaning". In the Ladder method it becomes a reason to ask yourself what blow you are bracing against and why you do not let yourself breathe. It is a question to yourself, not a diagnosis.
Can pain between the ribs come from stress?
Stress and anxiety can increase muscle tension and chest pain (NHS). But a doctor first rules out the heart, lungs and shingles, and only then does it make sense to think about stress.
Related topics
Psychosomatics does not replace tests and treatment. Only a doctor can make a diagnosis.