What is intercostal neuralgia? Intercostal neuralgia is a rare condition that causes pain along the intercostal nerves. Intercostal nerves are located between your ribs. Ribs are long, slender bones that curve around your chest to create your rib cage. The top 10 ribs on both sides of your body attach to your thoracic (midback) spine and breastbone (sternum). The bottom two ribs attach to your spine, but not to your breastbone. These ribs are sometimes called the “floating” ribs. The intercostal areas between the ribs contain muscles and nerves. These intercostal nerves can become damaged or inflamed due to a variety of diseases, disorders and conditions, resulting in intercostal neuralgia. Intercostal neuralgia may produce sporadic episodes of acute pain or pain that is dull and constant. The pain is often described as stabbing, tearing, sharp, spasm-like, tender, aching or gnawing. It typically feels like the pain wraps around your upper chest in a band-like pattern. The pain may intensify during exertion or with sudden movements involving the upper chest, such as coughing or laughing. Intercostal neuralgia is often associated with injury or inflammation of the nerves, muscles, cartilage and ligaments in the rib cage and middle spine area. Common causes of intercostal neuralgia include pregnancy, tumors, chest or rib injury, surgery to the chest or organs in the chest cavity, and shingles. Shingles can attack nerves in the chest and upper back. Intercostal neuralgia may be preventable and is often treatable. Seek prompt and regular medical care to minimize the risk of developing shingles, one common cause of intercostal neuralgia, and to diagnose and treat other causes as soon as possible. In some cases, intercostal neuralgia can cause severe, debilitating pain that makes it difficult to move and breathe effectively. In addition, pain in the rib cage area may be caused by a condition other than intercostal neuralgia that should be immediately evaluated in an emergency setting. A heart attack is an example. Seek immediate medical care (call 911) if you, or someone you are with, have unexplained, severe pain in your rib cage, chest pain, a crushing feeling or pressure in your chest, severe shortness of breath, difficulty breathing, or a change in consciousness.