Anyone experience Intercostal Neuralgia? or Rhomboid pain?

[pmrusa]

Quick question: has anyone experienced "intercostal neuralgia" with their PMR? I have had PMR for three years and I am currently tapering pred now at 5 1/2 mg (tapering 1/2 mg per month) without any troubles - this time. Around a week ago, I woke with shingles like pain wrapping around my right rib cage, right arm pit and tingling/burning down my right arm to my wrist. I did have a bit of soreness in my right rhomboid (spine area around right shoulder blade) prior to this, but I passed it off as a exercise soreness. Couple of days later the neuralgia like pain appeared.

Has anyone else experienced this? I did read on WebMD that rhomboid pain can be caused by PMR. I'm curious if there is a connection between rhomboid pain and intercostal neuralgia. I have not checked with my rheumatologist yet and performing a bit of due diligence before I do.

Apologies for the rambling and feel free to ask for my info if I'm not clear enough. Thanks everyone!

[PMRpro Ambassador]

Having looked it up - probably!!! But I always just put it down to the myofascial pain syndrome making my back muscles so tight that they pinch/irritate the nerve supply to the rib area! So I just didn't know the fancy name!!! Mine is mainly intermittent though, not constant. Sure it isn't shingles?

[pmrusa in reply to PMRpro]

Thank you for the quick reply. I had the shingles vaccine (2 jabs) about 4 months ago so I’m pretty sure it’s not shingles. This pain is not horrible - simply odd and annoying. If it gets worse or lasts more that 3-4 weeks, I’ll reach out to doctors. Thanks again 😎

[Lyndalou62 in reply to pmrusa]

Hi!!! I have tightness across ribcage both back and front that feels like im in a corset- its been there since the PMR started. I mentioned it to my GP who more or less passed it off as stress related! I also have constant pain in my upper right back muscles- ive had x rays that showed nothing apart from a little arthritic change in my thoracic spine so dont think that really accounts for the pain.The pred has solved the arm and shoulder stiffness and pain but doesnt really touch the rib and back thing. I was diagnosed by GP in november 2020 after suffering since june 2020 and have only so far had one telephone consultation with a rheumy who said after a 2 min chat that he wasnt surevif I have PMR!!! Its god to know im not alone in suffeting from these extra weird PMR? anomolies!

[PMRpro Ambassador in reply to Lyndalou62]

It is almost certainly due to tight muscles, often due to myofascial pain syndrome which is found alone but also more often alongside PMR. It will never be seen on an x-ray - a hands-on examination should be able to feel the tight and painful muscles. I was told by an orthopod (private, seen after a car accident for whiplash) that my back pain was wear and tear and I would have to learn to live with it - a year or so later of not being able to walk for more than 15 mins without pain, another orthopod identified it for what it was and admitted me for the quick fix. Unfortunately I reacted badly to one of the i.v. drugs they used and was then switched to the slower, more manual, approach which worked miracles over some months and provided I get it at intervals it still does.

[Lyndalou62 in reply to PMRpro]

Hi PMRpro!It is constant pain and feels bruised if i get hubby to massage the area- is this what the myofascial pain is like?- its quite excruciating some days and livable other days but almost certainly always there! Some areas on my upper right back area feel tender to the touch.

Thanks for the info BTW

[PMRpro Ambassador in reply to Lyndalou62]

Could well be - I'd describe it like that

[Nightingales]

Rib pain has always been one of my problems. I was diagnosed with costochondritus before PMR but I think it was one of the first signs. We do have intercostal muscles after all. I have had steroid injections under X-ray guidance, which have helped somewhat. Just a caution though that gall bladder pain can be felt as right chest and shoulder pain.

[alliebc]

I had to look up Rhomboid and think it describes exactly where I get pain down my upper back, between left shoulder blade and parallel to the spine.,where I can’t reach! I had it before PMR diagnosis and did have a chest X-ray taken a couple of years ago after I told my GP, but nothing showed up. The PMR pain disguised it, then it went away entirely on the higher doses of prednisone. Now I notice it’s back, nagging away in the background always there, especially in the evenings, uncomfortable to lean back in my chair. I don’t do anything unusual using that side of my body. I’ll read up WebMD, so glad you mentioned it, as because it disappeared when I started pred, I had forgotten the possible link between the two.