Intercostal neuralgia is marked by puncturing or lightning pain in the region with the distribution of intercostal nerves. It may be worsened by laughing, snee-zing or deep breath. In severe cases, pain may radiate to the shoulder and back. Intercostal neuralgia is usually secondary, primary case is rare. This syndrome pertains to pain in rib-side in TCM. It is usually caused by stagnation of liver qi, damp-heat in the liver and gallbladder, ob-struction of blood stasis and insufficiency of blood in the liver and kidney that lead to obstruction or malnutrition of the liver and gallbladder meridians.
Treatment
Prescription: Zhigou (TE 6 ) and Yanglingquan (GB 34).
Modification: For liver depression and qi stagnation, Qimen (LR 14) and Taichong (LR 3) are added; for ob-struction of the collaterals by blood stasis, Geshu (BL 17), Ganshu (BL 18) and Taichong (LR 3) are added; for insufficiency of blood, Ganshu (BL 18), Shenshu (BL 23), Sanyinjiao (SP 6), Zusanli (ST 36) and Xingjian (LR 2) are added.
Performance: Liver depression and qi stagnation as well as obstruction of the collaterals by blood stasis are sthenia syndromes and should be treated with reducing needling technique; Qimen (LR 14) and Back-Shu acu-points should be needled obliquely with rotating reducing technique or mild reinforcing and reducing techniques; in- sufficiency of blood pertains to asthenia syndrome and should be treated with reinforcing needling technique; Xingjian (LR 2) and Taichong (LR 3) should be needled with rotating manipulation.
Prescription: Chest (AH10), Ear Shenmen (TF4), Liver (COle) and Gallbladder (COIl).
Performance: Moderate and strong stimulation, re-tention of needles for 15 - 30 minutes.
