College of Massage Therapists of British Columbia (CMTBC) Practice Exam

Your patient has intercostal neuralgia. What would be the most effective treatment?

1. Treat the surrounding musculature for compensation, no local treatment

2. Apply heat local to the area and then apply rib springing

3. Apply cold to the area and strip the intercostal muscles

4. Stretch the affected side and apply direct fascial release to the symptomatic area

The correct answer is: Treat the surrounding musculature for compensation, no local treatment

The most effective treatment for intercostal neuralgia involves treating the surrounding musculature for compensation rather than focusing solely on the local area. Intercostal neuralgia can be related to muscle tightness and dysfunction in the regions surrounding the intercostal spaces. When muscle compensation occurs, it can contribute to the pain and discomfort experienced by the patient. By addressing the surrounding muscles, the treatment can help alleviate tension that may be contributing to the neuralgia. This holistic approach not only provides relief but also improves overall function and mobility. It recognizes that the body's systems are interconnected, and therefore, treating only the local area may not fully address the underlying issues contributing to the patient’s discomfort. Each other option, while they may have potential benefits in certain contexts, tends to concentrate too heavily on symptomatic relief in the localized area or on direct intervention of the intercostal muscles without considering the broader musculature and compensatory patterns that may be at play. This understanding of the body's compensatory mechanisms reinforces the choice to prioritize surrounding musculature in the treatment of intercostal neuralgia.