Intercostal Nerve Block
What is an intercostal nerve block?
An intercostal nerve block is an injection of a steroid or other medication around the intercostal nerves that are located under each rib.
What is the purpose of an intercostal nerve block?
The steroid injected reduces the inflammation and/or swelling of tissue around the intercostal nerves, in between the ribs or in the chest wall. This may in turn reduce pain, and other symptoms caused by inflammation or irritation of the intercostal nerve and surrounding structures. Herpes zoster or shingles pain in the chest is commonly treated with intercostal blocks. Pain around a chest scar after a chest surgery may also respond well to intercostal blocks.
This procedure only takes a few minutes. The injected steroid reduces any inflammation and swelling of tissue around the intercostal nerve. Discomfort during the procedure should be minimal since the injection site is numbed with a local anesthetic using a very thin needle during the performance of the block. Afterward, the patient rests briefly in the office. Most people can drive themselves home, but should take it easy and not return to work or other taxing activities until the next day. If a patient desires further sedation, that is certainly available. Usually this isn’t necessary and sedation does increase recovery time. Also a patient must then be driven home.
Patients are advised to be aware that after the injection, pain may seem to be gone; this is due to the anesthetic and will only last for a few hours. Unfortunately, the original pain will likely return in addition to some soreness at the injection site. The good news is that in three to five days, longer-term pain relief is possible.
Degrees of response vary. For a patient who some or much improvement, additional injections may be worthwhile.