Intercostal Nerve Block

It is an injection of medication or a steroid around the intercostal nerves which are located below the ribs. It is a form of pain management that is relatively safe and easy.

The steroid reduces the swelling and inflammation in the tissue that surrounds the intercostal nerves. It may be in the ribs or in the chest wall. It can reduce pain or other symptoms that are caused by irritation or inflammation of these nerves and the structures surrounding it.

The intercostal nerve block procedure involves the insertion through the skin and the tissue beneath with a needle. They are first numbed with a local anesthetic and then a thin needle is used for the injection.

Pain from Shingles or Herpes zoster are two common ailments treated with an intercostal block. If a patient experiences pain surrounding a chest scar that resulted from a surgery, an intercostal block can help reduce the pain.

The injection will only take a few minutes.

The patient is sedated and the procedure will occur in an operating room that has the use of fluoroscopy. The patient is then placed on his stomach and the area is cleaned. A local anesthetic is then given to numb the insertion area. Through the use of x-ray guidance the needle is guided to the desired nerve. Contrast can be used to make sure that the needle is placed properly. Once in place, the medication is injected.

Patients should not drive or use heavy machinery for at least 24 hours after the procedure. You can apply ice at the injection site to provide comfort to the area. Patients can return to their usual activity the next day.

It is a relatively safe procedure but like any other procedure, there are risks, complications, and side effects that may occur. One of the most common side effects is pain at the injection site. Patients may also experience bruising, infection, bleeding, and a collapsed lung. It is rare to experience a collapsed lung but it is possible. If the lung has collapsed the victim may feel winded or have a feeling that he can’t catch his breath. If this is the case, immediate medical attention is required.

The frequency of the injections is dependent on the patient. It is possible to get additional injections if the pain goes away. If this is the case, your doctor may approve you for an additional injections. Your doctor will know whether the procedure will need to be repeated.

Results vary per situation and per patient. There are many causes for the pain, so the results may vary depending on whether the pain is coming from this area or an area close to this area.

Moore, Daniel C. (1963). INTERCOSTAL NERVE BLOCK. International Anesthesiology Clinics. 1(3):721-736,

MURPHY, DERMOT F. M.B., F.F.A.R.C.S.I. (1986). Continuous Intercostal Nerve Block. Intensive Care Unit, Royal Perth Hospital.