FAQs on Intercostal Nerve Block in Colorado

 

An intercostal nerve block is an injection used to relieve pain of the chest region. This block is used in patients with chronic pain that is not adequately relieved using oral medications.

What are the intercostal nerves?

The intercostal nerves are located underneath each rib on both sides of the body. When one of these nerves, or tissue around the nerve, become irritated or inflamed, it causes pain.

Why is the intercostal nerve block done?

The block involves injection of a corticosteroid agent, which reduces inflammation and swelling of tissue around the intercostal nerves. This reduces pain and other symptoms of intercostal nerve irritation.

What conditions are treated using the intercostal nerve block?

The intercostal nerve block can be used for:

  • Herpes zoster (shingles)
  • Surgical incision pain
  • Diagnosing the source of chest wall pain
  • Rib fractures
  • Chest wall trauma

How is the intercostal nerve block done?

The doctor will first give you a sedative intravenously to relax you. You will be positioned on your side, with the painful side upward. The nurse will clean the skin over the ribs using an antiseptic. A small needle is used to numb the skin using an anesthetic. The procedure needle is inserted into the chest region using ultrasound or x-ray guidance. Once the needle position is confirmed, the medication is injected. After this, the site is covered with a bandage.

How effective is the intercostal nerve block?

Many patients report immediate pain relief after the injection. However, the pain can return within a few hours when the anesthetic wears off. Once the steroidal agent starts to work in 48-76 hours, long-term pain relief is achieved. The duration of pain relief varies from person-to-person. For some patients, pain relief lasts weeks, and for others it lasts several months.

What can I expect after the intercostal nerve block procedure?

A nurse will monitor you in the recovery area for around an hour. Expect some soreness at the needle insertion site. You are not permitted to drive or do rigorous activities for 24 hours after the intercostal nerve block. We recommend you rest the remainder of the day, and gradually return to usual activities. You can eat your usual diet and take regular medications right after the block.

What medications are used during the intercostal nerve block procedure?

An antiseptic solution (betadine) is used to clean the skin. In addition, anesthetics are instilled onto the nerves and used to numb the skin. Sometimes, a neurolytic agent (phenol or absolute alcohol) is injected onto the nerves. Finally, some pain management specialists use a corticosteroid in the block, such as triamcinolone or methyl-prednisolone.

Does the intercostal nerve block hurt?

Because an anesthetic is used to numb the skin and deeper tissues, you will not feel much pain. You may feel a pinching sensation when the anesthetic goes into the skin. Also, a mild sedative is given, so most patients have little memory of the procedure. This will depend on the doctor’s preference.

Does the intercostal nerve block procedure actually work?

In a recent study, researchers analyzed the medical records of patients who received the intercostal nerve block and compared the pain control to people who took oral medications. The researchers found that the block offered dramatic pain reduction for people with rib fractures.

Resources

Hwang EG & Lee Y (2014). Effectiveness of intercostal nerve block for management of pain in rib fracture patients. J Exerc Rehabil, 10(4): 241–244.