Intercostal Nerve Block

What is an Intercostal Nerve Block and why is it helpful?

An intercostal nerve block is the injection of a local anesthetic in the area between two ribs where the intercostal nerve is located. An intercostal block is performed for the diagnosis and treatment of upper back, flank, or chest pain that may be neuropathic (nerve) or somatic (muscle, bone) in origin. Neuropathic pain sometimes occurs after a nerve has been damaged, such as from shingles, a previous surgical incision or metastatic cancer eroding into a nerve. Somatic pain can result from metastatic cancer to the rib bones or a previous surgical incision made through the chest wall, ribs and muscles. Temporarily blocking or disrupting painful nerve impulses associated with neuropathic pain can result in various degrees of permanent relief. If after following a single block you achieve partial permanent relief, a series of several blocks can be performed of which each successive block may give a greater degree of sustained relief.

What happens during the procedure?

The procedure will take place at our Joint Commission Accredited facility.  If you are receiving sedation, an IV will be started so that the relaxation medication can be given. The area to be injected will be cleansed with an antiseptic. The doctor will place the needle into the intercostal space below the ribs and then inject the local anesthetic or cortisone preparation. Following the procedure, you will be released to our Post-Operation area where you will be evaluated until you are able to leave the facility. 

What happens after the procedure?

You will go back to the recovery area where you will be monitored for a short time. You will then be released and given a follow-up appointment or another procedure appointment if needed. This procedure is usually repeated in two (2) weeks. You will be asked to closely monitor your pain level for the next day or two, to determine what percentage of relief you get and for how long.

General Pre/Post Instructions

If you are receiving sedation, do not eat or drink anything six 6) hours prior to your procedure. Do not take pain medication or tranquilizers four (4) hours prior to your procedure. You may take your routine medications (i.e. high blood pressure and diabetic medication). If you are diabetic and MUST eat something, please make it LIGHT if you are receiving sedation. If you are on Coumadin, Heparin, Plavix, or any other blood thinners (including aspirin), or the diabetic medication Glucophage, you MUST notify the office so the timing of these medications can be explained. You will be at our facility approximately 1-2 hours for your procedure. If you are receiving sedation, you MUST have a driver with you and the driver must sign the release at the front desk when you check in.

You may return to your normal activities the day after the procedure, including returning to work.