Intercostal Nerve Block
What are the intercostal nerves and why are intercostal nerve blocks helpful?
Intercostal nerves are small nerves that travel along the lower border of the ribs. Irritation and inflammation of these nerves can cause pain in the mid-back, chest wall and abdominal area. Intercostal nerve blocks can be helpful in reducing pain from a variety of conditions that cause rib pain or chest wall pain, such as post-herpetic neuralgia.
What happens during the procedure?
The patient is placed on the procedure table on their stomach so the physician can best visualize the lower margin of the ribs where the intercostal nerves pass, using x-ray guidance. The skin is scrubbed using antibacterial soap. Next, the physician numbs a small area of skin with numbing medicine. This medicine stings for several seconds. After the numbing medicine has been given time to be effective, the physician directs a very small needle using x-ray guidance near the intercostal nerve. Then, a small amount of numbing medicine (local anesthetic) and sometimes an anti-inflammatory (steroid) is injected.
What happens after the procedure?
After the procedure, the patient is taken to the recovery room. An x-ray of the chest will also be ordered to make sure that the procedure has not cause a small deflation of the lungs (pneumothorax). Patients are then asked to report the percentage of pain relief. Patients may return to their normal activities on the day of the procedure.