Intercostal Nerve Block

Intercostal Nerve Block

Intercostal Nerve Block

Definition

Each rib on either side of the body has a nerve that travels along with the rib on its bottom side. These nerves provide sensation to the skin and underlying tissues such as muscle and bone of the abdomen and chest. If these nerves are damaged or irritated, they can cause significant pain.

Damage or irritation to these nerves can be caused by shingles, a surgical incision, rib fractures, or other injuries to the chest wall.

This injection procedure may be done to provide relief of chronic pain, or may be performed diagnostically to determine the source and cause of a patient’s pain.

Procedure

The procedure is performed by a Tulsa Pain provider and generally only takes a few minutes, however, the appointment may last longer as you will need to complete any required paperwork, speak to your provider before the procedure, and allow for recovery time before being allowed to return home.

Patients will lie on their side with the side that is to be treated facing up, or on their stomach with the arm stretched up toward their head. A local anesthetic will be administered to alleviate discomfort during the procedure, and a live x-ray called a fluoroscope will be used to assist the physician in determining the correct area for treatment. Contrast solution will be used to expose the area better on fluoroscope, and once the correct place for treatment along the rib has been determined, the physician will administer the injection consisting of a local anesthetic and a steroid medication. The local anesthetic will provide short-term relief of pain, while the longer-lasting steroid provides long-term relief of pain and inflammation. A small bandage may be applied to the injection site, and the patient will then be monitored for a short period before returning home.

After Care

Most patients are allowed to return to work and normal activity levels the next day, but it’s best to speak to your Tulsa Pain Consultants provider to determine the best recovery for you.

If the injection is being used therapeutically, the patient should begin to feel relief shortly after the procedure as the local anesthetic takes effect. This may wear off within a few hours to a day, and then the steroid medication will begin to provide relief within a few days.

If the injection is being used diagnostically and the provider has made the correct assumption of the location of a patient’s pain, the patient should feel pain relief from both the local anesthetic and the steroid. If not, it can likely be determined that the assumed cause of pain is not correct, and your provider will speak to you about the next diagnostic step or course of action.

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