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Intercostal Nerve Block

What is an Intercostal Nerve Block?

An intercostal nerve block is an injection of medication that helps relieve pain in the chest area caused by a herpes zoster infection (or “shingles”) or a surgical incision.

Intercostal nerves are located under each rib. When one of these nerves or the tissue around it gets irritated or inflamed, it can cause pain. A steroid medication and local anesthetic injected under the rib can help reduce the inflammation and alleviate the pain.

Intercostal nerve blocks also can be used to help diagnose the source of pain.

How is an Intercostal Nerve Block Done?

First, you’ll be given an intravenous medication to help you relax. Then, you’ll lie on your side — the one not causing pain. The doctor will use antiseptic to clean an area of skin near your ribs. Then he or she will:

  • Insert a thin needle under your rib and inject anesthetic
  • Use x-ray guidance to insert a second needle and inject a steroid pain medication
  • Typically, the procedure takes less than 30 minutes, and you can go home the same day.

What Happens After the Procedure?

Do not drive or do any rigorous activity for 24 hours after your intercostal nerve block. You can return to your normal activities the next day. You can continue your regular diet and medications immediately.

What are the Risks?

The risk of complication from an intercostal nerve block is very low. However, there could be bruising or soreness at the injection site. Serious complications, including infection, collapsed lung, nerve damage and bleeding, are uncommon.