An intercostal nerve block is a targeted, image-guided injection that quiets the nerves running along your ribs to relieve chest-wall and rib pain.
OVERVIEW
What an intercostal nerve block is and how it works
The intercostal nerves travel in a groove beneath each rib, supplying sensation to the chest wall, ribs, and part of the upper abdomen. When these nerves are irritated by injury, surgery, or shingles, they can produce sharp, burning, or band-like pain that wraps around the side of the chest. An intercostal nerve block places a small amount of local anesthetic — often combined with a corticosteroid — next to one or more of these nerves to interrupt the pain signals they carry.
The procedure can serve two purposes. As a diagnostic tool, the local anesthetic helps confirm that a specific intercostal nerve is the source of your pain. As a therapeutic treatment, the steroid can reduce inflammation around the nerve and may provide longer-lasting relief, which can also make it easier to take a deep breath, cough, and participate in physical therapy and daily activities.
CONDITIONS
What an intercostal nerve block treats
Our pain physicians in Gresham and the greater Portland, Oregon area may recommend this block for pain originating in the chest wall, ribs, and the nerves between them.
Commonly treats
YOUR VISIT
What to expect
Before
Your physician reviews your history, exam, and any imaging to map which rib levels are involved. Tell us about blood thinners, allergies, and possible pregnancy. You may be asked to pause certain medications beforehand and to arrange a ride home.
During
You rest on your side or stomach while the skin is cleaned and numbed. Using ultrasound or fluoroscopy for guidance, the physician advances a thin needle toward the targeted nerve below the rib and injects anesthetic, often with a steroid. Most blocks take roughly 15 to 30 minutes.
After
You rest briefly while we monitor you, then go home the same day. You may feel numbness or relief along the rib soon after; when a steroid is used, its benefit typically builds over several days. Many people resume normal activity the next day per their physician’s guidance.
QUESTIONS
Frequently asked questions
Is an intercostal nerve block diagnostic or therapeutic?
It can be both. The local anesthetic helps confirm whether a particular intercostal nerve is driving your pain, while an added steroid aims to calm inflammation for longer-lasting relief. Your physician will explain which goal applies to your situation.
How long does the relief last?
This varies from person to person and depends on the underlying cause. The numbing effect is usually temporary, while steroid-related relief may last weeks to months for some patients. The block can be repeated when appropriate as part of your broader pain plan.
Will I be put to sleep for the procedure?
No general anesthesia is required. The block is done with local numbing medicine while you stay awake, though the skin and deeper tissues are numbed for your comfort.
Is an intercostal nerve block safe?
It is generally well tolerated, especially when performed with image guidance. As with any injection near the chest, there are some risks, including bleeding, infection, temporary soreness, or, rarely, irritation of the lung lining. Your physician will review the benefits and risks with you and answer any questions before you proceed.
LEARN MORE
Related care at Columbia Pain & Spine Institute
An intercostal nerve block is one of several nerve block procedures we offer. Explore our full range of interventional pain services, or contact our Gresham and Portland offices to learn whether this treatment fits your care plan.