Intercostal Nerve Block

An intercostal nerve block is an injection of a steroid or other medication around the intercostal nerves that are located under each rib. The steroid injected reduces the inflammation and/or swelling of tissue around the intercostal nerves, in between the ribs or in the chest wall. This may in turn reduce pain, and other symptoms caused by inflammation or irritation of the intercostal nerve and surrounding structures.

Herpes zoster or shingles pain in the chest is commonly treated with intercostal blocks. Pain around a chest scar after a chest surgery may also respond well to intercostal blocks. The actual injection takes only a few minutes and consists of a local anesthetic and a steroid medication. Immediately after the injection, you may feel that your pain may be gone or quite less. This is due to the local anesthetic injected. This will last only for a few hours.

Your pain may return and you may have a sore spot for a day or two. This is due to the mechanical process of needle insertion as well as initial irritation from the steroid itself. You should start noticing a more lasting pain relief starting the third day or so, and its effect can last for several days to a few months. The intercostal nerve block injections are done about one week apart and only if needed. If the first injection does not relieve your symptoms in about a week to two weeks, you may be recommended to have a second injection. If you respond to the injections, you may be recommended for additional injections when the symptoms return.