- Where are the intercostal nerves located?
The intercostal nerves run just beneath the lowest portion of a rib. They begin in the spine, following the rib around the chest to the breast bone.
- Who can benefit from intercostal nerve blocks?
People who are experiencing pain as a result of a disturbance of the structure between two ribs (muscle, nerve, ligament or bone) or other types of neurologic disorders that cause chest wall pain such as post herpetic neuralgia may receive pain relief from intercostal nerve blocks.
- Why are intercostal nerve blocks performed?
The injections can provide pain relief as well as pinpoint the specific area that is causing the pain.
- How are intercostal nerve blocks performed?
The physician may choose to use X-ray guidance for your procedure. After the R.N. has you positioned for the procedure, the physician will clean your skin with an antibacterial solution. The physician will numb the skin with a local anesthetic. A needle is then passed through the numb area until it contacts the bottom of the rib. The needle is moved past the rib to the intercostal nerve. Local anesthetic and a steroid are injected through the needle which is then removed.
The physician may inject more than one level of intercostal nerves depending on the extent of your pain.
- How soon will the treatment help?
The onset of pain relief may be within 15-20 minutes. This is due to the effect of the local anesthetic. Your pain may return in 4-6 hours as the effects of the local anesthetic wears off. The steroid usually takes 48-72 hours to be effective and the length of pain relief varies from person to person.
- How often can these injections be repeated?
These injections may be repeated every two weeks for a total of three injections.
- Are there risks and complications?
Although this procedure is quite safe, very rarely, serious problems can develop. The following symptoms should be reported immediately. These symptoms may indicate a lung problem:
- Sharp stabbing chest pain which is worse with a deep breath
- Rapid heart beat
- Severe shortness of breath
If any of these problems occur, it is almost always detected at the time of the procedure and is very unlikely to occur after discharge. If the symptoms occur after discharge, contact the physician or go to the Emergency Room immediately.
- How should I care for myself after the procedure?
You should intermittently apply ice to the injection site for 24 hours after the procedure to minimize swelling. You may resume your usual medications after the procedure. You may resume your usual activities the day after the injection.