Intercostal Nerve Block

What is an intercostal nerve block?

Nerves conduct pain signals. All of the ribs have nerves travelling under them from the spine at the back of your body to the sternum breast bone which is located at the front of your body. These nerves are called intercostal nerves. Blocking pain signals travelling via the intercostal nerves can provide pain relief or alternatively help find the source of the pain when someone has chest wall pain over a localised area, e.g. due to shingles, post-operative pain, or a rib fracture etc.

What is injected in the nerve block?

Mostly, a combination of numbing medicine (local anaesthetics) and anti-inflammatory cortisone (steroids) is injected near the nerve. The purpose is to calm down the nerves and provide pain relief.

What is the benefit of nerve block and how long does it last for?

The benefits of intercostal nerve blocks tend to be temporary. Some patients get pain relief for a short period of time and others up to a year. Some nerve blocks may be repeated. This depends on the amount & duration of pain relief you get with the nerve block.

Are there any risks with the nerve blocks?

All medical interventions carry some risks. Side effects of nerve block include possibility of infection, bruising, injection soreness, and short term numbness due to spreading of the local anaesthesia. There is a small chance of puncturing the lung lining leading to pain and breathlessness. If you experience these symptoms, seek immediate medical help. Very rarely, a nerve block procedure can lead to permanent nerve damage causing numbness and exacerbation of pain. For diabetic patients, there may be a raised blood sugar level for a few days following the procedure due to steroid medications in the nerve block.


On the day of nerve block, is there a need for any specific preparation?

You do not have to skip any meals before your nerve block. Eat lightly and drink plenty of water. You can take your routine medications as useful unless advised otherwise by your doctor. Please bring a list of your medications with you.

What happens when I come to the hospital for the nerve block?

  • The doctor will discuss the procedure with you and obtain your consent

  • The procedure will take place in a treatment room

  • Ultrasound guidance will be used to locate the nerve

  • The skin around the injection site will be cleaned with cold antiseptic

  • The doctor will carry out the nerve block with a fine needle

After the procedure

  • When medical personnel have observed you and deemed you fit you may leave

  • You will be advised when to get dressed and go home

  • A letter will be sent to your GP describing the procedure that you underwent

Do I need to take any precautions after the nerve block?

You may be sore or have more pain before you feel better. Nerve blocks may take a few days to help. From the next day onwards, you can resume back to your normal activities.