A treatment known as the Intercostal Nerve Block is used to provide relief for chronic pain or to diagnose the source and cause of pain. There is a nerve that travels on the bottom side of the rib that provides sensation to the underlying tissues such as muscle and bone of the abdomen and chest. If these nerves should become damaged or irritated, significant pain can result. Often this type of damage or irritation to these nerves can be attributed to the after-effects of a surgical incision, shingles, rib fractures, or other types of injuries to the chest wall. Though the Intercostal Nerve Block injection procedure is used to minimize chronic pain, it is also used to diagnose the root cause of pain in the rib cage.
A local anesthetic is administered with the patient either lying on their side or their stomach and the arms stretched up toward their head. The physician will use a live x-ray, called a fluoroscope, to determining the correct area for treatment. Using a contrast solution and the fluoroscope, the physician will determine the area in need of treatment along the rib. Next, an injection consisting of a local anesthetic and a steroid medication will be administered. The combination of the two substances will provide both short-term and longer-lasting pain and inflammation relief. A bandage will be applied at the injection site and the patient will be monitored for a short time before release. The procedure only takes a few minutes at The Spine & Pain Center office.
Normal work routine and activity levels are possible the following day for the majority of patients. With the assistance of the anesthetic, the patient should feel immediate pain relief, though it may wear off once the effect of the anesthesia diminishes. Longer-lasting relief should occur once the steroid medication takes effect a few days after the injection. Should the patient not have noticeable improvement, they should speak with their physician at The Spine & Pain Center for follow-up treatment to determine a next course action.