Intercostal Nerve Block

Intercostal Nerve Blocks work to decrease pain felt between the ribs for surgical procedures, rib fractures, and upper abdominal procedures. Each set of ribs have an artery, vein, and nerve running underneath the ribs. Each intercostal block works to relieve pain in a band-like section, and can help decrease dependence on opioids and other pain medications. The intercostal nerves also innervate your diaphragm muscles, which control your breathing and ability for your lungs to expand appropriately.
We perform intercostal block with either ultrasound guidance or x-ray (fluoroscopy) to minimize the chance of intravascular injection and pneumothorax and to increase the reliability of dermatomal coverage. The injection can be made closer to the vertebral column (and more proximal in the course of the nerve) with ultrasound guidance because palpation of the rib is less important than with an anatomic landmark approach. The patient will likely be awake for the procedure, as it is not very invasive, and will be provided a local anesthetic to ease pain from the injection.
What conditions can this treat?
- Post-herpetic neuralgia (Shingles)
- Postoperative chest pain or abdominal pain
- Chronic post-mastectomy pain
- Pain after fractured ribs
- Cancer pain from metastasis to the ribs
Conditions
- Arthritis
- Cancer Pain
- Chronic Pelvic Pain
- Chronic Abdominal Pain
- Cervical Radiculopathy
- Complex Regional Pain Syndrome
- Compression Fractures of the Spine
- Diabetic Neuropathy
- Fibromyalgia
- Herniated Discs
- Knee Pain
- Low Back Pain
- Migraine Headaches
- Neck Pain
- Neuropathy
- Post Laminectomy Syndrome
- Shoulder Pain
- Trigeminal Neuralgia
- Whiplash CAD
Treatments
- Botox Injection
- Capsaicin (8%) Patch
- Cervical Epidural Steroid Injection
- Disc Nucleoplasty
- Dorsal Root Ganglion Stimulator (DRG)
- Endoscopic Discectomy
- Facet Joint Syndrome
- Hip Joint Injections
- Intrathecal Pain Pump
- Intercostal Nerve Block
- Ketamine Infusion
- Knee Joint Injection
- Kyphoplasty
- Lidocaine Infusion
- Lumbar Epidural Spinal Injection (LESI)
- Lumbar Sympathetic Ganglion Block
- Lumbar Radiofrequency Neurotomy
- Minuteman Procedure
- Medial Branch Block (MBB)
- Minimally Invasive Lumbar Decompression (MILD)
- Platelet Rich Plasma
- Peripheral Nerve Stimulation
- ReActiv8 Procedure
- Radiofrequency Ablation (RFA)
- Regenerative Medicine
- SI Joint Injection
- Stellate Ganglion Block
- Sympathetic Nerve Block
- Spinal Cord Stimulation (SCS)
- Trigger Point Injection
- Transforaminal Epidural Spinal Injection (TFESI)
- Vertebroplasty
- Vertiflex Procedure