Intercostal Nerve Block: Your Experience

An intercostal nerve block is done to relieve pain in your chest area that is caused by shingles (herpes zoster) or a surgical incision.  It can also be done to figure out the cause of chest pain.  Your healthcare provider injects a small amount of anesthetic (numbing medicine) into the area between two ribs (the intercostal space).  The procedure is done in your provider's office and takes about 15 minutes.

Before the procedure

You will need to prepare for the procedure.

• Tell your provider if you are allergic to IV dye, or iodine.

• At least a week before the block, tell your provider what medicines you take (including aspirin or other blood thinners). Ask whether you should stop taking any of them before treatment.

• Do not eat or drink anything 6 hours before your procedure.

• Have someone with you who can drive you home.  You will not be able to drive after the procedure.

During the procedure

You will sit or lie on an exam table so your healthcare provider can reach the affected area.

• The skin over the injection site is cleaned using an antiseptic solution. A pain medicine (local anesthetic) numbs the skin.

• Your provider will use a thin needle to inject a small amount of steroid and anesthetic into the intercostal space.

Reasons your procedure can be canceled

You may be asked to reschedule your appointment if:

• you are bleeding or have bleeding problems

• if there is an infection at the injection site

• if you have a fever, the flu, a cold, or other infections

• if you are pregnant

• if you are on antibiotics

• if you ate or drank something before your procedure

• if you do not have someone to drive you home

• if you did not stop taking omega 3 supplements, Vitamin E, or fish oil 7 days before the procedure

After the procedure

You will rest lying down for 10-15 minutes. The health care team will check your blood pressure and pulse. You will be asked to describe any changes in your pain before you leave.

After you leave:

• Take it easy for the rest of the day. You can return to your normal activities the day after the procedure.

• The injection sites may be sore for a day or so. Put ice or heat on the treated sites as instructed by your healthcare provider.

• You will need someone to drive you home post-procedure.

When to call your healthcare provider

Call your provider if you have increased pain, a fever over 100.4°F (38°C), chills, shortness of breath, or drainage at the treated site.