Intercostal Nerve Block

Similar to our clinics’ sympathetic block procedure, our pain experts use block injections to target the intercostal area of the client. This process can alleviate chronic intercostal pain for 6 to 12 months by blocking pain signals that would travel throughout the intercostal area.

What is an Intercostal Nerve Block?

An intercostal nerve block is a block of nerves that lie underneath the lower edge of each rib. For certain types of injuries, e.g., rib fractures, nerve injuries to the chest wall, postoperative pain along the rib nerves (“intercostal nerves”), injection of a small amount of local anesthetic can significantly diminish pain.

Intercostal Nerve Block

How It Works

An intercostal nerve block procedure typically done with you lying on your stomach with your arms stretched upward, if possible. Your blood pressure and oxygenation will be monitored. In addition to your doctor and the x-ray technician, there will be a nurse or medical assistant in the room at all times if you have any questions or discomfort during the procedure. The skin over the affected rib(s) is cleaned with antiseptic solution and then the procedure is done. A very small, slightly blunt needle is carefully placed under the rib, contrast agent is injected and its path is verified by x-ray. Then, the medicine is injected.

An intercostal nerve block is typically performed one of two ways, 1) as a diagnostic block or 2) a therapeutic block. 


  • Diagnostic Block – A small amount of local anesthetic, like Lidocaine or Bupivacaine, will be injected to see how the pain responds to a block of the intercostal nerve.
  • Therapeutic Block – If the diagnostic block shows a temporary decrease in pain and symptoms, a therapeutic block will follow with the administration of a neurolytic agent such as dehydrated alcohol or phenol.


Here are answers to some frequently asked questions related to Intercostal Nerve Block.

What are the Benefits of a Intercostal Nerve Block?

The intercostal nerves are a pathway for transmitting pain in the chest and upper abdomen. The nerves are easily accessible and there are many benefits of targeting them to alleviate pain. An intercostal nerve block is a minimally invasive procedure with documented success in treating neuropathic pain, metastatic bone pain, and even pain due to trauma. In cases where the blocks are successful, the procedure can be repeated periodically to manage recurring pain.

How Many Treatments Will I Need?

If successful, an Intercostal Nerve Block should alleviate pain for at least several months. If the pain returns after the first injection, you may be eligible for another injection, but only if you had relief from pain for a reasonable period of time.


When will I feel better?

The relief from a positive diagnostic block is almost immediate. The effects of the local anesthetic are typically felt before a patient even leaves the office. However, the medication will wear off in just a few hours and the pain will return, which is completely normal. This lets our specialist know the intercostal nerves are transmitting the pain, and that the pain hasn’t moved into the Central Nervous System yet – making the intercostals a good target for the therapeutic procedure.
The relief from the therapeutic procedure may take a few days to reach maximum effect. There may be some soreness in the area after the procedure, which will typically resolve on its own soon after.

Is an Intercostal Nerve Block Right for Me?

If you suffer from chest wall pain or upper abdomen pain that has failed to heal with conservative treatment and medication, this procedure may be right for you. 

If you have any other questions about our Intercostal Nerve Block, or you need more clarity on the procedure before setting an appointment, please don’t hesitate to contact us.