What is an Intercostal Nerve Block (INB)?

An intercostal nerve block is an injection of local anesthetic (numbing medication) sometimes with a steroid medication, injected just under the rib, where the intercostal nerve lies. An INB is typically performed for pain in the area of your ribs that comes after having surgery in that area, a rib fracture, herpes zoster (shingles), or when the intercostal nerve becomes trapped.

How long does an INB injection take?

The injection takes about 10 minutes.

What are the pre-requisites in order to perform this procedure?

You may need to stop taking certain medications several days before the procedure, especially anticoagulant or “blood thinning” medications, as well as other prescription and/or over the counter medications, including herbal and vitamin supplements.

Will the injection hurt?

Most people report that the stinging/burning of the numbing medicine is the most uncomfortable part of the procedure though everyone’s response to the pain is individual. As the injection is near a nerve, it is possible to get a temporary “electric shock” sensation that disappears immediately

What should I expect after the procedure and what are the side effects?

After the injection, you will feel numb in a band-like fashion that follows the rib(s). Your pain may be improved. It is important to keep track of how you feel for the remainder of the day. The steroid medication, when used, usually takes 2-3 days to have an effect, and usually peaks in about 2 weeks. You may feel lightheaded from the local anesthetic medication. This usually lasts a short time. Some tenderness around the injected area may occur for a couple of days after the injection. Using an ice pack with a barrier such as a towel between the skin and ice three or four times a day will help this. You may take your pain medication as prescribed following the injection as needed. Please note how much pain medication you have taken, the amount of pain relief you received, as well as how long the pain relief lasted.

What should I do after the procedure?

No heat is to be used on or around the injected area for the remainder of the day. No tub, bath, or soaking in water (i.e. pool, Jacuzzi, etc.) for at least 48 hours. You may eat, drink, and take your medications as prescribed on the day of the procedure (both before and after) unless instructed otherwise by your physician. If you experience shortness of breath, contact your physician or go to the Emergency Room.