Last updated: May 22, 2020

The intercostal space is the space between two ribs. There are 12 ribs on each side of the rib cage and 11 intercostal spaces. The intercostal nerves originate from the thoracic spine and travel in the intercostal spaces around to the chest.

Back or thoracic pain that radiates around the chest in a band-like fashion may be caused by inflammation of the intercostal nerve. Intercostal pain may produce pain that is dull and constant. The pain is often described as stabbing, sharp, spasm-like, tender, aching or gnawing. Pain may intensify during exertion or with sudden movements, deep breathing, coughing or laughing.

Common causes of intercostal nerve pain may include a chest injury, tumor, post-incision pain, or neuralgia due to shingles. Injury or inflammation of the nerves, cartilage, or muscles of the rib cage may also produce intercostal nerve pain.

The procedure consists of placement of an anesthetic/steroid solution to the intercostal nerves in the thoracic, or rib, region. The purpose of this injection is to decrease inflammation and irritation around the nerve roots before they exit the spine, thereby reducing pain. An intercostal nerve block is used to treat pain secondary to conditions such as shingles, post-herpetic neuralgia and postsurgical incision pain as well as a few other chronic pain disorders. All procedures are X-ray-guided to ensure proper placement of the medication and may be performed in an ambulatory surgical center, fluoroscopy suite or hospital setting.

Following the procedure, you may feel immediate relief. This may be due to the anesthetic. The area may develop some soreness over the next two days, but there should be a lasting pain relief by the third day. Repeated injections may be needed for complete relief.

This page was published on Jul 20, 2017, modified on May 22, 2020 by Dr. Freeman (Pain Management Specialist) of Redefine Healthcare
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