Pain is the chest and upper abdomen can be difficult to diagnose. One diagnostic tool that can be used is an intercostal nerve block. Intercostal nerves travel through the muscles between the ribs from the thoracic spine to the pectoral muscles. They innervate the diaphragm, muscles skin and bones in the upper chest, and the area between the lungs. Conditions that may be treated with intercostal nerve blocks include:
Your doctor will examine you to see if you qualify for an intercostal nerve block.
These injections include a steroid and an anesthetic medication to be used for both diagnostic and therapeutic purposes. The anesthetic medication alleviates nerve pain rapidly while the steroid medicine reduces inflammation and can provide long lasting relief. The steroid medication can take 2-3 days up to a week to fully work. Your initial response to the injection can provide useful information regarding the location of your pain.
The side effects are similar to that of all procedures and include: pneumothorax, bleeding, infection, and nerve damage. The chance of this happening is very rare as the doctor uses imaging guidance to ensure that he is in the correct location. Potential side effects to the steroid medication include high blood sugar, facial flushing, and difficulty falling asleep. This only lasts about a day.
Reduce procedural discomfort by applying ice for 15-20 minutes every 2-3 hours to reduce injection site swelling and irritation. NSAIDs and/or Tylenol are also recommended.