Intercostal Nerve Block
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An intercostal nerve block can provide relief from shingles in the chest, as well as any other pain caused by inflammation or irritation of the intercostal nerve.
An intercostal nerve block is an injection around the intercostal nerves, located under each rib. Pain in the intercostal region is generally a result of:
How is An Intercostal Nerve Block Done?
When a patient has inflammation around the intercostal nerves, in between the ribs, or in the chest wall, he or she may experience chronic pain, with little relief garnered from more conservative treatments. An intercostal nerve block can relieve this pain, giving the patient an improved quality of life. A small thin needle is used, usually with no sedation medication. A local anesthetic numbs the injection site, as the patient lies on one side of the chest, with the injection side facing up. The needle, containing an anesthetic and a corticosteroid medication for inflammation, will be inserted through the deeper tissues of the intercostal region.
Pain Relief from an Intercostal Nerve Block
Patients often feel that their pain is considerably less after receiving an intercostal nerve block, due to the local anesthetic. This absence of pain is likely to last only a few hours, as the anesthetic wears off. Within three to five days, however, the corticosteroid should kick in, and a more lasting pain relief should occur. Intercostal nerve blocks typically relieve pain for days or as long as a few months. If the first injection does not sufficiently relieve the pain, patients may have a second injection within a week from the first. If good pain relief is received, patients will generally have additional injections when the pain symptoms return.
Most patients are able to drive themselves home, however it is a good idea to have someone to drive you, if possible. Applying ice to the injection area can help relieve the pain of the injection, and reduce swelling. Most people can return to work the next day, if necessary, and will feel only a bit of soreness at the injection site. Although the procedure is considered low risk, there are always side effects and the potential for complications with any medical procedure. The most common side effect is temporary pain at the injection side. Less common side effects include bleeding, bruising and infection. One extremely rare side effect is a collapsed lung—if the patient feels winded, or has trouble catching his or her breath, a collapsed lung should be suspected and the patient should immediately go to the ER.
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