.png)
Lumbar Intercostal Nerve Block
The intercostal nerves run along the underside of each rib and are responsible for sensation across the chest and upper abdominal wall. When these nerves become irritated, compressed, or damaged — due to injury, surgery, shingles (postherpetic neuralgia), or rib fractures — they can produce sharp, burning, or shooting pain that wraps around the torso and makes breathing, moving, or even lying still genuinely uncomfortable. A lumbar intercostal nerve block delivers targeted local anesthetic and/or steroid medication around the affected nerve(s), interrupting
What is a Lumbar Intercostal Nerve Block?
The intercostal nerves run along the underside of each rib and are responsible for sensation across the chest and upper abdominal wall. When these nerves become irritated, compressed, or damaged — due to injury, surgery, shingles (postherpetic neuralgia), or rib fractures — they can produce sharp, burning, or shooting pain that wraps around the torso and makes breathing, moving, or even lying still genuinely uncomfortable. A lumbar intercostal nerve block delivers targeted local anesthetic and/or steroid medication around the affected nerve(s), interrupting pain signals and providing meaningful relief. At River Cities Interventional Pain Specialists, this procedure is performed with precision imaging to ensure safe, accurate placement.
What To Expect
The procedure is performed in our office or at Park Plaza Surgical Specialists and typically takes 20–30 minutes:
✔️ You'll be positioned on your side or seated, and the injection site will be cleaned and numbed.
✔️ Using fluoroscopic or ultrasound guidance, Dr. Brewer advances a thin needle to the inferior margin of the affected rib, where the intercostal nerve runs.
✔️ A small amount of anesthetic with or without steroid is injected around the nerve.
✔️ Multiple ribs may be treated in a single session if pain spans several levels.
✔️ You'll be monitored briefly after the procedure and cleared to go home.
Results and Recovery
Most patients can return to their normal activities within 24 hours. Mild soreness at the injection site may be present for a day or two. Pain relief may begin within hours if a local anesthetic was used, with the steroid's anti-inflammatory effects building over several days. This block can be repeated if needed. For chronic intercostal neuralgia (such as postherpetic pain), a series of blocks may be recommended alongside other treatments.
A lumbar intercostal nerve block is an effective option for patients experiencing:
✔️ Postherpetic neuralgia — persistent nerve pain following a shingles outbreak on the torso
✔️ Pain following thoracic or abdominal surgery
✔️ Rib fractures causing pain that limits breathing
✔️ Intercostal neuralgia from nerve compression or injury
✔️ Chest wall pain that hasn't responded to oral medications
WHO IS THIS BEST FOR?
Benefits of Lumbar Intercostal Nerve Blocks
Accurate Pain Source Diagnosis
Medial branch blocks are a type of injection treatment used for minimally invasive, non-surgical pain relief.
No Surgical Procedure Necessary
Medial branch blocks are a type of injection treatment used for minimally invasive, non-surgical pain relief.
Immediate Pain
Reduction
Medial branch blocks are a type of injection treatment used for minimally invasive, non-surgical pain relief.
Frequently Asked Questions
Yes. Postherpetic neuralgia — the nerve pain that can persist after a shingles rash resolves — is one of the most common reasons for intercostal nerve blocks. Repeated blocks can help manage this often debilitating condition.
The intercostal nerves run very close to the pleural lining of the lung. An experienced interventional pain specialist uses imaging guidance and careful technique to minimize this risk. Pneumothorax (collapsed lung) is a known rare complication, which is why imaging guidance and post-procedure monitoring are standard practice.
Yes. Intercostal nerve blocks are frequently used to manage pain following thoracic surgery, rib procedures, or even upper abdominal surgeries where intercostal nerve injury or irritation has occurred.
For acute pain (such as rib fractures), one or two blocks may be sufficient. For chronic conditions like postherpetic neuralgia, a series of injections may be recommended as part of a broader pain management strategy.
.png)