Wessex Pain Clinic

Intercostal Nerve Block

An intercostal nerve block is a targeted injection used to manage pain in the chest or upper abdominal wall. It works by delivering local anaesthetic — often combined with steroid — near the intercostal nerves, which run between the ribs. This can help reduce pain caused by nerve irritation, injury, or inflammation.

How the Procedure Works

The intercostal nerves are a group of nerves that run along the underside of each rib, supplying sensation to the chest wall, upper abdomen, and sometimes part of the back. These nerves can become irritated or damaged due to surgery, trauma, infection (such as shingles), or strain.

During the procedure, your consultant carefully inserts a fine needle near the affected rib, guided by anatomical landmarks or ultrasound. A small amount of local anaesthetic and possibly steroid is injected around the nerve to interrupt pain signalling and reduce local inflammation.

The treatment can be both diagnostic and therapeutic — helping confirm the source of pain while providing symptom relief.

Wessex Pain Clinic

What Conditions It Can Help With

Intercostal nerve blocks may be recommended for:
Intercostal neuralgia (nerve pain along the ribs)
Pain following rib fracture or chest trauma
Post-thoracotomy pain (after chest surgery)
Pain following chest drain or biopsy
Shingles-related (herpetic) nerve pain
Upper abdominal wall pain after surgery

Aimed Benefits

The purpose of the injection is to:
Relieve sharp, burning, or aching pain along the chest or rib area
Improve breathing and comfort during movement
Confirm that the intercostal nerve is involved in your pain
Support recovery after surgery or injury by reducing pain-related guarding
Relief may be short-term or longer-lasting depending on the cause of the pain and response to treatment.

What to Expect

This is a short outpatient procedure, usually lasting 15–30 minutes. You’ll lie in a comfortable position while the skin over the rib area is cleaned and numbed. The consultant locates the correct rib and gently inserts a fine needle just beneath it, where the nerve runs.

You may feel a brief sensation during the injection, followed by numbness or relief in the affected area.

Risks and Considerations

All procedures carry some risks, which will be discussed in detail with you during your consultation. You will have the opportunity to ask questions, and formal consent will always be obtained before any procedure is carried out.

Combined Approach / Multidisciplinary Care

At Wessex Pain Clinic we find that the best results come from combining medical treatments with active rehabilitation. Procedures are often most effective when paired with physiotherapy, movement-based exercise, and — where appropriate — psychological support. This comprehensive approach addresses both the physical and emotional aspects of pain and supports longer-term improvement.

Key Points Summary

  • Injection targeting nerves between the ribs
    Used to treat chest or
  • upper abdominal wall pain
  • Aims to provide both diagnostic clarity and symptom relief
  • Simple outpatient procedure with minimal downtime
  • Results vary between individuals and cannot be guaranteed. Your consultant will discuss whether this procedure is appropriate for you.
    Often part of a broader pain management plan

Disclaimer

Results vary between individuals and cannot be guaranteed. Your consultant will discuss whether this procedure is appropriate for you.

At Wessex Pain Clinic, we work as a team and meet regularly to discuss complex, treatment resistant or unusual cases. As such you will often receive the expertise of several pain consultants. We believe that we are one of very few pain clinics to offer this.

Driving advice: You should not drive that day if receiving any sedation. Our procedures do vary on whether they are possible to drive home from yourself, please seek advice from your consultant about driving advice. If you are seeing us for an injection and planning on driving, please check with us beforehand about whether it will be possible to drive yourself home afterwards.

Wessex Pain Clinic provides consultant-led assessment and treatment for acute and chronic pain conditions. Our multidisciplinary team includes Consultant Pain Specialists, Physiotherapists and Psychologists, offering evidence-based interventions alongside rehabilitation and self-management support. We welcome patients from across Hampshire, Dorset, Wiltshire, Surrey and Sussex, including Winchester, Basingstoke, Southampton, Portsmouth, and Chichester – with both in-clinic appointments and remote consultations available across the wider Wessex region.