Intercostal neuralgia and chest wall pain is caused by nerve compression in the abdominal area, which is the area by the ribcage. The intercostal nerves arise from the spinal cord and lie under the rib, along with the vein and artery. These nerves innervate the muscles of the rib cage, skin and chest cavity. The intercostals nerves can be injured from surgery or trauma, viral infections such as shingles, or idiopathic, meaning they have no identifiable cause. Symptoms include spasmodic pain occurring around the ribs. Due to the placement of the nerve, motions such as breathing, laughing or sneezing can cause pain. Other symptoms include left sided pain in the back, pain in the left side of the ribs, tingling, numbness, loss of appetite, paralysis and atrophy of the muscles. In severe cases, the pain may feel like a lightening bolt and could extend to the back.
How is the procedure performed?
Patients have the option of being given a light anesthetic, or twilight. A small needle is carefully inserted into the inferior border of the rib. The needle is then walked off the rib to lie immediately below the rib. A small amount of contrast material is injected to outline the nerve. A small amount of local anesthetic and steroid is then injected to block the nerve, as well as relieve pain.
What should be expected?
Patients experience minimal pain from the procedure. There is a small risk of pneumothorax, which is a puncture of the lung, and systemic absorption of the local anesthetic. If the pain recurs, there are other procedures that can be considered for long-term pain relief, such as a pulsed radiofrequency ablation of the nerve root or spinal cord stimulation.
Please give us a call at 201-729-0001 for a consultation, if you have chest wall pain. We offer weekday and weekend appointments. Our conveniently located clinics can be found in West Orange, Aberdeen, Clifton, and Lyndhurst.