After an injury to the ribs or following an active shingles infection, the body can develop what is known as intercostal neuralgia (nerve pain). Intercostal pain typically radiates along the ribs, following the intercostal nerves, and into the mid back region. Pain can also radiate slightly higher or lower based on the primary affected area. Most sufferers of intercostal neuralgia complain of increased pain during physical activity, especially stretching or deep breathing. If the neuralgia was precipitated by the shingles virus, the area may also be itchy, painful, and sensitive.

In this situation, an intercostal nerve block is employed to reduce the inflammation and relieve pain. Using X-ray guidance, Restore Medical Partners physicians place a small needle adjacent to the ribs and inject a mixture of local anesthetic and corticosteroid. Physicians may also recommend a thoracic epidural injection if the radiating pain is advanced enough to cause significant symptoms in the back.