Intercostal nerve blocks are specialised injections used to diagnose and treat pain involving the chest wall, upper abdomen, or ribcage. These nerves run between the ribs and can become irritated or compressed due to surgery, trauma, or inflammation.
At PainMed, intercostal nerve blocks are performed under imaging guidance for safety and precision, and are used both as a diagnostic tool and a therapeutic intervention to manage persistent nerve pain in the thoracic region.
The intercostal nerves emerge from the spinal cord and travel along the ribs, supplying sensation to the chest wall, sides of the torso, and upper abdominal area. Pain from these nerves can feel sharp, burning, or shooting, and is often worsened by movement, coughing, or deep breathing.
An intercostal nerve block involves injecting local anaesthetic, often combined with steroid, near the affected nerve to calm inflammation and block pain signals.
Post-thoracotomy pain syndrome (after lung or heart surgery)
01
Rib fractures or chest wall trauma
02
Intercostal neuralgia
03
Post-herpetic neuralgia (following shingles)
04
Persistent post-surgical pain (e.g. following breast, hernia, or abdominal surgery)
05
Chest wall or flank pain without a clear structural cause
06
Upper abdominal pain due to nerve involvement
07
1
You will be positioned lying on your side or stomach, depending on the location.
2
The skin is cleaned and numbed with local anaesthetic.
3
Using ultrasound or fluoroscopy (X-ray) guidance, a fine needle is placed just under the rib, near the intercostal nerve.
4
A small volume of local anaesthetic (with or without corticosteroid) is injected.
The procedure typically takes 15–30 minutes and is done as a day case.
Intercostal nerve blocks are generally safe when performed by experienced
clinicians using image guidance. Possible risks include:
01
Temporary soreness or bruising
02
Pneumothorax (very rare; a small air leak around the lung)
03
Infection or bleeding (uncommon)
01
Temporary soreness or bruising
02
Pneumothorax (very rare; a small air leak around the lung)
03
Infection or bleeding (uncommon)
05
Transient numbness or weakness near the injection site
06
No improvement (still diagnostically helpful)
05
Transient numbness or weakness near the injection site
06
No improvement (still diagnostically helpful)
Your doctor will discuss these risks and the expected outcomes in detail before the procedure.
Intercostal nerve blocks are appropriate for patients with:
We offer:
Referrals are welcome for both single injection trials and ongoing interventional care.
Let’s Take the Pressure Off Nerve Pain
If you’re experiencing persistent rib, chest wall, or upper abdominal pain, an intercostal nerve block may help clarify and relieve your symptoms.
©2025 PainMed. All Rights Reserved. Built by Clickmatix – Digital Marketing & Web Experts
Originally from England, Sally graduated from St George’s Hospital, University of London in 2004 with a BSc (First Class Hons) in Physiotherapy. Since settling in Australia, Sally has worked in private practice and in the public hospital setting across Sydney.
Sally gained a Masters in Medicine Pain Management from the University of Sydney in 2019 and is a Titled Pain Physiotherapist (as awarded by the Australian Physiotherapy Association).
In addition to private practice, Sally currently works as a Senior Physiotherapist at Westmead Hospital Pain Management Service.
Sally is highly skilled in assessing, diagnosing and treating people who experience chronic pain. She enjoys working with injured workers and CTP claimants. She has a deep understanding of the impact of pain on the whole person and on their functioning in daily life. In partnership with her colleagues, Sally enjoys applying her knowledge and clinical skills to provide a safe space for exploration of the physical and emotional meaning of pain and for recovery of function.
Qualifications and Experience
Dr. Adam is a Fellowship-trained Pain Medicine Specialist with a Fellowship from the Faculty of Pain Medicine (FFPMANZCA) and a Master of Pain Medicine from the University of Sydney. He is dedicated to the comprehensive management of chronic pain across all age groups.
Dr. Adam trained in adult pain medicine at Liverpool Hospital, Nepean Hospital, and the Department of Pain Medicine, and completed additional training in paediatric chronic pain at The Children’s Hospital at Westmead. He currently serves as a Staff Specialist at Westmead and St George Public Hospitals (NSW Health), and is a Visiting Medical Officer (VMO) at Liverpool Public Hospital, St George Private, Sydney Southwest Private, Holroyd Private, Norwest Private, and Nepean Private Hospitals.
He adopts a whole-person, multidisciplinary approach rooted in the socio-psycho-biomedical model, utilising both pharmacologic and interventional techniques. These include:
Dr. Adam is an Authorised Prescriber of Medicinal Cannabis and holds a Diploma in Medicinal Cannabis. He is also certified in Opioid Treatment Programs, including Methadone. His areas of interest include opioid dependence management, medicinal cannabis, and interventional pain procedures.
He also completed advanced training in Virtual Reality Therapy for chronic pain and mental health disorders in Barcelona, Spain, and has further qualifications in Focused Psychological Strategies, Cognitive Behavioural Therapy (CBT), and Clinical Hypnosis.
Qualifications:
