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All Posts Tagged: intercostal nerve


A twenty five year old talked about her painful journey to Intercostal Nerve Blocks

For the past few months I felt like someone has been piercing in my lower right rib. Or sometimes it felt like someone has just hit me in the ribs with a baseball bat. The pain often varies during the day in intensity. The recent diagnosis showed up nerve pain from post procedure scar tissue formation from my gall bladder surgery. During my surgery a few years ago I wasn’t even aware of the scar tissue formation as a possible side effect. During the whole day the pain makes me feel like being stabbed in the ribs with an imaginary knife

Last week I had a very slightly invasive procedure called an Intercostal Nerve Block performed by Dr Zaki Anwar, Founder of the Pain Management Institute Anesthesiologist and Pain Management Specialist, which is what I can say was the only hope for me. And to my expectation the pain relieved I had my mother and brother accompanied me an hour drive to The Pain Management Institute, Chicago, Frankfort as, at first the procedure seems like a bit frightening

Dr Zaki Anwar, MD told me in advance that I may be put to sleep, but when I reached there on the day of the procedure he only discussed my medical history and gave me some relaxants and local anesthetics

The procedure was split into a few steps

The very first I was given an IV sedation that helped me relax without putting me to sleep, I was directed to lay on my stomach on the examination table wearing a hospital gown. The my back and rib area was marked and I was told, I was about to be injected with local anesthesia. At first the injected anesthesia burned really bad, all in all the local anesthetics were three. And after a burning sensation I felt like my ribs and back has been numbed.

The most important part of the whole procedure was the intercostal nerve blocks, I was lying still stomach down as if I had moved there might be chances of needle damage my lungs, and Dr. Zaki Anwar, MD uses the X-ray guidance for the intercostal nerve blocks. When Dr. Zaki administered the injection I felt pressure as I was told before. During the whole procedure of performing Intercostal Nerve Blocks Dr. Zaki Anwar kept asking me if it hurts and I answered that I only felt pressure

After the intercostal nerve blocks I was under observation for half an hour, meanwhile the sedation wear off. Dr Zaki Anwar already told me for a couple of days the pain may increase, but soon after I will feel better

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Intercostal nerve block; what you need to know?

Ash Walsh concluded  at 3am this morning that pain from four fractured ribs was too much to race in this weekend’s Supercheap Auto Bathurst 1000

The 29-year-old had idea he’d fend off from the sports car crash with only bruising, but a CT scan yesterday unveiled four fractured ribs. “After a few laps in my friend’s car I thought  I’d be alright and I just woke up this morning a lot terrible,” Walsh explained.

“I hardly slept and at 3 am, I concluded, I can’t do this. It’s more terrible than ever, I was on pain killers and it wasn’t easing. I have been taking plenty of rest from the last weeks, but getting up and doing routinely activities or driving and then rest making it extremely uncomfortable” thanks to Dr. Zaki Anwer, MD, at The Pain Management Institute who introduced intercostal nerve block and helped me get back to competition.

Some of the most recurring complaints from patients visiting emergency rooms all over the United States with chest and abdominal pain

An intercostal nerve block is an injection of medication that assists in relieving chest pain caused by rib fracture resulting from sudden injuries, tragic accidents and shingles. The intercostal nerves are found under each rib, when any of the nerves or tissues encircling get damaged or inflamed, it causes severe pain.

A steroid medication and local anesthetic injected under the rib can help you ease inflammation and eliminate pain explains Dr. Zaki Anwer, MD

Intercostal nerve blocks can also be practiced to help diagnose the source of pain”. Dr. Zaki Anwer, MD

How is an intercostal nerve block done?

Dr. Zaki Anwer, MD, explains the intercostal nerve block procedure At Pain Management Institute.

My patient’s comfort is my primary concern, I will give an Intravenous medication to relax, then you’ll lie on your side, the one not causing pain. I will use an antiseptic solution to clean an area of the skin where the injection will be given.

I will then insert a thin needle under your rib to inject anesthesia. An X-ray guidance will be used to insert a second needle and inject steroid pain medication. Typically the procedure takes less than half an hour and you can go home the same day

Talking about the post procedure outcomes and pain reduction after the injection Dr. Zaki Anwer, MD, elucidates, some patients experience pain relief immediately after the injections, but the pain may return a few hours later as the anesthesia fades.

Lasting relief typically begins in two to three days, once the steroid taking action. The pain relief may be different for every patient, for some patients it may last months, if the treatment works for you I recommend, you can have intercostal nerve block injections from certain intervals to stay pain free

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Intercostal nerve block and your rib pain


An intercostal nerve block is a medical procedure followed  by injections given with a small amount of local anesthetic in the intercostal  nerves to relieve severe pain arising from rib fractures, nerve damage, injuries to the chest wall, postoperative pain along the rib nerves, and shingles

The intercostal nerves are placed under each rib, the pain arises when one of these nerves gets inflamed or irritated. The steroid medications and local anesthetic intercostal nerve blocks  can help reduce pain and inflammation

The procedure

The procedure is done with  the patient lying face down with the arms stretched upwards, if convenient. The blood pressure and the oxygen level are constantly observed, the physician will ask questions to make sure if the patient is not feeling any discomfort during the whole procedure. The area to be treated around the ribs is cleaned with an antiseptic solution, a  very small, thin and lightly blunt needle is attentively placed under the rib and a different colored substance is injected to the intercostal nerves, the injections are guided by X-ray

The intercostal nerve block injections are a blend, of local anesthetic and steroids, the injections only take a  few minutes, however, the whole procedure takes about an hour to complete. The intercostal nerve blocks feels like a little pinching and stinging effect soon after the skin in numbed the feeling fades, the injection needle exerts a little pressure at the site of injection

What to expect after the intercostal nerve block injections?

Soon after the intercostal nerve block the patient will experience a potential reduction in pain, the patient will be kept in observation for a short period. The physician might advise to take rest for a few days, however, the patient can carry with light activities. The intercostal nerve block will provide relief for the period of effectiveness of the local anesthetic

Risks and side effects

The intercostals nerve block exhibit a minimal amount of risks, however, any procedure that involves injection brings some complications that  may include pain at the site of injections, a puncture in the sack containing CSF because of mishandling that may result in headaches, infection, excessive bleeding, nerve rupture or sometimes no reduction in pain. In very rare cases there might be a complication of collapsed lungs. If you experience difficulty in breathing soon after the procedure of the intercostal nerve block, call your doctor immediately

If you or your loved ones are suffering from rib pain, and looking for potentially safe and affordable treatment, know the benefits of intercostal nerve block by a professional advice from Dr. Zaki Anwar, by placing an appointment at 815-464-7212. He is a world renowned Pain Medicine Physician who has been practicing regenerative injection therapies for the past several years with remarkable results.



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