Peripheral nerve injections: intercostal nerve block
Targeted injections of local anaesthetic and corticosteroid around peripheral nerves — including intercostal, ilioinguinal, genitofemoral, lateral femoral cutaneous and other named peripheral nerves — for post-surgical neuropathic pain, entrapment neuropathies and selected chest-wall pain syndromes.
Led by Dr Arul James (Consultant in Pain Medicine, GMC Specialist Register) at The Vesey, Sutton Coldfield. Self-pay and insurance accepted (BUPA, Vitality, AXA, WPA, Cigna, Aviva, Healix). Same-week appointments typical.
Who this procedure is for
- Post-surgical neuropathic pain — after thoracotomy, mastectomy, hernia repair or hip surgery.
- Post-herpetic neuralgia in a peripheral nerve distribution.
- Entrapment neuropathies (e.g. meralgia paraesthetica) that have failed conservative management.
- Rib-fracture pain or persistent chest-wall pain post-trauma.
- Diagnostic block to confirm the suspected pain-generator before considering longer-term neuromodulation.
How the procedure is performed
Ultrasound-guided injection of local anaesthetic and a small dose of steroid around the targeted peripheral nerve(s). For intercostal blocks, typically 2–4 levels are treated per session. Procedure time 15–25 minutes.
Before, during and after
- Before: no fasting required for most peripheral nerve blocks. Wear loose-fitting clothing.
- During: position depends on the targeted nerve; awake, with local anaesthetic to the skin. You may feel referred sensation in the nerve distribution — this confirms correct placement.
- After: 20–30 minutes of monitored recovery. Diagnostic relief is immediate; therapeutic effect develops over 3–10 days.
Recovery and aftercare
No driving for 24 hours. Avoid heavy lifting for 48 hours. Restart usual activity and rehabilitation the next day. Relief typically lasts 2–4 months and the procedure can be repeated as part of a structured plan.
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Risks and side effects
Common: brief site soreness, small bruise, transient numbness or weakness in the nerve distribution. Uncommon: vasovagal reaction. Rare: bleeding, infection, allergic reaction. Intercostal blocks: very rare pneumothorax (minimised with ultrasound guidance).
When this procedure is not appropriate
Uncorrectable bleeding disorder, active local infection, severe contrast allergy (if image-guided), pregnancy for selected blocks.
Cost and pathway
Initial consultation £260. Ultrasound-guided peripheral nerve block from £800, including consent, image guidance, drugs and aftercare guidance.
- Open 7 days including Sundays — 8am to 8pm, no weekend surcharge
- No GP referral required — book directly with Dr Arul James
- Sutton Coldfield location — serving Birmingham, Walsall, Tamworth, Lichfield and the West Midlands
- CQC-regulated — rated 4.88/5 on Doctify from 700+ verified reviews
View the full pain management pathway →
Sutton Coldfield · Birmingham · Walsall · Tamworth · Lichfield · West Midlands · Open 7 days 8am–8pm
Open 7 days · 8am–8pm · 0121 387 3727