Q: I am a professional boxer. How can I kill a nerve between my 6th rib?, with alcohol or phenol? Can it be done with steroids? What about Plo Gel? I have heard about injections of maricane, buviocaine, lidocain and depomedrol. But they only last for 2-5 days. I have heard that I can have all this in a Plo Gel. I have been told to freeze or heat the nerve. But I still have no idea what it is. Its the 6th rib on both sides. I have got hurt there. Sometimes I am incapasitated for 5-10 minutes or 1-2 weeks. It feels like a broken rib but it is not. I have been told that it could be intercostal neuralgia, myofascial pain syndrome or Teitze syndrome. Please advise.

A:Neural blockade and similar injection procedures often are prescribed for therapeutic benefits. They are used for alleviating acute pain or an exacerbation of chronic pain and to provide direct and localized therapeutic action, especially in patients in whom pain is accompanied by swelling and inflammation. They help the patient in maintaining an ambulatory or outpatient treatment status; permit the patient to continue in a physical therapy or rehabilitation program; reduce the need for analgesics; and sometimes may help avoid or delay surgical intervention. The application of any injectable substance can lead to allergic, idiosyncratic, or adverse side effects and its safe and effective use requires thorough knowledge of the pharmacology of local anaesthetics (LAs). Local anaesthetic peripheral nerve injection aims to get the local anaesthetic as close to the nerve as possible to ensure that as much of the nerve as possible is exposed to it. Lidocaine and bupivacain are widely used LA. Neurolytic peripheral nerve injection aims for nerve destruction by using substances like phenol or absolute alcohol, which are applied directly to the nerves, which supply the part of the body responsible for causing the pain. Corticosteroids are used commonly to treat presumed tissue inflammation and stabilize nerve membranes. Please contact a Pain Clinic/Dept. of Anaesthesiology in any major hospital and they should be able to help.