Intercostal Nerves (Full)

nervi intercostales (T1-T11)

The intercostal nerves (T1-T11) supply the chest and abdominal wall in dermatomal bands. The classic dermatome pattern — each nerve supplying a circumferential strip — makes intercostal nerve injury (rib fracture, thoracotomy, or herpes zoster reactivation) produce the characteristic band-like pain. T4 is at the nipple level, T7 at the xiphoid, T10 at the umbilicus, and T12 below the umbilicus.

Region: Chest

Anatomical Data

Origin, Insertion & Supply

Origin	Anterior rami of T1-T11 thoracic spinal nerves

Clinical Relevance

Clinical Notes

Intercostal nerve blocks between the internal and innermost intercostal muscles at the posterior rib angle provide thoracic and abdominal wall analgesia. Post-thoracotomy pain syndrome from intercostal nerve trauma and neuroma formation is treated with intercostal nerve blocks, transcutaneous electrical nerve stimulation, and occasionally surgical nerve decompression. Post-herpetic neuralgia in the intercostal distribution is the most common chronic pain syndrome from herpes zoster.

Pathology

Common Injuries & Conditions

Post-Thoracotomy Pain Syndrome

Intercostal nerve entrapment or neuroma after thoracotomy producing persistent chest wall pain managed with nerve block and transcutaneous nerve stimulation.