The human rib cage contains small intercostal muscles located between the ribs. These muscles form the chest wall and are involved in breathing, helping the rib cage expand and contract. It is possible to “pull” or strain these intercostal muscles, an injury where muscle fibers are stretched or torn. This type of injury commonly causes chest or rib area pain.
Recognizing the Symptoms
A pulled intercostal muscle typically causes pain in the chest or rib area. This pain can be a sharp, stabbing sensation or a more generalized dull ache. The discomfort often worsens with movements like twisting or bending the torso. Deep breaths, coughing, sneezing, or even laughing can also intensify the pain due to the muscles’ involvement in respiration.
The affected area between the ribs may feel tender to the touch, and you might experience muscle stiffness or tightness. While a mild strain causes minor discomfort, a more severe strain can lead to intense pain and make deep breathing difficult. This difficulty may lead to shallow breaths to avoid increasing the pain.
Common Causes
Intercostal muscle strains often result from excessive force or repetitive motion on the torso. Sudden, forceful twisting or bending is a frequent cause. This can occur during sports like rowing, golf, tennis, or baseball, which involve repetitive upper body movements.
Direct trauma or impact to the rib cage, such as from a fall, car accident, or contact sports, can also lead to these strains. Forceful or prolonged coughing and sneezing, especially during an illness, can cause the intercostal muscles to stretch or tear. Improper lifting techniques or a sudden increase in unaccustomed physical activity can also contribute to an intercostal muscle strain.
Healing and Recovery
Rest is a primary component of recovery; avoid activities that aggravate the pain. Applying ice to the affected area for the first 24 to 48 hours can help reduce inflammation and pain. After this initial period, switching to heat therapy, such as a warm bath or heating pad, can help relax the muscles and promote blood circulation.
Over-the-counter pain relievers like ibuprofen can manage pain and reduce inflammation. Once the initial sharp pain subsides, introduce very gentle, pain-free movements and stretches to prevent stiffness, avoiding anything that causes discomfort. Practicing gentle deep breathing exercises can help maintain lung capacity and prevent shallow breathing, but do them carefully to avoid pain. Recovery time varies by severity: mild cases heal in days to weeks, moderate in three to seven weeks, and severe even longer.
When to Seek Medical Attention
While many intercostal muscle strains can be managed at home, certain symptoms warrant medical evaluation. Seek medical attention for severe, worsening pain that doesn’t improve with home care, or if accompanied by difficulty breathing or shortness of breath. Other concerning signs include chest tightness, fever, chills, or a cough producing phlegm, as these could indicate a more serious condition like an infection.
Pain that spreads to other areas, such as the arm or jaw, or any pain following significant trauma like a car accident or a fall, should also prompt a medical visit, as a rib fracture could be present. Numbness or tingling in the arm or hand alongside rib pain are also red flags. A healthcare professional can accurately diagnose the cause of your pain, ruling out conditions like rib fractures, pleurisy, or heart-related issues that can sometimes mimic intercostal muscle pain.