Intercostal Muscle Strain: Causes, Symptoms, and Treatment

What is Intercostal muscle strain? Before knowing about intercostal strain, you should know about the intercostal muscles. The intercostal muscle lies between the ribs and helps in attaching them. There are three layers of muscles: the external, internal, and innermost layers. These intercostal muscles help in stabilizing the rib cage while the upper body twists or bends in any direction. Also, these muscles especially help in breathing.

If the intercostal muscle is too stretched or pulled, it can tear off which causes intercostal muscle strain. In other words, intercostal muscle strain is an injury in the layer of any intercostal muscle. It causes immense pain in the mid-and upper-back when you have pulled rib muscle or strained rib muscle. Walk down through this article to all know about the intercostal muscle strain treatment along with the common intercostal muscle strain symptoms.  

Causes Of Intercostal Muscle Strains

Many reasons can cause Intercostal muscle strains and some of them are as below:

  • Direct shock to the rib cage
  • Twisting and rotating beyond its normal range
  • Reaching overhead
  • Engaging in repetitive and forceful motions
  • Lifting while twisting

Intercostal Muscle Strain Symptoms

intercostal muscle strain


Below is a list of few symptoms that may help you to identify the intercostal muscle strain:

  • Pain: You will feel a sharp pain at the moment of injury or it may occur more gradually. You will feel more pain when you twist, stretch, breathe in deeply, cough, or sneeze.
  • Tenderness: in the area, where the strain is present between the ribs, it will be sore to the touch.
  • Difficulty breathing: it will be so painful to breathe. You may feel that you are taking small, shallow sips of air which can lead you to shortness of breath.
  • Swelling: There will be inflammation in the partially torn or strained muscle. Also, there will be some swelling between and around the ribs where you have an intercostal muscle strain.
  • Muscle tightness: you may feel tight around the muscles which have strain when you breathe, reach, or twist.

Home Treatment For Intercostal Muscle Strain

It is very painful when you have an intercostal muscle strain. Whether you have intercostal muscle strain in the back or female intercostal muscle strain, here are some home treatments for intercostal muscle strain that you can use at home:

Over-The-Counter Painkillers

There are many anti-inflammatories you can take such as ibuprofen also known as Advil, naproxen (Aleve). You can also take simple pain relievers like acetaminophen (Tylenol) for pain. But you need to be careful about how much and how often to take these medicines.

Also, if you are prescribed any other medication other than over-the-counter medication such as medicines for colds or menstrual cramps, you need to consult the doctor. However, you need to be sure that you are not overmedicating.

Hot And Cold Therapy

Hot and cold therapy is one of the best treatments for the pain caused by intercostal muscle strain to improve intercostal muscle strain stretches. It helps in relieving your pain and also reduces inflammation of the muscle. Take a cold pack and apply it to that particular area for 20 minutes at a time. For the first two days, apply it several times a day for better results. You can also use different things like cold packs. For example, an ice bag, a gel cold pack, a plastic bag with ice, ice in a clean towel, and even a bag of frozen veggies can do the work for you.

After using cold packs, you may want to use hot packs. The heat also helps in the relaxation of muscles. Take a hot pad or a warm damp towel and place it on the area for approximately 20 minutes.

Epsom Salt Soaks

Another effective and relaxing home treatment for intercostal muscle strain is taking a warm bath with Epsom salt. Epsom salt is nothing but a magnesium sulfate that you can buy at any local drug store or online site. You just have to add about 2 cups of Epsom salt to your bath and soak yourself in that warm water for 15 to 20 minutes.

Magnesium is an important mineral for muscle function and when you soak it in, your body absorbs it via your skin. However, it slightly increases the amount of magnesium in the body. The slight increase in the blood levels of magnesium doesn’t do much work but the warm water does. This remedy also helps your body to relax and eases the pain.

Why Breathing Exercise Is Important In Intercostal Muscle Strain?

intercostal muscle strain


When you have an intercostal muscle strain, normal breathing is very painful. You start taking only shallow breaths instead of full and deep breaths. If you continue this process for a long time, it may lead to infection and pneumonia. Therefore, deep breathing exercise is very important and it also helps in reducing stress. Here are few tips that you can practice while doing few minutes of breathing exercise:

  • Place a pillow against the strain muscles tightly
  • Breathe in gradually and as deeply as you can
  • Hold your breath for few seconds
  • Breathe out leisurely
  • Repeat 10 times after short breaks

How To Sleep With Intercostal Muscle Strain

Intercostal muscle strain makes lying down and getting up quite painful, so how to sleep with intercostal muscle strain? Here are few ways that will surely help you to find out how to sleep with intercostal muscle strain:

  • Choose a reclining mattress and bed frame that will help you to rest while sitting upright. Also, you can select a special bed wedge to get a similar effect.
  • Be sure to place pillows around your body for keeping you upright after you fall asleep and make sure that your neck is comfortable.
  • Practice some mild breathing exercises before going to bed.
  • To reduce upper back pain, you can place another pillow under the knees as well

Medical Treatment For Intercostal Muscle Strain

intercostal muscle strain


There are different treatments that you can select for the pain but here are some other ways to treat your intercostal muscle injury:

Ultrasound Therapy: 

Some doctors use a special machines and provide wearable devices. These devices rely on high-frequency sound waves for eliciting a healing effect in the muscle tissue that has an injury.

Transcutaneous Electrical Nerve Stimulation: 

It is a type of physical therapy that utilizes electrical signals to stimulate the nerves through the skin. With the help of this stimulation, there is also a reduction in pain by activation of the muscles and releasing natural endorphins.

Muscle Relaxants: 

Intercostal muscle strains may lead to excessive tightness and spasms because of the contractions in the muscle. Muscle relaxants may also help you in the reduction of spasms.

Nerve Blocks: 

An injection temporarily blocks the nerves that are present in the ribcage, around the strained area. Nerve blocks may help you to escape the pain for hours which depends on the type of injection.

Only doctors can recommend these therapies and are always entirely based on the severity and nature of the injury, pain levels, and prognosis. However, don’t go for any therapy unless your doctor recommends it.

Also Read: Learn Different Muscular Endurance Exercises

When To Visit A Doctor For Intercostal Muscle Injury?

The severity of the injury tells us when to visit a doctor. If you are feeling a low level of pain, a little bit of stiffness, and there is no shortness of breath, within a few days you will be normal. The pain will gradually go away. But if there is pain and lasts more than two or three days, it is advisable to make an appointment with the doctor. Also, if the injury interferes with sleep or your daily activities you should not delay medical treatment. If there is a case of a fall or an accident, check for immediate medical attention.  

A Soft Tissue Occupational Therapist For Intercostal Muscle Strain

A soft tissue occupational therapist may also help you with the pain of intercostal muscle strain. He or she will assess the determination of the cause of the strain, and provide hands-on neuromuscular techniques. Neuromuscular techniques include trigger point therapy, dry needling, and myofascial release, tendons, ligaments, and fascia. These techniques help in releasing tense muscles and improving improper muscle functioning and postures. Soft tissue occupational therapy also helps in preventing recurring intercostal strains.


There are many reasons for Intercostal muscle pain, but mostly this pain is due to a muscle strain. But don’t worry about intercostal muscle strains that can be fully cured within 6-8 weeks. If you have any intercostal muscle strain symptoms, you should not delay a doctor’s visit. It is important to visit the doctor for intercostal muscle strain. Take into consideration different treatments and home remedies if you feel pain. Also, in intercostal muscle strain, you have to avoid twisting and reaching activities that can make your pain worse.

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