Understanding Intercostal Muscle Strain: Causes and Treatment


Intercostal muscle strain is a common condition that can cause discomfort and limitation in daily activities. Understanding the causes and management of this condition is crucial for effective treatment and prevention. In this comprehensive guide, we will delve into the intricacies of intercostal muscle strain, exploring its causes, symptoms, diagnosis, and treatment options.

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Intercostal muscles are muscles that present within the rib cage. Contain three layers of muscles: external, inner, and innermost layers. They combine to fill up the area in between the ribs. External intercostals muscles are the outermost layer. It lies directly under the skin originating from the lower border of the rib and runs obliquely and into the top boundary of the rib below.

It expands the chest wall surface during inhalation. Inner intercostals, the intermediate layer, originate from the costal groove near the inferior boundary of the rib above to the upper border of the rib below. They also help to collapse the Lung during expiration. Inner intercostals muscle crosses more than one intercostal space. It also helps the inner and external intercostals in their function.

Intercostal muscle strain differs according to the type and intensity of the injury. The strain of intercostal muscles causes rib/chest pain, upper back pain, and affects the breathing pattern. The person will have a short breathing pattern because of discomfort. It is an injury that affects the muscles between 2 or more ribs.

Mechanism of Injury

Intercostal muscle pressure doesn’t happen with usual daily tasks. It occurs when the muscles are weakened. It can be caused by overexertion of muscles, direct injury from falling or cars and truck crash, or strike in sports such as hockey, or repetitive torso turning.

  • A direct blow to the rib cage: such as falling, automobile mishap, or trauma from contact sporting activities such as football, hockey. In which the intercostal muscles will stretch or tear as ribs are suddenly compelled to move apart.
  • Turning the torso: turning while training, from dancing, yoga poses, and also some sports such as tennis, golf. In which the ribs are moved apart from its usual place. Excessive torso turning may take place throughout sporting activities.
  • Reaching overhead: extended time of above tasks or lifting over shoulder undue stress on the muscles, as in painting the ceiling.
  • Recurring forceful activity: such as rowing, hitting a tennis sphere.

Intercostal Muscle Strain Risk Factors

  • Physical labor. Such as activities that consist of repeated turning, prolonged overhead tasks, constant weight lifting.
  • High-thrust sporting activities. Repetitive use of the arm, shoulder, and upper back puts tension on intercostal muscle mass.
  • Contact sporting activities. A strain occurs when a direct, sudden pressure strikes the top body.
Intercostal Muscle Strain Symptoms

Symptoms vary according to the level of muscle pressure, strength, and type of injury:

  • Severe unexpected pain in the upper back or rib cage. It can be a result of a direct blow or sudden pressure to the chest or unexpected increase in the exercise.
  • Muscle tension and stiffness cause muscles to respond to injury by tightening, creating upper back pain, and stiffness with activity.
  • Gradual worsening pain. Pain is aggravating within days or weeks if the intercostal muscular tissues are still under the tension of repetitive, steady pressure. This type prevails after sports such as baseball.
  • Difficulty breathing, with an intercostal muscle strain, the breathing pattern will be affected by pain. It will be a short, shallow breathing pattern to avoid pain. That may cause much less blood oxygenation.
  • Tenderness of the affected muscles and surrounding ribs.
  • Inflammation. A strained muscle may be associated with swelling and an increased level of sensitivity in the damaged area.
  • In some rare instances, swelling of intercostal muscles causes a blood clot around the muscle, triggering a hematoma.
  • Pain from intercostal muscle strain increases with coughing, sneezing, or breathing deeply.
  • Diagnosing Intercostal Muscle Strain
  • Diagnosing imaging X-ray, MRI not needed for the medical diagnosis of intercostal stress, but it’s used to eliminate the possibility of rib fracture or internal organ injury.
  • Medical diagnosis is based on individual background and also physical exam:
  • Personal history. You will be asked about symptoms, when and how the pain started if there is a history of current trauma, your exercises.
  • Physical exam, palpation to specify the area of tenderness and swelling. Instructions to do active activities of the torso/trunk to understand to what level it affects the function and also movement.
  • Differential Medical diagnosis:
  • Intercostal muscle pressure may be mistaken for upper back pain. It is reasonably hypermobile, and injury is unusual. Upper back pain is caused by bad posture for a long time. It is a sharp burning pain that can spread out to the neck, shoulder, and also the discomfort is periodic. 
  • An intercostal strain is a result of trauma from the overexertion task. The individual can locate its area of discomfort. Unlike the pain from a lung disorder, it is tough to identify.
    • Management
    • Recovery relies on the severity of the injury. The time varies from a couple of days to 8 weeks in the majority of cases. However, in some cases, it lasts longer and causes upper back pain. The very first advice is relaxing for a few days as well as applying ice back in the very first two days of discomfort to remove the swelling.
    • Try holding a cushion to stabilize the injured, painful area throughout deep breathing as well as coughing.
    • Medical Management:
    • Pain relief medication. These include acetaminophen to disrupt discomfort signals sent to the brain as well as reduce overall discomfort levels.
    • Muscle relaxant medications. In acute severe discomfort for a short term effect to reduce muscle tension and spasm.
    • Anti-inflammatory medicines.
    • Treatment Options
    • Treatment for intercostal muscle strain focuses on relieving pain and promoting healing. Depending on the severity of the injury, treatment options may include:
    • 1. Rest and Activity Modification
    • Resting the affected area and avoiding activities that exacerbate pain can help reduce strain on the intercostal muscles and promote healing.
    • 2. Pain Management
    • Over-the-counter pain relievers such as ibuprofen or acetaminophen may be recommended to alleviate discomfort.
    • 3. Physical Therapy
    • Gentle stretching and strengthening exercises prescribed by a physical therapist can help improve flexibility and promote healing of the intercostal muscles.
    • 4. Ice and Heat Therapy
    • Applying ice packs to the affected area can help reduce inflammation and numb pain. Heat therapy, such as warm compresses or heating pads, may also provide relief.
    • 5. Deep Breathing Exercises
    • Gradually reintroducing deep breathing exercises can help improve lung function and prevent complications such as pneumonia.
    • Prevention Strategies
    • While it may not be possible to completely prevent intercostal muscle strain, there are steps you can take to reduce your risk:
    • Warm-Up: Always warm up before engaging in physical activity to prepare your muscles for exertion.
    • Proper Lifting Techniques: Use proper lifting techniques and avoid lifting heavy objects without assistance.
    • Core Strengthening: Strengthening the muscles of the abdomen and back can provide additional support to the chest muscles.
    • Cross-Training: Incorporate a variety of exercises into your routine to prevent overuse injuries.
    • Conclusion
    • Intercostal muscle strain can be a painful and limiting condition, but with proper management and prevention strategies, you can minimize your risk and promote healing. By understanding the causes and symptoms of intercostal muscle strain and implementing appropriate treatment options, you can get back to enjoying your daily activities with greater comfort and ease.

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