Intercostal muscle strain refers to damage in the muscles between the ribs. These muscles are responsible for aiding in respiration, bracing, twisting, and a variety of other motions, and as such can be an incredibly frustrating injury to deal with, as it’s very easy to trigger pain after damaging the intercostal muscles.
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This makes even resting difficult, as intercostal muscle strain can make lying down, getting up, and even breathing deeply quite painful. Sadly, there are few ways to help deal with intercostal muscle pain, outside of taking care to let the injured muscle rest, mild stretching, and seeking appropriate pain relief from your doctor. Some general tips for improving sleep include:
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- Use a reclining mattress and bedframe to rest while sitting upright.
- You can use a specialized bed wedge to achieve a similar effect.
- Be sure to use pillows to help keep you upright after you fall asleep and keep your neck comfortable.
- Consider some mild breathing exercises before bed.
- Place a pillow under the knees as well, to prevent or reduce associated upper back pain.
What Are Intercostal Muscles?
The intercostal muscles are smaller muscles between your ribs that aid in the expansion and contraction of your ribcage. There are three sets of intercostal muscles – internal intercostal muscles, external intercostal muscles, and the innermost intercostal muscles.
Each set focuses on a different major function. Aside from aiding in breathing, they are also involved in keeping the torso braced, and can be strengthened through stretching exercises and resistance training. Most intercostal muscle strain is a result of:
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- Direct trauma to the muscles themselves (a blow to the chest wall, ribs, or back).
- Sudden twisting or excessive stretching.
- Reaching overhead.
- Certain exercises (such as weighted pull overs).
Common symptoms of an intercostal muscle strain include:
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- Chest pain when coughing, sneezing, or breathing.
- Pain when twisting, curling up, or stretching the rib cage.
- Tightness in the ribs or back.
- Muscle tension, soreness, swelling, and/or discoloration.
Some risk factors also greatly increase the risk of developing intercostal muscle strain, such as the strength and flexibility of the muscle, and the age of the patient.
Preventing Intercostal Pain During Sleep
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The difficulty in preventing flare-ups and general pain when dealing with a rib injury or intercostal muscle strain is that breathing alone can stretch and contract the intercostal muscles, and we simply cannot give up breathing. We can, however, try to keep the torso neutral and minimize twisting or unwanted contact with other surfaces. Intercostal pain may also lead to much shallower, difficulty breathing as a compensatory action, but this could lead to other issues, and potentially interfere with the healing process.
Ask your doctor about appropriate breathing exercises and try to perform them once a day or as prescribed depending on the severity of the injury. Your doctor may also give you a spirometer, so you can monitor your own inhalation and be sure to avoid excessive shallow breathing. Depending on your pain levels and individual factors, your doctor may also recommend certain over-the-counter medication, and/or apply pain relief to the area directly.
Severe strains and tears may warrant corticosteroids and local anesthesia to bring down the swelling and reduce pain signals. When trying to rest, try and stay upright as best as possible. If you’re back home, consider investing in a modified bed frame or a bed wedge to try and recreate a reclining bed, so you don’t have to lie down horizontally, which can exacerbate the pain (especially when you have to get back up).
Living and Coping With Intercostal Muscle Strain
Depending on the severity of your strain, you may be asked to perform certain low-intensity exercises to help the muscle heal – usually simple overhead stretches and breathing exercises. While this sounds counterintuitive, it is best to find the sweet spot between total bed rest and high-impact exercise when helping muscles recover. This is called “active recovery”, and can aid in minor tears and injuries, helping the muscle recover faster and heal properly.
Your doctor may also recommend heat therapy, or pain-relieving ointments. Be sure to discuss combining pain relief strategies with a doctor – certain ointments do not interact well with heat or cold, for example, and it is very dangerous to combine medication. More severe strains may require more rest and medication, however, as well as other pain management methods.
Pain Management and Treatment Options
Aside from home remedies such as rest, ice, and exercise, your muscle strain may be treated via a variety of ways including:
Ultrasound Therapy
Some clinics utilize a special machine or provide wearable devices that rely on high-frequency sound waves to elicit a healing effect in the muscle tissue.
Transcutaneous Electrical Nerve Stimulation
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This type of physical therapy utilizes electrical signals to stimulate the nerves through the skin, reducing pain by activating the muscles and releasing natural endorphins.
Muscle Relaxants
Sometimes, muscle strains can lead to excessive tightness and spasms as the muscle contracts to avoid stretching. Muscle relaxants can reduce the spasms.
Nerve Blocks
An injection meant to temporarily block the nerves located in the ribcage, targeted around the injured area. Nerve blocks can last hours or longer depending on what was injected.
Whether these therapies are necessary depend entirely on the severity and nature of your injury, your pain levels, and your prognosis. Be sure to ask your doctor about other available pain management options.
Avoid Intercostal Muscle Strain Self-Diagnosis
Even doctors go see other doctors – but it’s especially important to visit a professional if you’re complaining of symptoms related to an intercostal muscle strain rather than making a simple self-diagnosis, because these symptoms closely mirror the symptoms of other much more serious injuries and conditions, including rib fractures, bronchitis, lung disorders and/or growths, and pneumonia.
Even if the onset of the pain was trauma or a sudden sharp stab after twisting or lifting, it is still smart to go see a medical professional as soon as possible and undergo some basic diagnostic tests. After your doctor has confirmed it is an intercostal muscle strain, he may still do some further testing to determine how bad the injury really is.
Different degrees of strain require different levels of treatment and anticipatory pain management, as well as early intervention in cases of serious damage (such as a total muscle tear, which may require surgery). Please note that muscle strain is an all-encompassing term that refers to any damage dealt to the muscle, ranging from minor to total tearing. Healing can take anywhere from three weeks to several months.
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