Intercostal Muscle Strain: Signs, Treatments, And Remedies

Maybe your like

Medical News TodaySubscribeWhat is an intercostal muscle strain?

Medically reviewed by Meredith Goodwin, MD, FAAFP — Written by Sherry Christiansen — Updated on April 17, 2025

Symptoms
Causes
When to see a doctor
Diagnosis
Treatment
Outlook
Summary

Intercostal muscle strain is an injury affecting the muscles between two or more ribs. Symptoms can include sharp, direct pain, stiffness, and mobility difficulties.

The intercostal muscles have different layers that attach to the ribs to help build the chest wall and assist in breathing. When an intercostal muscle gets twisted, strained, or stretched too far, it can tear, causing intercostal muscle strain.

In this article, we examine the signs of an intercostal muscle strain, and how to tell one apart from other upper body pains and injuries. We also look at the causes and treatment options for these strains.

Signs and symptoms

A person climbing a climbing wall-2. — Jordi Salas/Getty Images

The signs and symptoms of an intercostal muscle strain can differ slightly, depending on their cause. However, as the intercoastal muscles are present in the trunk of the body and are essential for breathing, symptoms are localized to this area and often involve breathing.

Symptoms may include:

sharp upper back and rib pain
severe and sudden pain, particularly if caused by a blow to the chest or back
gradual worsening pain after repetitive movement, such as rowing, swimming, or other physical exercises
stiffness and tension in muscles, causing upper back pain
muscle rigidity when bending or twisting the upper body
worsening pain when coughing, sneezing, or breathing in deeply
spasms of the intercostal muscles
tenderness in the area between the ribs

Intercostal muscle strain vs. other upper body pains

Injuries rarely occur to the upper back because it is relatively immobile. According to Harvard Medical School, if this area is the cause of pain, it is often due to long-term problems with posture, such as slouching. It can also be due to a severe injury that has weakened the sturdiness of the upper spine, such as a car accident.

People usually experience pain from upper back injuries as a sharp, burning pain in one spot. The pain can spread to the shoulder, neck, or elsewhere in the upper body, and it may come and go.

Intercostal muscle strain is almost always the result of some event, such as overexertion or injury. In contrast, the initial source of pain from pneumonia or other lung disorders is difficult to pinpoint.

If the specific area of discomfort can be located, such as between the ribs, this indicates the pain is not coming from the lungs or the upper back. People often describe lung pain as sharp and spreading outward.

With a rib fracture, the pain is usually much more severe than that of intercostal muscle strain.

The following symptoms may signal a rib fracture:

feeling breathless
a protrusion or a sharp stabbing sensation in the rib area
an area around the ribs that is extremely tender to touch

A fractured rib is a medical emergency requiring immediate attention.

Common causes

Routine activities are not usually the cause of intercostal muscle strain. These strains most often occur as the result of an injury or overexertion of the muscles.

Common causes include:

a direct blow to the rib cage, such as from a fall or car accident
an impact blow from contact sports, such as hockey or football
twisting the torso beyond its usual range of motion
twisting while lifting weights
forceful twisting, such as from golf or tennis
twisting from specific yoga postures or dance positions
reaching overhead, for example, when painting a ceiling
lifting any heavy object above shoulder height
prolonged overhead reaching
repetitive forceful movements, such as hitting a tennis ball

A sudden increase in physical activity can also lead to an intercostal muscle strain. This is particularly true when a lack of exercise or poor posture may lead to weaker muscles.

When to see a doctor

The time to see a doctor depends on the severity of the injury. A mild injury may result in a low level of pain and stiffness that goes away within a few days.

It is advisable to see a doctor if the pain from a rib injury is severe, lasts for more than a few days, or interferes with sleep or daily activities.

The United Kingdom’s National Health Service (NHS) notes that if a traumatic injury, such as a fall or an automobile accident, has occurred, breathing is difficult, or a person is coughing up blood, immediate medical attention is necessary.

The NHS also highlights that people should see a doctor if they have a broken or bruised rib and:

their pain has not improved within a few weeks
they have a fever or feel hot and shivery
they are coughing up yellow or green mucus

Diagnosis

Diagnosing intercostal muscle strain involves a physical exam. The aim is to check for any limitations of movement and assess areas that are tender. For example, this may include a pulmonary exam, which can help with diagnosing problems in the trunk of the body. The doctor will also ask about any recent injuries or sports involvement.

A healthcare professional may order imaging tests like ultrasound or MRI scans. This can help to rule out other injuries, such as a fractured rib.

Treatment

Home treatment may be all that is necessary if the injury that causes an intercostal muscle strain is not severe and symptoms are mild. The NHS notes that home treatment options can include the following:

Applying an ice pack or cold pack, followed by heat therapy. Heat therapy options include a warm bath, heating pads, or adhesive heat wraps.
Resting and limiting all physical activity for a few days to allow time for the muscle strain to recover.
Taking pain medications to reduce swelling and pain. Over-the-counter medications that may help with intercostal muscle strain include acetaminophen or ibuprofen.
Splinting the area if breathing is painful by holding a pillow against the injured muscle. However, difficulty breathing means a person must seek medical attention right away.

In addition to the home remedies described above, the doctor may order the following:

muscle relaxants for severe pain and spasms
physical therapy (PT)
injection of lidocaine and corticosteroids to reduce pain and swelling if other treatments fail

Physical therapy

PT may involve various stretches and breathing exercises to help strengthen intercostal muscles. These may include side bending and deep breathing, according to the NHS.

If breathing becomes difficult or painful, deep breathing exercises can help improve shallow breathing. Long-term shallow breathing can lead to complications, such as pneumonia.

A person with intercostal muscle strain should not do any stretching exercises unless under the supervision of a physical therapist or other healthcare professionals.

An individual should stop stretching immediately if it increases pain or makes symptoms worse.

Outlook and prevention

How long an intercostal muscle strain lasts depends on the severity of the injury, according to Harvard Medical School. Mild intercostal muscle strain commonly heals within a few days. Moderate strains may take 3 to 7 weeks to heal, and severe strains that involve a complete tear of the muscles can take longer.

The NHS notes that, in general, most intercostal muscle sprains and other rib injuries should heal within a 6-week time span.

Prevention of future muscle strains involves warming up and stretching before performing strenuous exercises. It is important not to overdo it when it comes to working out or taking part in sports.

Keeping muscles strong also helps with the prevention of intercostal muscle strain.

Summary

Intercostal muscle strain refers to an injury affecting the muscles between two or more ribs. It may cause sharp, direct pain, stiffness, and mobility difficulties.

This type of injury often results from overexertion or injury during exercise, such as twisting while lifting weights, prolonged overhead reaching, or a direct blow to the ribs.

Treatment may involve cold and heat therapy, rest, or OTC pain medications. In some cases, people may require PT, muscle relaxants, or injectable medications, such as corticosteroids and lidocaine.

People should contact a doctor if rib pain from a minor injury does not go away within a few days. They should seek emergency medical treatment if they sustain a traumatic rib injury such as during an automobile accident, are having difficulty breathing, or are coughing up blood.

Rheumatology
Sports Medicine / Fitness

How we reviewed this article:

SourcesMedical News Today has strict sourcing guidelines and relies on peer-reviewed studies, academic research institutions, and medical journals and associations. We only use quality, credible sources to ensure content accuracy and integrity. You can learn more about how we ensure our content is accurate and current by reading our editorial policy.

4 ways to turn good posture into less back pain. (2020).https://www.health.harvard.edu/pain/4-ways-to-turn-good-posture-into-less-back-pain
Broken or bruised ribs. (2024).https://www.nhs.uk/conditions/broken-or-bruised-ribs/
Daniels SP, et al. (2021). US-guided musculoskeletal interventions of the body wall and core with MRI and US correlation.https://pubs.rsna.org/doi/full/10.1148/rg.2021210050
Hopkins B. (2019). Intercostal muscles.https://www.lancaster.ac.uk/fas/psych/glossary/intercostal_muscles/
Kuo K, et al. (2023). Rib fracture.https://www.ncbi.nlm.nih.gov/books/NBK541020/
Muscles of the trunk. (n.d.).https://training.seer.cancer.gov/anatomy/muscular/groups/trunk.html
Pulmonary exam: Percussion and inspection. (n.d.).https://stanfordmedicine25.stanford.edu/the25/pulmonary.html
Rib injury. (2023).https://www.uhsussex.nhs.uk/resources/rib-injury-2/
Shmerling RH. (2023). Muscle strain.https://www.health.harvard.edu/a_to_z/muscle-strain-a-to-z
Tang A, et al. (2023). Anatomy, thorax, muscles.https://www.ncbi.nlm.nih.gov/books/NBK538321/

Share this article

Medically reviewed by Meredith Goodwin, MD, FAAFP — Written by Sherry Christiansen — Updated on April 17, 2025

Latest news

Can treating rheumatoid arthritis before it sets in help delay its onset?
Night owls may have a higher cardiovascular risk: Here's why
Low vitamin D may increase respiratory infection risk by as much as 33%
2 or more alcoholic drinks a day linked to 91% higher colorectal cancer risk
Predisposition to blood sugar spikes linked to 69% higher Alzheimer's risk

Related Coverage

What is intercostal neuralgia?
Intercostal neuralgia is a condition in which an individual experiences neuropathic pain throughout their rib cage and abdomen. Learn more here.
READ MORE
Pulled muscle in chest: Symptoms and treatmentMedically reviewed by Angela M. Bell, MD, FACP
A pulled muscle in the chest can result in mild discomfort or cause severe symptoms. Learn about the causes and treatment here.
READ MORE
What causes muscle soreness and stiffness?Medically reviewed by Angela M. Bell, MD, FACP
Muscle stiffness is when the muscles feel tight and difficult to move. Most cases can be treated with home remedies, but some require medical…
READ MORE
Unexplained muscle pain in arms and legsMedically reviewed by Angela M. Bell, MD, FACP
Unexplained muscle pain may be due to injury or overuse. However, it may also be a sign of an underlying condition. Learn more here.
READ MORE
Cyclobenzaprine oral tablet dosageMedically reviewed by Alexandra Perez, PharmD, MBA, BCGP
Learn about the dosage of cyclobenzaprine oral tablet for treating muscle spasms. You can also find information on the drug’s strengths, form, and…
READ MORE

Tag » What Is Thoracic Muscle Strain

Intercostal Muscle Strain: Signs, Treatments, And Remedies

Health Conditions

Health Products

News

Original Series

Podcasts

General Health

Health Tools

Quizzes

About Medical News Today

Find Community

Follow Us

Signs and symptoms

Intercostal muscle strain vs. other upper body pains

Common causes

When to see a doctor

Diagnosis

Treatment

Physical therapy

Outlook and prevention

Summary

How we reviewed this article:

Latest news

Related Coverage

Thoracic Or Lumbar Sprain Or Strain - Plainsboro Township, NJ

Thoracic Back Strain (Aftercare Instructions)

Thoracic Strain/Sprain | Blog Maywood Physical Therapy

Thoracic Muscle Strain | SpringerLink

Upper And Middle Back (Thoracic) Strain: Care Instructions

Upper Back Pain From Intercostal Muscle Strain - Spine-health

Back Strains And Sprains - Cleveland Clinic

Thoracic Strain: Causes, Symptoms And Treatment - Findlocal Doctors

Thoracic Sprain - NJ's Top Orthopedic Spine & Pain Management ...

Thoracic Back Pain | Symptoms, Causes And Treatment

Thoracic Back Pain - Physiopedia

Thoracic Sprain/Back Sprain Doctors NYC & NJ

Intercostal Muscle Strain: Symptoms, Treatment, And More - Healthline

Contact