Intercostal muscles are those muscles that are present between the ribs. They play an important role in the movement of ribs and facilitate respiration or breathing.
Strain or sprain of the intercostal muscle is marked by spasmodic intense shooting pain. It is however a self-restricting condition and often resolves in some weeks. Treatment involves alleviation and management of symptoms with medications, rest, and other therapies.
What are the Intercostal Muscles
There are eleven sets of intercostal muscles which occur on the left and right side. The muscles are present in three layers; the inner layer is referred to as internal oblique intercostal muscles, the middle layer is called transverse intercostal muscles, and the outer layer is termed as external oblique intercostal muscles. These 3 layers are connected to the lower and upper rib area which is known as the intercostal space. The internal and external fibers of intercostal muscle pass in opposite oblique courses, while the middle layer of intercostal muscle runs a horizontal course.
The primary function of intercostal muscles is stabilization of the chest wall structure. They also connect the ribs to one another and help the breathing process.
Symptoms of intercostal muscle strain and spasm
Some of the signs and symptoms of intercostal muscle strain and spasm are listed below:
- Constant and intense pain in the area of the chest wall. This is the most prominent symptom.
- The pain is severe, sudden, and acute
- When the chest area with intercostal muscle sprain is examined or touched, then the patient will experience intense pain.
- The pain is usually linked to tenderness
- The degree of pain is sharp, shooting, and intense
- Pain is local and limited to the area with the sprained muscles
- Swelling and inflammation along with tenderness is evident
- Swelling is usually secondary to inflammation of the intercostal muscles or subcutaneous hematoma
- Patients may suffer from stiffness in the chest wall. The stiffness is local and limited to the affected chest wall region
- Movement of the upper body or moving the chest muscles to look to one side may be difficult and painful
- Patients find it difficult to take deep breaths. Their breath is usually shallow.
- There may be shortness of breath or dyspnea
- Increase in severity of pain may hamper the breathing process
- Shortness of breath is secondary to increase of pain intensity during inhalation.
- Breathlessness is secondary to elevation of pain severity when inhaling
- If intercostal muscle sprain and spasms is not treated, then over time the pain may commence with minor chest movements or even with activities like sneezing, breathing, and coughing, etc.
Causes of intercostal muscle strain and spasm
Some of the common causes of intercostal muscle strain and spasm are listed below:
- A sudden twist of the upper body area
- A forceful twist of the chest area can cause injuries and stretch the intercostal space. This can lead to abnormal pulling of the intercostal muscles and eventually intercostal muscle sprain and spasm.
- Any forceful activity which puts extreme pressure on the chest area
- Sudden rotational movement or stretching of the upper body can cause the intercostal muscles to tear or strain. This can occur when stretching suddenly, over stretching, or playing contact sports or games like tennis, volleyball, badminton, or basketball.
- Direct trauma or impact to the chest wall is another cause of intercostal muscle strain and spasm. It can occur as part of sport or work injury or in a car accident.
- Forceful swinging of the arm can cause the rib cage to be pulled in the direction of the swinging arm. When forceful arm swinging is accompanied by twisting of the lower body in the other direction, then intercostal muscle strain or rupture may occur. The intercostal nerve may get trapped within the spasmodic intercostal muscle and result in extreme neuralgic pain in the area. This injury typically occurs in golf, tennis, and baseball, etc., professional athletes.
- Body has limited capacity for physical work. Overexertion can therefore result in fatigue and weakness along with inattentiveness and lack of focus. Carrying out different tasks in such situations can increase the risk to straining the intercostal muscles.
- Not doing warm up exercises before working out or playing sports can cause muscle strain and spasm with even mild or minor movements or twists of the body.
Treatment
Mild intercostal muscle strain and spasm heal in 2 to 3 weeks, moderate sprains recovery takes 6 to 7 weeks, while severe sprains that occur along with muscle rupture may take 6 or more weeks to heal completely.
A few treatment options for intercostal muscle strain and spasm are listed below:
- NSAIDs for pain alleviation
- Muscle relaxants for easing muscle ache and spasm
- Cold compresses; application of ice on affected chest wall area
- Sufficient bed rest
- Some stretching exercises. Strenuous activities must however be avoided during the recovery process
- Intercostal nerve block or INB with corticosteroid injections at really painful areas may be carried out to treat inflammation and ease pain.
