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Intercostal Muscles: Rib Pain, Breathing Difficulty

Rib pain, side cramps also called stitches and difficulty breathing can be signs of intercostal muscle dysfunction.

What pain and symptoms are associated with the intercostal muscles?

  • Pain in between or under the ribs
  • Can cause a ‘stitch’  or sharp  pain in the side
  • Pain in the rib area when lying on your side
  • Pain when twisting the body side to side
  • Sharp pain while taking a deep breath, sneezing, coughing and laughing
  • Pain when lifting arm(s)

Where are the intercostal muscles?

The intercostal muscles are the muscles between the ribs.

What movements do the intercostal muscles control?

  • Raises the ribs with inhalation
  • Assists with trunk rotation
  • Assist with upright posture

Activities that cause intercostal pain and symptoms:

  • Labored breathing (asthma, emphysema, bronchitis, pneumonia)
  • Gasping for air during sports activities
  • Hyperventilation
  • Chest surgery
  • Slumped posture
  • Excessive twisting of the body
  • Chronic coughing
  • Bra band that is too tight
  • Shingles (herpes zoster) can cause pain in and around the ribs


Intercostals Muscles Origin, Insertion, Action, Innervation

The intercostal muscles help you breathe and assist with upright posture.

Interesting facts about the intercostal muscles:

Pain around the bottom of the ribs is often diagnosed as inflammation of the ribs, separated ribs, ulcers or gallbladder trouble. This symptom can be trigger points in the diaphragm and intercostal muscles.

Clinical diagnoses to which the intercostal muscles symptoms may contribute:

  • Rib Subluxation/dislocation
  • Rib separation
  • Costochondritis
  • Bruised ribs
  • Rib fracture
  • Slipping rib syndrome
  • Pleurisy
  • Cardiac disease
  • Intrathoracic disease
  • Gallbladder
  • Ulcer

Other muscles that should be considered and examined in conjunction with the intercostals:

Satellite trigger points associated with the intercostal muscles:

  • Serratus Anterior

For detailed anatomy information:  
Intercostal Muscle Anatomy

Help with Intercostal Muscle and Rib Pain and Symptoms

Cold Therapy Gel For Intercostal Muscle Injury and Rib Pain

Biofreeze Pain Relieving Gel is an excellent pain relieving gel that I use on clients with recent injuries and muscles and joints that are swollen. Biofreeze cold therapy gel works like ice and does not promote swelling. A recent study showed that Biofreeze decreased pain 2 times more than ice and the pain relief lasts 9 - 10 longer. If your pain is from a recently strained intercostal muscles, or bruised, cracked or broken ribs and or sternum, I highly recommend Biofreeze. It will dull the sharp pain and ease the aching to help make you more comfortable.

Warm Therapy Gel for Rib Pain and Breathing Difficulty

Sombra Warm Therapy Pain Relieving Gel is a pain relieving gel that I use both personally and professionally in my massage therapy practice. Unlike other over the counter heating creams, it provides warmth without burning heat.  If your rib pain is caused from breathing difficulty, bronchitis, pneumonia, or COPD, rub Sombra into the rib cage area, chest and upper back to help bring relieve. I recommend Sombra for chronic pain and chronically sore tight muscles.

Hot Cold Pack For Lower Leg Treatment

CorPak Soft Comfort Hot & Cold Pack Wrap is a versatile pack that can be used to treat most areas of the body. The pack is filled with pliable gel and has a soft frost free cover that will not irritate your skin. For recent injuries, use it cold to reduce swelling. For older injures or chronic pain use heat to relax the muscles and increase circulation.

Rib Support For Women

The ITA-MED Breathable Elastic Rib Support is a good rib brace for women. It is cut to fit your shape and it comes up high enough to give you plenty of support. The brace is made from elastic which provides support and compression without the pinching and binding of other rib supports. The Velcro closure allows for easy on and off as well as easy adjustment. If you are suffering pain from a rib or rib muscle or cartilage injury this brace will help you decrease your pain and breath easier. The size chart is available in the additional photos at the top of the page on the left side. Be sure to measure to get the correct size!

Rib Support For Men

The ITA-MED Breathable Elastic Rib Support For Men is an elastic wide band that provides compression and support for the rib cage.  The elastic material will not pinch and bind like some other rib braces. It has a Velcro closure for easy on / off and easy adjustment. If you are suffering from a rib cage injury this band will help decrease your pain and allow for easier breathing. The size chart is available in the additional photos at the top of the page on the left side Be sure to measure to ensure that you get the correct size.

Self Treatment To Relieve Intercostal Muscle and Rib Pain

Do you know that small knots and other dysfunction in the intercostal muscles can contribute to pain in the in and around the rib cage including the sharp pain of a side stitch? The muscles can also contribute to breathing problems.

Pain in and around the rib cage is a common complaint. Pain that is not caused by a recent rib injury is often traced to trigger points in the muscles between the ribs and/or the diaphragm.  The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief can help you find the trigger points in the muscle, treat the area and relieve your pain. Trigger point therapy is also very useful after the acute phase of an injury to help restore muscle balance. It takes a little time and practice to self-treat, but this book is an invaluable source to learn about and treat many types of muscle pain.