Intercostal Muscle Pain

The intercostal muscles are the muscles between the ribs. These muscles cause pain anywhere in the ribcage area. You may experience pain when taking a deep breath, coughing, and sneezing. Problems in these muscles can also make it painful to lift your arms overhead and twist the body side to side.

Intercostal Muscle Pain Pattern
Intercostal Muscles Pain Referral

Where are the intercostal muscles?

The intercostal muscles connect the ribs together making the ribcage. The muscles connect to the bottom of one rib to the top of the rib immediately below.

What Movements Does It Control?

  • Raises the ribs with inhalation
  • Assists with trunk rotation
  • Assist with upright posture
Intercostals Muscles Origin, Insertion, Action, Innervation
Intercostal Muscles

Looking for detailed muscle anatomy? The Intercostal Muscle Anatomy page has origin, insertion, innervation, and blood supply information. It also lists agonists and antagonists for each muscle action.

What Are The Signs and Symptoms of Intercostal Trigger Points?

Trigger points in the intercostal muscles can be so painful that you may think you have bruised or cracked a rib.

The symptoms:

  • Pain in between or under the ribs
  • Sharp pain while taking a deep breath, sneezing, coughing and laughing
  • Can cause a ‘stitch’  or sharp  pain in the side
  • Pain when twisting the body side to side
  • Pain when lifting arm(s)
  • Pain in the rib area when lying on your side
  • Pain in the ribcage when trying to stand up straight
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Trigger points are small knots found in the muscle that when pressed increase pain in the area or send referred pain to another area of the body. To learn more about trigger points read Muscle Trigger Points and How They Contribute To Muscle and Joint Pain.

What Causes Trigger Points To Develop In The Intercostals?

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

How To Avoid Development of Trigger Points In The Intercostal Muscles

  • Slumping posture contributes to pain throughout the body. Slumping also causes the muscles and organs responsible for breathing to work harder than necessary which contributes to stress throughout the body. Make a conscious effort to stand and sit upright.
  • Avoid repetitive twisting of the trunk. When possible turn the body instead using a twisting motion of the body.
  • Try not to allow yourself to become so out of breath that you are gulping air
  • Check your breathing habits. Does your abdomen or chest rise and fall when you inhale and exhale? If movement is in your chest make a conscious effort to breathe more deeply, inhale until your abdomen expands then exhale slowly.  Practice until this becomes a habit.
  • Ladies if your bra band is too tight it will cause soreness and trigger points to develop. Make sure you are wearing the correct size.

If you have a tendency to slump, have rounded shoulder or forward head posture correcting your posture will reduce your neck, back, shoulder pain and make breathing easier. I  recommend the HailiCare Posture Corrector The corrector fully supports the back and abdominal area while gently pulling your shoulders back which helps you retrain muscle memory to maintain proper posture. You will notice immediately a reduction of pain, tension and find inhaling and exhaling much easier. Start slowly, wearing the brace only 20-30 minutes a day slowly increasing the time you wear it. Some people find it uncomfortable at first, but stay with it as it does get better! 

Intercostal Muscles Trigger Point Treatment

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.

There are many physical therapists, massage therapists, and chiropractors that are trained in trigger point therapy that can show you how to find and treat specific TrPs. Not all have the specific training so be sure to ask before making an appointment.

You can learn self-treatment with help. The Trigger Point Therapy Workbook: Your Self-Treatment Guide for Pain Relief can help you find the trigger points in the muscle, treat it and relieve your pain. Trigger point therapy is also very useful after the acute phase of a chest or rib injury to help restore muscle balance. It takes a little time and practice to learn, but this book is an invaluable source to learn about and treat many types of muscle pain. I highly recommend this book.

Sombra Warm Therapy Pain Relieving Gel is a pain-relieving gel that provides warmth without the burning heat of other over the counter creams and gels.  If your rib pain is caused by breathing difficulty, bronchitis, pneumonia, or COPD, rub Sombra into the rib cage area, chest and upper back to help bring relief. Sombra is highly recommended for chronic pain and chronically sore tight muscles

Biofreeze Pain Relieving Gel is an excellent pain-relieving gel to use on recent injuries as well as 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 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.

Improper or irregular breathing is a major contributor to serratus posterior superior muscle pain.  Learn To Breathe is a DVD by internationally renowned yoga instructor Max Strom that walks you through several breathing exercises that will help you improve your quality of breathing.

The Cureve Hot Cold Pack can be used for warm and cold treatments. The large size works well for intercostal muscle treatments. Use heat for before and after TrP treatments to relax the muscles. Use cold for injury and muscle strain treatments.

If pain in the ribcage is debilitating a compression wrap can help you get through the day. The Braceability Rib Brace will provide compression and support for the rib area helping to reduce pain. Different styles for Men and Women.

How Long Before I Feel A Reduction In Pain?

Intercostal trigger points usually resolve after several treatments though there may be a lingering soreness. For the best outcome treat TrPs several times throughout the day for 1-2 minutes per treatment. It is important to continue treatments until the trigger point is completely deactivated (gone).

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.

Intercostal pain and symptoms can be similar to, contribute to, and be affected by these medical diagnoses:

  • Rib Subluxation/dislocation
  • Rib separation
  • Costochondritis
  • Bruised ribs
  • Rib fracture
  • Slipping rib syndrome
  • Pleurisy
  • Cardiac disease
  • Intrathoracic disease
  • Gallbladder
  • Ulcer
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Other muscles that should be considered and examined in conjunction with the intercostal muscles:

Check this muscle for satellite trigger points:

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Other muscles with similar pain patterns:

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