Tips for Sleeping with Intercostal Muscle Strain | Sleep Foundation (2022)

When you are recuperating from an injury, such as intercostal muscle strain, sleep is an important component of the recovery process. As you sleep, your body repairs tissues and cells. Developing strategies for falling asleep and staying asleep despite pain from the injury can help you recover.

What is Intercostal Muscle Strain?

Intercostal muscle strains are muscle tears in the intercostal muscles. These types of strains are a common cause of musculoskeletal chest pain.

Your intercostal muscles are located in between your ribs, and they help you breathe during physical activity. The external intercostal muscles contract to raise your ribs when you inhale. The internal intercostal muscles contract when you forcibly exhale.

Causes of Intercostal Muscle Strain

Strains are a common soft-tissue injury in sports. Intercostal muscles can sustain a strain from sports that require intense upper body effort.

For example, both batting and pitching in baseball and softball twist the upper body. A study examining 20 years of baseball injuries found that over 90% of recorded muscle strains involved either the intercostal muscles or the internal/external oblique muscles in the abdomen. Other common sports that cause intercostal muscle strain include weight lifting and rowing.

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Intercostal muscles can also be strained from one-time injuries or from repetitive movements, such as coughing, painting a ceiling, or chopping wood.

Symptoms of Intercostal Muscle Strain

If you have strained your intercostal muscles, you may experience a number of symptoms:

  • Localized Pain: The pain may worsen when you use your intercostal muscles, such as when you take a deep breath or cough.
  • Tenderness: The affected area is typically sensitive to touch.
  • Swelling: Swelling may occur in some cases of muscle strain, but it may take several hours to appear.
  • Muscle Spasms: Some injuries can cause the muscles to involuntarily contract or spasm.

Diagnosis of Intercostal Muscle Strain

If you experience pain in the ribs, it is important to get a proper diagnosis from a healthcare professional. A healthcare provider typically diagnoses intercostal muscle strain by first asking questions about how the injury happened, and whether you have had similar injuries in the past.

They also perform a physical exam, which includes feeling the affected area for tenderness. Often the questioning and exam are sufficient for diagnosis. However, in some cases your doctor may order x-rays or magnetic resonance imaging (MRI) tests to check for other injuries, such as fractures or swelling.

Muscle strains can be classified into one of three categories:

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  • First Degree (Mild): Muscle fibers are stretched and a few may be torn.
  • Second Degree (Moderate): A significant number of muscle fibers are torn.
  • Third Degree (Severe): All muscle fibers are torn.

Second- and third-degree strains require more time to heal.

Treatment for Intercostal Muscle Strain

After addressing potentially serious injuries, your doctor may recommend one or more of the following treatments:

  • Rest: It is especially important to avoid movements that cause the pain to reoccur. For athletes, this may require time away from practice and competition or limited movements to avoid reinjury. Your treatment provider can work with you to gradually strengthen your muscles and work on regaining range of motion.
  • Ice: In the days immediately following the injury, you may be able to reduce swelling by applying an ice pack wrapped in a towel for 15 to 20 minutes at intervals throughout the day.
  • Heat Therapy: After the first few days have passed, you can switch from using an ice pack to using a heating pad to treat the strain. Heating the injured muscles may help relieve pain and speed up the recovery process.
  • Pain Relievers: Some medications can reduce the amount of pain you experience from the strain. Talk to your doctor about which medications are appropriate to take, as some may increase bleeding.
  • Surgery: If the muscles are completely torn, you may need surgery.

The average intercostal muscle strain takes about four to five weeks to heal, but the healing process may be shorter or longer depending on the severity of the strain.

How to Sleep With Intercostal Muscle Strain

Falling asleep or staying asleep while in pain can be a challenge. Responses to the National Sleep Foundation’s 2015 Sleep in America poll showed that people who experience severe pain obtain less sleep at night, experience poorer-quality sleep, and feel less in control of their sleep.

Managing your pain is a key step to better sleep and recovery from an intercostal muscle strain. There are a number of strategies you can use to relieve symptoms and get the full night of rest you need.

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Talk to Your Doctor

You should inform your healthcare provider of your pain levels and sleeping difficulties so they can determine a treatment plan that is right for you. Be sure to let your doctor know what treatments you have tried or are currently using, such as heat therapy and over-the-counter pain relievers.

In more serious cases where the muscles continue to be reinjured, your healthcare provider may inject the area with corticosteroids or lidocaine. These injections can provide relief from pain.

Gentle Breathing and Stretching Exercises

Your healthcare provider may recommend stretching and breathing exercises to assist in recovery and ensure that the pain from your injury does not unduly limit your breathing capacity.

Research also shows that deep breathing may help reduce pain and stress, so these exercises may also be helpful as part of a bedtime routine. Proceed cautiously and consult your healthcare provider if the pain worsens.

Meditation Exercises to Reduce Pain

Preliminary research suggests that mindfulness meditation may help improve pain and promote physical relaxation. While there are many different forms of meditation, they usually include the following components:

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  • Sitting in a comfortable position
  • Meditating a quiet space
  • Focusing attention on breathing, an object, or selected words
  • Maintaining an open attitude, or a mindset of letting distractions come and go without judgment

Keep Your Torso Neutral and Minimize External Pressure

If you struggle to fall asleep because of pain from an intercostal muscle strain, consider changing your sleep position. The ideal sleep position should keep the spine properly aligned, with the torso in a neutral position that protects against unwanted twisting or added weight on the injury. If you sleep on your side, you may feel more comfortable sleeping on the side that is not injured. You should find a comfortable mattress and the best pillow to support your head, neck, and upper body.

Especially during the first couple of days, you may find it helps to keep your upper body elevated. Try propping yourself up using pillows, or an adjustable base if you have one.

Practice Good Sleep Hygiene

Implementing healthy habits can help lay the groundwork for better sleep as you recover. Elements of good sleep hygiene include:

  • Keeping a Consistent Sleep Schedule: On both weekdays and weekends, going to bed and waking up at the same time helps facilitate sound sleep.
  • Creating a Bedtime Routine: Activities such as meditating, reading, or taking a warm bath can help you unwind before bed.
  • Exercising During the Day: Exercise has been shown to positively impact sleep. Although you may not be able to practice your regular sport, gentle activities such as walking or yoga can keep your body moving.
  • Making a Comfortable Sleeping Environment: An ideal bedroom is dark, cool, and quiet. If necessary, use sleep accessories such as an eye mask or earplugs to make the environment more conducive to sleep. You can also use blackout curtains to prevent light from entering the room, or a white noise machine to muffle background noise.
  • Avoiding Electronics Before Bedtime: Cell phones, computers, TVs, and gaming devices all emit bright light that can make falling asleep difficult.
  • Limiting Use of Your Bed to Sex and Sleep: To help your brain form a connection between your bed and sleep, avoid lying in bed for longer than 20 minutes if you are unable to sleep. Instead, go do a relaxing activity in another room and come back to bed when you feel sleepy.

If you are still struggling to fall asleep or stay asleep, talk to your healthcare provider. They can help identify if there is an underlying sleep disorder that is negatively impacting your ability to get a full night’s sleep.

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FAQs

How do you sleep with a strained intercostal muscle? ›

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.

How do you sleep with a pulled rib? ›

If you have a bruised or fractured rib, the best way to sleep is upright. Use pillows and bolsters to help you sit up in bed, or sleep in an easy chair. Lying on your rib cage at night puts pressure on the injury, which can cause significant pain. Use lots of soft pillows to cushion your rib cage as you sleep.

How do you lay down with a pulled muscle? ›

Try lying on your back with your legs to one side and pop a pillow between your knees. Extra supportive pillows will work better and are definitely worth considering. Other positions include lying on your side in the foetal position or lying on your stomach with a pillow underneath your abdomen.

How do you release tight intercostal muscles? ›

Extend both arms to the sides. Then, bend the upper body toward the right, so the right arm rests on the extended leg. Continue to reach the left arm overhead so a stretch is felt in the left ribs. Hold the stretch between 15 and 30 seconds, then repeat on the left side.

How can I speed up muscle tear recovery? ›

Read on for seven tips for muscle injury recovery that will speed up or improve your recovery.
  1. Stay Hydrated. ...
  2. Reduce Inflammation With Cherry Juice. ...
  3. Increase or Improve Sleep. ...
  4. Compress the Affected Muscle. ...
  5. Switch to Low-Impact Exercise During Injury Recovery. ...
  6. Up Your Protein Intake. ...
  7. Limit Alcohol and/or Tobacco Consumption.
15 May 2021

Can intercostal strain get worse? ›

Additionally, a sudden increase in physical activity can strain an intercostal muscle and lead to sudden, intense pain. Gradually worsening pain. Upper back pain may develop progressively over several days or weeks if repetitive, gradual stress is placed on the intercostal muscles.

How do you massage your intercostal muscles? ›

Massage for the Intercostal Muscles - YouTube

Why do my ribs hurt more when I lay down? ›

Sleeping on your side can put excessive strain and pressure on your ribcage, arm, and shoulder and thus may be the cause of your aches and pains in the morning. If you have a traditional flat mattress, this may exacerbate your pain even more.

How painful is intercostal strain? ›

Pain: You may feel a sharp pain at the time of injury, or it may come on more gradually. The pain will get worse when you twist, stretch, breathe in deeply, cough, or sneeze. Tenderness: The area of the strain between your ribs will be sore to the touch.

How long does an intercostal tear take to heal? ›

It can take as long as 10 weeks for intercostal muscle strains to heal, which can be frustrating. The area may be injected with lidocaine and corticosteroids if you have a painful or swollen strain. A rib stress fracture is sometimes associated with intercostal muscle strains.

How do you strengthen your intercostal muscles? ›

There are two primary free weight exercises you can do to strengthen the intercostals: barbell pullovers, and dumb bell flyes. When focusing on strengthening the intercostals moving with your breath is essential. Perform the barbell pullover as you normally would but be sure to choose light weights.

How do you sleep with a strained back? ›

1. Sleep on your side to relieve pain from a pulled back muscle
  1. Avoid a tight curled-up fetal position (knees pulled in toward the body), and instead sleep with your body slightly elongated.
  2. Slip a slim pillow between your knees to support the natural curvature of your spine.

How do you stretch your internal intercostal? ›

Intercostal Muscle Stretch - YouTube

How do you stretch your intercostal rib muscles? ›

Diaphragm & Intercostal Muscle Stretches - YouTube

How long does intercostal muscle pain last? ›

Healing depends on the severity of the injury, the time range from a few days to 8 weeks in the majority of cases and in some cases lasts longer other last longer cause upper back pain.

What foods help repair muscle damage? ›

The 10 Best Muscle Recovery Foods and Drinks
  • Tart cherry juice. Drinking tart cherry juice may benefit both trained athletes and novice gym-goers alike. ...
  • Watermelon and watermelon juice. Watermelon is sweet, hydrating, and loaded with nutrients. ...
  • Fatty fish. ...
  • Pomegranate juice. ...
  • Beet juice. ...
  • Whey protein shakes. ...
  • Eggs. ...
  • Dairy.
19 Aug 2021

Can a xray show a pulled muscle? ›

Your physician may be able to diagnose a sprain based on a history and physical exam. An X-ray may be necessary to be sure you don't have a broken bone, but it won't show a muscle injury. An MRI is the best type of imaging for looking at tissue.

What is the fastest way to heal sore ribs? ›

Do
  1. take painkillers, such as paracetamol or ibuprofen – avoid taking ibuprofen for 48 hours after your injury as it may slow down healing.
  2. hold an ice pack (or a bag of frozen peas in a tea towel) to the affected ribs regularly in the first few days to bring down swelling.
  3. rest and take time off work if you need to.

What doctor treats rib pain? ›

If you have started to feel pain while breathing or feel extreme tenderness over the area of one or more ribs, then you should meet with an orthopedic doctor.

Can a chiropractor help with intercostal muscle strain? ›

CHIROPRACTIC is very effective in the treatment of Intercostal Neuralgia or rib pain. Examination of the chest and mid back starts with light touch, hands on, palpation of the Thoracic spine, Rib cage, Sternum, and musculature in order to determine the Rib head that is involved.

What is the home remedy for rib pain? ›

If the rib cage pain is due to a minor injury, such as a pulled muscle or bruise, you can use a cold compress on the area to reduce swelling. If you're in significant pain, you can also take over-the-counter pain relievers such as acetaminophen (Tylenol).

Where is the intercostal nerve located? ›

At the back of the chest, they lie between the pleura and the posterior intercostal membranes. Later near the sternum, they cross in front of internal thoracic vessels and sternocostalis muscle.

Will massage help intercostal muscle strain? ›

Massage therapists generally loosen the fascia (a band of connective tissue that separates the muscles) to get those intercostal muscles to let go, Hovi said. "When they relax, the center of the bone is drawn back together and you can breathe easier," he explained.

Does a rib injury get worse before it gets better? ›

The worst pain is usually the first 1-2 weeks and gets gradually better after that.

Why do my ribs hurt at the back? ›

An intercostal muscle strain refers to a muscle injury between two or more ribs. The intercostal muscles, commonly referred to simply as the intercostals, connect the ribs and help make up the chest wall. When these muscles overstretch or tear, they can cause significant pain in the mid- and upper back.

How painful is intercostal strain? ›

Pain: You may feel a sharp pain at the time of injury, or it may come on more gradually. The pain will get worse when you twist, stretch, breathe in deeply, cough, or sneeze. Tenderness: The area of the strain between your ribs will be sore to the touch.

How long does intercostal strain last? ›

Healing depends on the severity of the injury, the time range from a few days to 8 weeks in the majority of cases and in some cases lasts longer other last longer cause upper back pain.

Is massage good for intercostal muscle strain? ›

If you have had a cold, or your chest and upper body are feeling tight and compressed, let your massage therapist know that you'd like a little extra work on the intercostals. Your therapist can massage these thin grooves or spaces between the ribs quite effectively to give you relief.

How long does an intercostal tear take to heal? ›

It can take as long as 10 weeks for intercostal muscle strains to heal, which can be frustrating. The area may be injected with lidocaine and corticosteroids if you have a painful or swollen strain. A rib stress fracture is sometimes associated with intercostal muscle strains.

What is the fastest way to heal sore ribs? ›

Do
  1. take painkillers, such as paracetamol or ibuprofen – avoid taking ibuprofen for 48 hours after your injury as it may slow down healing.
  2. hold an ice pack (or a bag of frozen peas in a tea towel) to the affected ribs regularly in the first few days to bring down swelling.
  3. rest and take time off work if you need to.

How do you strengthen your intercostal muscles? ›

There are two primary free weight exercises you can do to strengthen the intercostals: barbell pullovers, and dumb bell flyes. When focusing on strengthening the intercostals moving with your breath is essential. Perform the barbell pullover as you normally would but be sure to choose light weights.

How do you give yourself an intercostal muscle massage? ›

Examine the entire area between the two ribs for sensitive points – starting from your sternum following the line of your ribs all the way back to the lateral side of your ribcage. Massage each of these sensitive points a few times. Move with your thumb from just before to just after the spot.

How do you stretch your internal intercostal? ›

Intercostal Muscle Stretch - YouTube

Why do I keep straining my intercostal muscles? ›

The likelihood of an intercostal strain increases when the muscles are weakened, either from overusing the muscles to the point of burnout, from atrophy due to lack of exercise, or from chronic poor posture.

What exercises cause intercostal pain? ›

You can strain the intercostal muscles suddenly or by doing certain movements over and over. Coughing. Exercises or sports with repetitive movements, twisting, lifting or stretching. Injuries to the chest from a fall or hard hit.

What is the home remedy for rib pain? ›

If the rib cage pain is due to a minor injury, such as a pulled muscle or bruise, you can use a cold compress on the area to reduce swelling. If you're in significant pain, you can also take over-the-counter pain relievers such as acetaminophen (Tylenol).

What doctor treats rib pain? ›

If you have started to feel pain while breathing or feel extreme tenderness over the area of one or more ribs, then you should meet with an orthopedic doctor.

Can a chiropractor help with intercostal muscle strain? ›

CHIROPRACTIC is very effective in the treatment of Intercostal Neuralgia or rib pain. Examination of the chest and mid back starts with light touch, hands on, palpation of the Thoracic spine, Rib cage, Sternum, and musculature in order to determine the Rib head that is involved.

Why do cracked ribs hurt more when lying down? ›

Sleeping while lying down may exert unwanted pressures on the spine, which might be transferred to the ribs. This, in turn, causes the ribs to ache, making it difficult to get out of bed.

How should you sleep with bruised ribs? ›

Try to sleep in a comfortable semi-upright position for the first few nights. You can do this by placing a few pillows under your neck and upper back. This position will help you breathe more comfortably. Begin to sleep on your unaffected side after the first few days of injury.

Can you pull a muscle in your side while sleeping? ›

“It's common to think of muscle strains as sports injuries. But everyday activities, such as sitting at a desk or sleeping in an awkward position, cause strains, too,” says Dr.

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