How To Sleep With Intercostal Muscle Strain

How To Sleep With Intercostal Muscle Strain (2024)

Last updated: 31.10.2023 Reading time: 7 Min.

Are you struggling to sleep with intercostal muscle strain?

You're not alone - A strain in the intercostal muscles, which run between the ribs, can make everyday activities like sleeping and even breathing a nightmare.

There's no avoiding breathing, and sleep is essential for healing, so what are you meant to do? 🤔

Take a (not too deep) breath and relax: We're here to help.

We'll guide you through what you can do to promote healing, alleviate pain, and ensure you get a good night's sleep.

Let's take a look at how you can take back your sleep. 💤

Sleeping with intercostal muscle strain

What are intercostal muscles?

Let's take a minute to dive into what the intercostal muscles are and what they do (for anyone who wants to know).

Or, you can skip straight to our 'How to sleep with intercostal muscle strain' section. 👇

Woman confused
Understanding what an intercostal muscle is can help you work out if you've strained yours.

The intercostal muscles are tucked between your ribs.

They help your ribcage expand and contract. 🫁

This team of rib muscles comprises of three key players: the internal intercostal muscles, external intercostal muscles, and innermost intercostal muscles.

What is an intercostal muscle strain?

So, you know what intercostals are and what they do, but what is an intercostal muscle strain?

Simply put, it's a tear in the intercostal muscle. 😣

This can happen in varying degrees of severity.

These include:

  • First Degree or mild strain: the intercostal muscle fibres are stretched, and a few may be torn.
  • Second Degree or moderate strain: now we're talking about a good chunk of the torn muscle fibres.
  • Third Degree or severe strain: this is the most severe since every muscle fibre is torn.

A doctor can help you understand your type of intercostal muscle strain and how to deal with it. 🧑‍⚕️

Now, let's take a look at how intercostal muscle strains happen.

Common causes of intercostal muscle strain

An intercostal muscle strain can have similar symptoms to more serious issues.

Therefore, it's important that you see a doctor if you are experiencing pain in the rib muscles to ensure you get the correct treatment. ✅

Man confused
Pain in your ribs may indicate something more serious than a strain, so it's best to consult your doctor if unsure.

It's also, of course, helpful to know the most frequent causes of intercostal muscle injuries. 🤔

These include:

  • One-time injuries or repetitive movements: This could be anything from a nasty cough to giving your ceiling a fresh coat of paint or even chopping wood.
  • Sporting activities: Contact sports and activities that require intense upper body movements, like rugby, batting, pitching, weight lifting, or rowing, can cause intercostal muscle strains.

Now we know what intercostals are and what can cause a strain, let's get into what an intercostal muscle strain feels like. 👀

Symptoms of intercostal muscle strain

Recognising the feeling of an intercostal muscle strain can help you take appropriate action faster.

Common symptoms of intercostal muscle strain include:

  • Localised pain: Sharp, piercing pain or soreness in your upper back and ribs, especially when you breathe deeply or cough.
  • Tenderness and stiffness: Sensitivity to touch, muscle tension, and upper back pain.
  • Swelling: Though less common, puffy spots may appear after an intercostal muscle tear.
  • Muscle spasms: Involuntary contractions or sudden tightening of the muscles.

Knowing the symptoms of a pulled rib muscle helps, but you should still head to the doctors for professional advice and treatment options (especially if you are experiencing chest pain). 👍

Now we know the symptoms, it's time to understand how to sleep with intercostal muscle strain.

How to sleep with intercostal muscle strain

Sleep is essential and has even been linked to accelerated recovery [1], especially for sports-related muscle strains.

Most healthy adults should sleep at least 7 hours every night [2]. 😴

Check out our sleep calculator for more information on how much sleep you need.

Unfortunately, the sharp pangs of pain associated with intercostal muscle strain can make settling down for a restful night's sleep and even breathing an uphill battle.

However, there are practical steps you can take to navigate this discomfort and achieve better quality sleep.

So, without further ado, let's dive into how you can sleep better with intercostal muscle strain. 👇

What are the best sleeping positions when you have intercostal muscle strain (or pulled rib muscles)?

Many people struggle to sleep when they have pulled rib muscles.

But the correct spinal alignment can significantly ease the strain on your intercostal muscles, mitigating the pain that's keeping you awake.

Let's get into it!

Sleeping on your back with intercostal muscle strain

Ideally, you should sleep on your back.

back sleeper spinal alignment
Sleeping on your back, with your spine aligned, can help relieve intercostal muscle strain pain.

A good mattress for back sleepers is usually medium-firm and will go a long way in helping you sleep, but it's not the only thing that matters.

Using a knee pillow under your knees can also help improve your spinal alignment, prevent you from twisting, and reduce upper and lower back pain.

But most people actually find sleeping with their upper body slightly elevated relieves pain and makes breathing a little easier. 🌬️

This semi-horizontal position puts less pressure on your chest than lying flat on your back.

If you have a reclining mattress, try it in a semi-horizontal position.

Of course, we know that most people don't have a reclining bed or mattress lying around.

Body pillow
A body pillow can help keep your upper body comfortably propped up.

Luckily you can also use a body pillow, v-shaped pillow, or wedge pillow to help elevate your upper body instead.

The Kally Body Pillow is relatively affordable and generally comfortable if you want to try sleeping with your upper body or legs elevated.


Sleeping on your side with intercostal muscle strain

If your pain is only on one side, you may sleep best on the opposite side.

So the injured muscles would be facing up, and the side with the uninjured rib muscles would be against your mattress. 💤

However, others may find this sleeping position causes their torso to twist (especially if they have a firmer mattress).

Fortunately, if your mattress is slightly too-firm, you can add a mattress topper for a softer feel that is more accommodating for your hips and shoulders.

softening mattress topper
A mattress topper can make your too-firm mattress more comfortable and ensure your spine is more optimally aligned.

If sleeping on your side causes pain or discomfort, it's best to switch to sleeping on your back, ideally with your upper body slightly elevated. 👍

Relieving intercostal muscle pain

If you are experiencing high pain levels in your rib muscles or have broken ribs, your doctor may prescribe stronger pain medications or even steroids.

However, in other cases, your doctor may suggest using at-home remedies to relieve your rib pain.

So let's take a look at what you can do at home. 🏡

Using over-the-counter painkillers to relieve intercostal muscle pain

Over-the-counter painkillers can help to take the edge off, allowing you to relax and sleep better.

Paracetamol and anti-inflammatory pain medications like ibuprofen and aspirin work well for intercostal muscle strain. 😀

These pain relievers are very easy to find, with most available in local shops, supermarkets, and pharmacies.

Man with thumbs up
Over-the-counter painkillers are quite effective at relieving pain so that you can get a better night's sleep.

Alternatively, you can also find naproxen at most pharmacies if you're an adult.💊

However, bear in mind that naproxen isn't a one-size-fits-all solution.

The NHS website provides more information on who shouldn't use naproxen [3]. ❌

It's also worth chatting with your doctor before taking painkillers to check if it's right for you, especially if you have a lot of rib muscle pain.

Disclaimer: We're not medical professionals. Please check with your GP or other health professional before taking over-the-counter or prescription medication.

Using ice or heat therapy to relieve intercostal muscle pain

You'll want to swap from ice to heat therapy, depending on what stage of recovery you are in.

In the immediate days following the strain or injury, ice will be your best friend. 🧊

Hot and cold compresses
You should use ice in the days immediately after your strain and then swap to heat therapy.

You can apply an ice pack to the injured area in 10- to 20-minute sessions to reduce swelling and curb muscle pain in the ribs.

Wrapping your ice pack (or frozen peas) in a towel will make this more comfortable.

After the initial few days have passed, it's recommended that you switch gears and opt for heat therapy. 🔥

You can take a warm bath or use heating pads to relieve lingering pain, relax your tight muscles, and promote the healing process of your intercostal muscles.

Preparing to sleep with intercostal muscle pain

Many of us struggle to fall asleep fast, especially if we're in pain or generally uncomfortable.

But, of course, that doesn't mean it's impossible.

There are plenty of ways to encourage sleep, even if you're struggling with a pulled rib muscle. 👇

Light stretching

Before we delve into how you can stretch your way into more comfortable sleeping, it's essential to state the obvious.

You should seek the advice of a medical professional before trying new stretches, particularly when you have an intercostal muscle strain.

Overdoing your stretches may further strain your intercostal muscles, the exact opposite of what you need.

Happy woman stretching
Low-intensity, overhead stretches can help keep the muscles by your ribs active, promoting healing.

But adding low-intensity overhead stretches to your routine could make a world of difference. 🤸‍♀️

So take it slow and steady, and always seek advice from your healthcare provider.

Gentle breathing exercises

Much like stretches, you must seek advice from your doctor before trying breathing exercises (even gentle ones).

The intercostal muscles are responsible for helping our ribs expand and contract, allowing us to breathe in and out. 🫁

In most cases, gentle breathing exercises can be part of an active recovery process, promoting blood flow and encouraging faster healing.

Doing gentle breathing exercises before bed, especially taking slow, rhythmic breaths, can help reduce feelings of pain and stress [4].

Just make sure you consult with your doctor before getting stuck in. 🧑‍⚕️


If you've never meditated before, let us give you a quick overview of what it is. 📚

Meditation, in its essence, is about focusing your attention on the present moment.

Man saying all good
Meditation can help you relax, fall asleep faster, and improve sleep quality.

This usually involves concentration, clearing your mind and deep breathing (though with intercostal muscle strain, let's just say the 'deep' in deep breathing should be taken lightly). 😅

Meditation for sleep is catching on fast and has been linked to enhanced relaxation and reduced feelings of pain.

Meditating before bed not only helps to reduce stress and anxiety levels but also may improve the quality of your sleep, allowing you to fall asleep and reach the stage of deep sleep faster. This practice helps to relax the body and mind, giving you much-needed inner peace. Various studies also found a link between meditation and chronic pain relief.

Romsy Barrios [5]

Medical Doctor

What to do if you have an intercostal muscle strain

If you're feeling a nagging muscular rib pain, don't ignore it.

While it may be an intercostal muscle strain, it could also be a sign of a more serious condition (like bronchitis, a lung condition, or fractured ribs). 🚨

It's best to seek advice from a healthcare professional if you have rib muscle pain.

Diagnosis is typically straightforward, involving some questions and a physical examination.

Medical examination
While most intercostal muscle strains can be diagnosed without tests, your doctor may order an X-ray or MRI to double-check.

In rare cases, additional tests like X-rays or MRIs may be ordered. 🔎

And in severe cases, physical therapy or even surgery may be advised by your doctor.

However, for most, rest, gentle movement, cold compresses, heat therapy, and over-the-counter painkillers will aid recovery without the need for medical intervention.

How long does it take for intercostal muscle strains to heal?

Typically, intercostal muscle strains (pulled rib muscle) will heal within 4 to 5 weeks.

But, of course, this healing timeline will depend on the severity of your strain and how well your recovery goes.

Time and stress
It's worth contacting a medical professional if your strain is healing particularly slowly.

If the strain does not feel like it's healing or the muscular rib pain is worsening, it's time to call 111 or make an appointment with your GP.

Can you sleep with intercostal muscle strain?

Sleeping with intercostal muscle strain can be challenging, but it's not impossible.

Taking pain relieving medication, following your doctor's advice, and sleeping with your upper body propped up will ensure you get the best night's sleep possible.

If you still can't sleep, consult your doctor.

Check out our favourite sleep accessories for keeping you elevated and comfortable:

Frequently asked questions

  • How do you tell if you have a cracked rib or pulled muscle?

    Worried about if you have a cracked rib or a pulled muscle? 

    Cracked ribs typically cause severe pain in your chest, especially when you breathe in, alongside possible swelling, tenderness, and visible bruising

    There might be a discernible crack if it's a broken rib

    In contrast, an intercostal muscle strain (a muscle pulled in the ribs) usually involves sharp pain.

    Taking a deep breath or coughing can amplify pain and cause muscle spasms.

    Swelling and bruising are less common but are possible with a strain. 

    Therefore, it's best to get a professional diagnosis for the correct treatment.

  • How do you sleep with a pulled rib?

    Opt for an upright position to sleep if you have a pulled rib.

    This is much the same if you're wondering how to sleep with a broken rib.

    Many people with bruised ribs feel pain lying down because lying flat can put pressure on the ribs, intensifying the muscle rib pain you feel.

    Therefore, if you want to know how to sleep with intercostal muscle strain, we suggest using pillows (or, even better, body pillows or wedge pillows) to keep your upper body propped up.

  • Can you pull a muscle in your chest?

    Indeed, you can pull a muscle in your chest, commonly the intercostal muscles nestled between your ribs. 

    These muscles can be strained from overstretching or undue pressure, and you can even get a pulled muscle from coughing

    Athletes performing intensive upper body activities and older individuals are at a higher risk of experiencing pulled muscles in the ribs. 

    Light stretching, heat and cold therapy, and meditation could ease the discomfort.

    However, if you are experiencing chest pain, it could be something more serious, and you should seek medical advice.

  • What is the best painkiller for bruised ribs?

    Over-the-counter medications, like ibuprofen, aspirin, paracetamol, or naproxen, are usually recommended to tackle pain from bruised ribs. 

    Managing pain is often one of the first steps if you're wondering how to sleep with intercostal muscle strain.

    However, it's essential to remember that individual needs may vary. 

    You should consult a healthcare professional to determine the best-suited painkiller for you, especially since muscular pain in the ribs can also indicate more serious issues.

    Disclaimer: We're not medical professionals. Please check with your GP or other health professional before taking over-the-counter or prescription medication.
  • What is the fastest way to heal intercostal muscle strain?

    The fastest way to heal an intercostal muscle strain involves using a cold pack initially (in the first 72 hours) and then transitioning to heat therapy.

    You must also take adequate rest for muscle recovery. 

    If your intercostal muscle strain won't heal despite following these steps, it's time to consult a healthcare professional. 

    They can rule out more serious conditions and guide you through appropriate next steps like physiotherapy exercises.

  • What makes intercostal pain worse?

    Activities that expand or contract your rib cage, such as deep inhalation, sneezing, or twisting motions, can aggravate intercostal pain (from a pulled muscle in the ribs). 

    You should also avoid any intense physical activity.

    This discomfort may lead to short, shallow breaths, which won't help your recovery.

    Instead, you should rest, only doing gentle breathing and stretching exercises (as recommended by your doctor).

  • Is it hard to breathe with intercostal muscle strain?

    Breathing can be difficult with intercostal muscle strain due to pain.

    This is because the intercostal muscles help our ribs to expand and contract with our lungs.

    Unfortunately, intercostal muscle strain and pain lead some people to take short, shallow breaths to mitigate the discomfort, which may result in decreased oxygen in the blood.

    Over-the-counter painkillers and rest may alleviate this pain, allowing you to breathe more easily.

    But if you are still struggling, you should seek medical help immediately.

  • Can you get a pulled muscle from coughing?

    Yes, coughing can cause a pulled muscle.

    So if you think you pulled a muscle coughing, you could be right.

    Most commonly, the affected area is the rib muscles (also known as the intercostal muscles).

    You should rest, stretch gently, and apply a cold compress in the first 72 hours and a heating pad after that to promote healing after you’ve pulled a muscle from coughing.

  • References

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Katharyn Duffy

Content Writer

Katharyn is a research pro with a BA in English and over 4 years of experience writing health and well-being content. She uses her understanding of sleep and its importance to cut through the nonsense and provide honest information about various sleep products and topics.

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