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Coughing is a natural reflex action that can sometimes be uncontrollable. It can be caused by various conditions, such as the common cold, flu, or asthma, and it can also be a symptom of more serious conditions like bronchitis or pneumonia. While coughing is typically not harmful, severe or persistent coughing can lead to certain complications, including rib pain. In some cases, this rib pain may be a sign of a pulled muscle, also known as a muscle strain. Intercostal muscle strains, which affect the muscles between the ribs, can be extremely painful and are often caused by violent coughing or sneezing. The repeated movement of coughing can cause the intercostal muscles to stretch, pull, or partially tear, resulting in symptoms such as sharp pain, muscle stiffness, and difficulty breathing.
| Characteristics | Values |
|---|---|
| Intercostal muscle strain | Occurs as a result of excessive coughing and sneezing due to colds |
| Intercostal muscle | Lies between the ribs and attaches them to one another |
| Intercostal muscle strain symptoms | Muscle tightness and soreness, sharp pain, cracking or popping sound, difficulty breathing, pain when twisting the body, worsening pain when coughing |
| Intercostal muscle strain treatment | Ultrasound devices, ointments and emollients, physical therapy, cold and heat therapy, rest, OTC pain medications, wrapping torso, muscle relaxants, injectable medications |
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What You'll Learn
Intercostal muscle strain
Symptoms of intercostal muscle strain include sharp pain, stiffness, and mobility difficulties. The pain can worsen with coughing, sneezing, or deep breathing. Other symptoms include swelling, bruising, and tenderness in the affected area.
Diagnosis of intercostal muscle strain involves a physical examination to assess movement limitations and areas of tenderness. Imaging tests, such as X-rays or MRIs, may be ordered to rule out other possible causes, such as rib fractures.
Treatment for intercostal muscle strain depends on the severity of the injury. Mild cases may only require home remedies such as rest, ice packs, and over-the-counter pain medications. More severe cases may need medical intervention, including physical therapy, muscle relaxants, or injectable medications.
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Coughing and asthma
Coughing can cause a pulled muscle in your rib cage, known as intercostal muscles. Intercostal muscles are present in the trunk of the body and are essential for breathing. When you cough, these muscles have to work harder, and the repeated movement can cause them to stretch, pull, or partially tear, resulting in mild discomfort or severe symptoms.
Now, onto the topic of coughing and asthma. Coughing is often associated with conditions like the common cold, flu, or bronchitis. However, persistent coughing may be indicative of asthma, particularly if it keeps recurring. Asthma affects the airways in the lungs, causing them to become inflamed and swollen. This inflammation makes the lungs more susceptible to allergens or irritants, such as pollen, pet dander, strong scents, pollution, or cold air.
Coughing in people with asthma is the body's attempt to remove whatever is irritating the lungs. While asthma is typically associated with wheezing and shortness of breath, there is a form of asthma called cough-variant asthma (CVA), where coughing is the primary or only symptom. People with CVA generally do not find relief from over-the-counter cough medicines and require prescription asthma medication, often in the form of inhalers.
Coughing from asthma can be triggered by various factors, including outdoor allergens, exercise, exposure to specific irritants, laughing, and changes in temperature or weather. It is important for individuals with asthma to identify their triggers and avoid them whenever possible. If coughing or other asthma symptoms are severe, unpredictable, or frequent, consulting an allergist can help determine the underlying cause and provide appropriate long-term treatment.
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Treatment options
If you suspect that you've pulled a muscle due to coughing, it's likely that you have an intercostal muscle strain. Intercostal muscles are located between your ribs and help with breathing. A pulled intercostal muscle can cause mild discomfort or severe symptoms, including:
- Sharp pain
- Muscle stiffness and soreness
- Worsening pain when twisting, stretching, or taking deep breaths
- Tenderness around the ribs
- Difficulty breathing
- Swelling between and around the ribs
To treat an intercostal muscle strain, you can try the following options:
Rest
Give your body time to recover by resting for 24 to 48 hours. Avoid any activities that cause pain or discomfort, such as twisting and reaching. For athletes, this may mean taking time away from practice or competitions. Work with your treatment provider to gradually strengthen your muscles and regain your range of motion.
Ice and Heat Therapy
In the initial days after the injury, apply ice wrapped in a towel for 15-20 minutes at intervals throughout the day to reduce swelling. After the first few days, switch to using a heating pad to help relieve pain and speed up recovery.
Over-the-Counter Medications
Take over-the-counter anti-inflammatories like ibuprofen (Advil) or naproxen (Aleve) to reduce inflammation and pain. You can also try simple pain relievers like acetaminophen (Tylenol). Always follow the package directions for dosage and frequency. Be cautious not to overmedicate by taking multiple products containing pain relievers.
Physical Therapy
If your intercostal muscle strain persists, your doctor may refer you to a physical therapist. They can provide safe stretching exercises and transcutaneous electrical nerve stimulation (TENS) to aid in your recovery. Physical therapy can help you get back to your usual activities faster and improve your range of motion.
Medical Attention
If your symptoms persist or worsen, seek medical attention. Your doctor can perform a physical exam to check for limitations of movement and assess tender areas. They may also recommend imaging tests like ultrasounds or MRI scans to rule out other injuries. In more severe cases, your doctor may inject the area with corticosteroids or lidocaine to provide relief from pain.
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Causes of intercostal muscle strain
Intercostal muscle strain is a common cause of chest pain, accounting for 21 to 49 percent of all musculoskeletal chest pain. The intercostal muscles lie between the ribs and help with breathing. A strain occurs when these muscles are twisted, stretched too far, or partially torn.
Intercostal muscle strain is almost always the result of overexertion or injury. This can include a sudden increase in physical activity, especially in individuals with poor muscle strength due to a lack of exercise or poor posture. High-thrust sports that involve repeated use of the arm, shoulder, and upper back can put stress on the intercostal muscles. Contact sports can also cause intercostal muscle strain due to the direct and sudden force on the upper body.
Coughing can also cause intercostal muscle strain. Conditions such as colds, flu, or asthma can cause frequent coughing, which can lead to intercostal muscle strain as the muscles work harder with each cough. The repeated movement can cause the muscles to stretch, pull, or partially tear. Other respiratory issues, such as upper respiratory infections, can also cause coughing and lead to intercostal muscle strain.
In addition to coughing, intercostal muscle strain can result from other repetitive movements or twisting motions. This includes activities such as rowing, swimming, and other physical exercises. A direct blow to the ribs or sudden impact to the chest can also cause intercostal muscle strain.
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Prevention
Coughing, especially when it is severe, can cause rib pain. The repeated movement involved in coughing can cause the intercostal muscles to stretch, pull, or partially tear. Intercostal muscles are those that lie between the ribs and attach them to one another, helping to stabilise the upper body and aiding in breathing.
- Treat the cough: If your cough is caused by a cold, flu, or upper respiratory infection, try to treat the cough directly. Having warm drinks, sucking on cough drops, or adding honey to your tea can help. Cough medicines, decongestants, and steam inhalation can also improve your cough.
- Cough with care: When you feel a coughing fit coming on, sit in a chair and lean forward slightly. Press your arm against your belly and cough sharply a couple of times into a tissue. Relax for a moment and then do it again. If coughing hurts, press a pillow or cushion against your belly or chest while you do it.
- Use heat or cold therapy: Applying a heating pad or a cold compress to the sore area can help ease pain and soothe strained muscles.
- Use creams or gels: Applying a cream or gel formulated to treat muscle pain to your chest might help if your ribs are sore from repeated coughing. Creams containing arnica, a herbal substance, can be effective at reducing pain.
- Brace yourself: If you have a cold and coughing is making your pulled muscle worse, try taking a small pillow and bracing yourself with it as you cough.
- Try over-the-counter pain relievers: If your kidney function is okay and you don't have an underlying condition, you can try taking ibuprofen with food. Acetaminophen may also help, but consult your doctor first.
- Yoga: Yoga can help, but it is important to get clearance from your doctor first. They can advise on specific poses that won't exacerbate the strain.
If you think you've pulled a muscle when coughing, it is important to talk to a doctor. They can identify which muscles have been strained and ensure that your symptoms are not caused by something else.
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