Home / Blog September 03, 2023

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How to Sleep with Intercostal Muscle Strain (7 Top Tips)

Intercostal muscle strain can be caused by physical labor, high thrust sports, or forceful, repetitive motion. The cunning pain you feel comes from the tearing of pulled, twisted, or overstretched muscles around your ribcage. Fret not… your well-deserved rest is still possible despite this pain.

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Sudden, repetitive, or forceful motion can lead to intercostal muscle strain.

To sleep well, try sleeping on the side that doesn’t hurt and having a heating pad on.

Be careful not to self-diagnose any serious conditions when you feel rib strains. 

Did you know?
Between 21 to 49% of all muscle-related pain in the torso comes from the Intercostal muscles.

Have you ever felt sharp pain on either the left or right side of your ribs? Chances are… you’ve had intercostal muscle strain. But worry not… we’ve all been there.

Whether it is weight lifting, playing sports, or simply stretching, any sudden or prolonged twisting of the muscles on our ribs can cause strains. This pain can make it difficult to go through your day, but even worse, to get your ZzZs at night!

But with the right sleeping posture, great pillow support, and a heating pad… you will be more than okay to sleep despite intercostal muscle pain.

What is Intercostal Muscle Strain?

It is a painful condition caused by the tearing of two or more muscles found between your ribs. These muscles are what are referred to as “Intercostal muscles”.

So, the sneaky discomfort can creep up on either side of your body leading to sudden pain on the right side or left side. When you feel this, just know that your rib cage muscles have been pulled, twisted, or stretched too far.

But, why does this happen? Well, intercostal muscle strain is more likely with risk factors like intense physical labor, contact sports, and high-thrust sports.

Causes of Intercostal Muscle Strain

Our torso holds a good group of muscles, so rib strain can be due to:

  1. Sudden movements. Motions such as twisting or reaching overhead
  2. Repetitive forceful motion. As in weight lifting, intense dancing, or rowing
  3. Impact trauma/Injury. Like a fall or a punch to the rib cage
  4. Poor posture. Such as leaning on either side of your ribs for extended periods of time
  5. Dehydration. This leads to muscle fatigue, which increases the risk of muscle strain 

Knowing the common causes of intercostal muscle spasms can make it easier to find the treatment for your discomfort. So, when you feel sharp pain around or under the ribs and chest area… you may want to assess one of the causes above.

Other Conditions vs. Intercostal Muscle Strain:

Intercostal muscle spasms happen on the right side or left side of the body, and sometimes, closer to the chest. The spasms are usually slight and sudden pains that go away with decreased mobility.

If the pain is too intense and does not easily go away, then other culprits for your pain may be:

  • Cardiac problems
  • Costochondritis
  • Thoracic radiculopathy
  • Bone fractures
  • Fibromyalgia 

Symptoms of Intercostal Muscle Strain

The signs and symptoms may vary depending on the causes of the strain on the right or left side of your ribs:

1. Sudden pain: If you feel a sudden, sharp pain in your rib area, then it might be intercostal muscle pain. This is most likely if you just experienced a blow to the ribs like in sports such as football. In this case, you may want to also check for intercostal neuralgia.

2. Muscle tension: This shows up as some stiffness or tightness, which can be felt as muscle spasms. Such tension can make it harder for you to do simple acts like bending or reaching overhead.

3. Tenderness: You may want to check if the side you're feeling pain on is somewhat sore to the touch. If so, then wearing any tight clothes or carrying heavy things might make your pain even worse. Other conditions come with a similar symptom too, so it is important to know when the soreness you are feeling is pointing to something more serious.

4. Difficulty breathing: Intercostal muscle strain leads to worsening pain when you take a full breath. This can make it harder for you to inhale the oxygen you need because the pain forces you to take shorter breaths.

5. Swelling: This is most likely to occur if you have a sudden impact to your rib cage. Local inflammation in your rib area can also show up as some swelling. Regardless, you may want to seek immediate medical attention to pinpoint potential culprits behind your discomfort.

What Makes Intercostal Muscle Strain Worse?

Feeling a sharp pain on your left side? Or a sudden strain on your right side? Then be careful of aggravating this intercostal muscle pain when you do the following:

  • Breathing in deeply or fully
  • Coughing or sneezing
  • Twisting your torso
  • Sudden stretching of your hands or your full body 

How do you sleep with an Intercostal Muscle Strain?

Below, we have curated a list of tips and tricks to make you rest comfortably when you are healing from intercostal muscle strain:

1. Maintain a neutral sleeping posture: Be careful not to sleep on the side where the pain is originating from. Also, you may want to try sleeping positions that maintain the natural curve of your spine.

2. Adopt pillow support: Having the right pillows can be a game-changer in dealing with intercostal muscle pain. For support in maintaining a good sleep posture, body pillows work best. Our Cuddler, for example, is designed to melt away tension and give you endless snuggles as you heal.

3. Grab a heating pad: You may want to set your heating pad to a low or medium for 15 to 20 minutes. The heat from the pad will help relax the muscles by promoting blood circulation.

4. Attempt Gentle Breathing: Your doctor might recommend that you try breathing exercises so as not to lean into the pain caused by the rib strains. A study reported by the National Institute of Health (NIH) showed that breathing exercises can be helpful for pain sensitivity.

5. Try slow stretching: Certain mobility exercises and yoga poses can help loosen up the muscles in your rib or chest area. Be careful not to stretch while the intercostal muscle pain is still acute because that stretching might make the pain worse.

6. Consider Mindful Meditation: One NIH report detailed that meditation practices can help promote relaxation and pain relief. These practices involve staying in a quiet place and focusing on breathing while staying in the present moment.

7. Stay cozy: You may want to have with you a weighted blanket whose even weightiness helps promote deeper sleep. Our Cotton Napper has soft, breathable fabric and its even weight distribution promotes the production of melatonin (the sleep hormone).

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Be careful not to sleep for too long on one side though. Doing so could lead to waking up with numbness or pain in your hands, which will make you feel worse. Sometimes, pain relief medication can be efficient in helping the pain not interrupt your sleep.

What is the best position for Intercostal pain?

Decreasing your range of motion will be essential in finding positions that will promote quick healing from intercostal pain.

  • The key is this: laying or sitting in an elevated position is an easy way to relieve any pressure from your rib cage. You can have a pillow with you, which can go under your upper back or head. An example of this is our Cuddling, an ergonomically-designed bolster pillow meant to support muscle relief. 

What is the fastest way to heal intercostal muscle strain?

Like with most muscle strains, the RICE method is the most effective way to find your intercostal muscle strain treatment. This is recommended by the American Academy of Orthopaedic Surgeons (AAOS). So, what exactly does RICE stand for?

  • Rest. It is important to reduce or pause any intense physical activity, particularly those that may have caused the pain in the first place.
  • Ice. Applying cold packs (not plain ice) for roughly 20 minutes or so can help ease the strain on your rib cage muscles.
  • Compress. You can wrap soft, elastic bandages to keep the hurting area under steady and gentle pressure.
  • Educate. Typically, E stands for “Elevation”, which works for injuries in the lower upper body. However, “Educate” is more reasonable for intercostal muscle treatment. So, educate yourself on the causes of the pain and the healing timeline in order to manage your expectations. 

Should I see a doctor or visit the ER for Intercostal Muscle Strain?

If the intercostal muscle pain lasts for more than 3 days, then it is wise to seek medical help. This is especially true if you are feeling sudden, sharp pains closer to the chest area.

You may want to check whether the intercostal muscle pain began from a direct impact, like from a fall. It is essential to assess if your pain may be from possible bone fractures. Consider booking an appointment even if the pain is manageable with over-the-counter medications.

Beware of Self-Diagnosing from Intercostal Muscle Strain

With internet searches of symptoms comes the temptation of self-diagnosis. Yes, the intercostal muscle pain can have more serious roots… but, you may want to put some brakes on the self-diagnosis.

You can confidently know the reason for the sharp pain on the sides of your ribs by getting a physical examination. Your doctor will most likely use an X-ray or MRI scan to assess the exact cause of the intercostal muscle pain.


Intercostal muscle strains happen when we stretch, twist, or pull the muscles in between our ribs. It is a common condition that usually does not point to something serious.

To sleep well, ensure that you are maintaining an elevated posture and have a heating pad. You can also stay warm and cozy by having a weighted blanket and comfortable pillows. Our Cotton Nappers are blankets designed with even weight distribution, ready to give you snuggles all night long.

If the pain lasts for more than 3 days, you may want to see a doctor or visit your nearest emergency room (ER) for a physical exam.