From the Guidelines
Treatment for an intercostal muscle tear typically involves rest, pain management, and gradual rehabilitation. Initially, apply ice to the injured area for 15-20 minutes every 2-3 hours for the first 48-72 hours to reduce inflammation and pain. Over-the-counter pain medications like ibuprofen (400-600mg every 6-8 hours) or naproxen (220-440mg twice daily) can help manage pain and reduce inflammation 1. For more severe pain, your doctor might prescribe stronger medications temporarily. Gentle breathing exercises are important to prevent complications like pneumonia, despite the pain. As healing progresses, usually within 1-2 weeks, gradually introduce gentle stretching and strengthening exercises. Complete healing typically takes 3-6 weeks depending on the severity of the tear. During recovery, avoid activities that cause pain, including heavy lifting, intense exercise, or sports. If pain worsens, breathing becomes difficult, or symptoms don't improve after 1-2 weeks, seek medical attention. Intercostal muscle tears heal through the body's natural inflammatory response, which repairs damaged tissue fibers, so proper rest and gradual return to activity are essential for optimal healing.
Some key considerations for managing intercostal muscle tears include:
- Pain management: using a combination of over-the-counter and prescription medications to control pain and inflammation
- Rest and rehabilitation: allowing the injured area to rest and gradually introducing stretching and strengthening exercises to promote healing
- Breathing exercises: gentle breathing exercises to prevent complications like pneumonia
- Avoiding activities that cause pain: avoiding heavy lifting, intense exercise, or sports that can exacerbate the injury
It's essential to note that the provided evidence does not directly address the treatment of intercostal muscle tears, but the general principles of pain management and rehabilitation can be applied. The most recent and highest quality study 1 provides guidance on pain management for patients undergoing video-assisted thoracoscopic surgery, which can be relevant to managing pain associated with intercostal muscle tears. However, it's crucial to consult with a healthcare professional for personalized advice and treatment.
From the FDA Drug Label
Cyclobenzaprine hydrochloride tablets are indicated as an adjunct to rest and physical therapy for relief of muscle spasm associated with acute, painful musculoskeletal conditions The treatment for an intercostal muscle tear may include rest and physical therapy, and possibly cyclobenzaprine as an adjunct for relief of muscle spasm associated with the condition 2.
- Key points:
- Cyclobenzaprine is used for short periods (up to two or three weeks)
- It is used for acute, painful musculoskeletal conditions
- Improvement is manifested by relief of muscle spasm and its associated signs and symptoms, namely, pain, tenderness, limitation of motion, and restriction in activities of daily living
From the Research
Treatment for Intercostal Muscle Tear
The treatment for an intercostal muscle tear typically involves a combination of rest, ice, compression, and elevation (RICE principle) to reduce pain and inflammation.
- Rest: Avoid activities that aggravate the injury 3
- Ice: Apply ice to the affected area to reduce pain and inflammation 4, 3
- Compression: Use compression bandages or wraps to help reduce swelling 3
- Elevation: Elevate the affected area above the level of the heart to reduce swelling 3
Medical Therapy
Medical therapy, such as nonsteroidal anti-inflammatory drugs (NSAIDs), may be prescribed to reduce pain and inflammation 5, 4.
- NSAIDs: Reduce swelling and pain, but may have gastrointestinal side effects 5
- Analgesics: May be used to relieve pain, especially if pain is the only symptom 5
Rehabilitation
Rehabilitation exercises should be started gradually to restore range of motion, strength, and endurance 5, 3.
- Progressive agility and trunk stabilisation exercises: May yield better outcomes for injured skeletal muscle than programmes based exclusively on stretching and strengthening 3
- Physical therapy: Should be initiated to restore flexibility and strength as pain and swelling subside 4
Specific Considerations for Intercostal Muscle Tears
In the case of intercostal muscle tears, the use of intercostal muscle flaps and intracostal sutures may be effective in decreasing postoperative pain after thoracotomy 6.
- Intercostal muscle flap: May reduce pain score and use of analgesics in the first week and up to 3 months after surgery 6