Can you really strain intercostal muscles without realising it? Agony!

[JulietSierra]

I started a thread the other day about pleurisy…I was convinced I had it because of the agonising pain in my ribs, under my breast, that came on the other day whilst sitting at my desk.
I got checked out yesterday and was told it’s muscular as when I’m still, there’s not really any pain. Breathing deeply, sneezing or lying down however is agony!
I slept last night in a chair. I’d gone bed, all propped up on a beanbag and woke up thinking I was dying with the most incredible burning pain in my ribs. Don’t know if the strained muscles had spasmed or something?
But I’m really struggling to accept that this is muscular. I’ve done absolutely nothing that could strain these muscles!
So, has anyone ever strained intercostal muscles without any obvious reason why? And can muscular pain really be this bad?

Mine was left rib cage, around tit area, so still could be

Ooh yeah it’s all round my boob but on the right side . I’ve read costochondritis is usually on the left. How long did it last?

Hmm, its about 20 years ago now, so can't be sure. About 2 weeks before it got much worse and I went to a and e thinking it was a heart attack. Give or take, I'd get it checked out though.

And can muscular pain really be this bad?

Yes absolutely. Intercostal is the worst. On my 4th bout but all have been accidental damage rather than out of nowhere.

I get this sometimes, usually after a cough. A hot water bottle on the chest helps. An no bra!

Ibuprofen too, not that I'm allowed to take it any more, sadly.

No, I can’t take ibuprofen either but I’m using the gel.
I have been checked out and the practitioner said muscular. I’ll probably give it til mid week before going back if I don’t see any improvement.

Hot bath and try to sleep well, it's not nice, I hope it clears up soon.

What checks have you had to determine Muscular?

Chest xray? Bloods?

If not, i would ignore someone ‘just looking at you’ and go to A&E

No, she just listened to my chest and then did blood pressure, oxygen sats, temperature etc.
She said it was muscular because moving/ lying/ breathing deeply exacerbates it and when I’m still, it’s fine.

How carefully did they listen to your lungs?

I had this and it was a partially collapsed lung. Not very likely, but worth bearing in mornings. I wasn't breathless and my oxygen was fine. It was also agonisingly painful on lying down.

If the pain is severe I would go to A&E and they will do a chest x ray. You don't necessarily need to be admitted for a small pneumothorax, but you do want it diagnosing.

I was diagnosed with this . Tur ed out to be the starting grumbles of gallstones

Did they mention pericarditis OP?

Pain that is worse when lying down or breathing deeply but lessens when sitting up is a symptom.

I would get a 2nd opinion if i was you

Exactly same pain as I had a few nights ago. I’ve had costochondritis before but never this bad. Pain was off the scale and I’m used to pain. Nothing I tried would stop it and I tried everything that’s worked in the past. Prescription strength cocodamol dulled it down for all of 20 minutes. Eventually I called 111 who insisted on sending an ambulance. And of course an hour later the pain subsided. Luckily I could cancel ambulance. Never known pain like it.

She was actually really careful and thorough when sounding my chest. Did front , back and sides; top, middle and bottom!
Going to go up to bed now and try and lie down but doubt I’ll last long so I’ll get my snuggly blanket ready on my chair too.
If it hasn’t improved in a few days then I’ll go to minor injuries where they’ve got x ray facilities.
Thanks for the support everyone.

My first flare up of costochondritis was so bad that DH dragged me into A & E at 3am... I was almost passing out with the pain. I spent a few days on the cardiac ward having all sorts of tests but was discharged without diagnosis - luckily a GP at our practice knew straightaway what it was. That first bout lasted about 3 months but the 1st fortnight was the worst. The pain was in my left rear shoulder, lower left side and centre of my sternum but migrated round my entire ribcase at times. I was on a cocktail of painkillers but nothing touched it... in the end I worked out lidocaine patches helped the most and an osteopath. I get the odd flare up if I'm run down/stressed.

I haven't had it pop up for a decade now, amd I'm so glad, it was soooo painful. I hope you get whatever it is sorted, OP.

DH had this and passed out from the pain. He was in agony, couldn't move, breathe, lie down etc. Said it was the most painful thing he'd ever had by a long way. The paramedic said his vitals (BP, sats etc) were all fine and it was probably muscular and he could stay at home with painkillers. I refused and insisted they take him in.

Following blood tests, chest xray and CT scan they diagnosed him with pneumonia, pleurisy and pulmonary embolism. They said it was the pleurisy that was causing the pain and it was a good job he had it or they wouldn't have known about the clots. They said his vitals had seemed initially fine because he's very fit normally.

Morphine in hospital didn't help much but once diagnosed they gave him specific drugs for pleurisy and he improved quite quickly.

If it's that bad I'd go to A&E and get another opinion.

Only you know how painful it is and how well you deal with pain. But if you're in agonizing sudden pain and normally have a fairly high pain threshold then I think it's a big mistake not to go to A&E.

I don't have a very high pain threshold and have definitely been to A&E with things that turned out to be trivial. The pain I had with my collapsed lung was severe but so non-specific I convinced myself it was either upper back pain radiating around the sides or pleurisy (which I have had several times). But I wasn't otherwise ill, didn't have a fever etc.

This isn't to say that it's likely to be a collapsed lung, which isn't very common, less common in women, and would be heard by a stethoscope if the doctor knew what they were doing. But I think it would be a good idea to get some proper imaging. I'm not sure that a pulmonary embolism would be detected by a stethoscope and you definitely want to rule that out.

I know two people who’ve had a virus recently causing this type of pain (though not as severe as yours) without many other symptoms.

I’ve got the same pain and same diagnosis, OP. I didn’t want to go to the GP because I knew they were going to say this but DH insisted. Dr said it was caused by the coughing from a cold I had recently and that it’s really common. Mine is on the left side though. Paracetamol doesn’t touch it and I can’t have ibuprofen either. I’m in wait and see mode to be honest - haven’t ruled out ringing 111 if it doesn’t go away.

I had to namechange to tell this story as it would be outing to anyone in my family. Several years ago DH had an awful cough and ended up with severe pain like OP has described, under/around his ribs. My dad kept mentioning pleurisy and how bad it is/needs treatment so I eventually convinced DH to book a drs appointment. DH is the type of man who can count on one hand the number of times he's been to a Dr I'm his lifetime. He got home and recalled how the appt went:
GP: "Hello, how can I help today?"
DH "I've had an awful cough and am in pain around my ribs, my father in law suspected it could be pleurisy so I thought I should be seen"
GP: OK. Is your FIL at GP?
DH: No, he's a lawyer

DH laughed it off but said it was so embarrassing and suffice to say 8 years later he hasn't set foot in a drs surgery since!

He did not in fact have pleurisy but as the OP had strained the intercostal muscles.

Thats interesting.

I have rib pain on both sides

But no pain when laying down like the OP

Another terrible night on the chair with perhaps 2 hours sleep. I’ve developed a cough and have coughed up a lot of gruesome brownish mucus 🤢 so I think I’m going to go to minor injuries this morning where hopefully they’ll do a chest x ray.
So utterly fed up.