Upper Back Pain, Pain Below The Rib & Difficulty Breathing? What's Happening?

  • 20 months ago
4 minute read.
Upper Back Pain, Pain Below The Rib & Difficulty Breathing? What's Happening?

An intercostal muscle strain is an injury to one of the muscles that connect the ribs and allow the rib cage to expand and contract during breathing. There are more than ten intercostal muscles in the human body, but the Pain from an injury in the intercostal muscles typically occurs in 2 or 3 of them in the chest area on one side of the rib cage.

It's most commonly caused by physical exertion or trauma, especially among athletes and people who participate in contact sports or high-impact exercises like running or dancing. Here's the breakdown of what upper back pain, rib pain, and difficulty breathing could mean and what you can do about it!

What Causes Upper Back Pain (Intercostal Neuralgia)?

Intercostal neuralgia is an example of a type of neuromuscular Pain. One can develop this condition due to an injury or prolonged pressure on a nerve in the chest that supplies sensation to the intercostal muscles.

Symptoms include sharp stabbing pains and tingling sensations in one or both sides of the body, which may radiate from areas such as under your arm, into your chest wall, or up your neck. Pain management may help alleviate some symptoms but does not stop the progression. Several different conditions and injuries can damage these nerves. Here are a few.

Post Thoracotomy Pain Syndrome (PTPS)

If you have had surgery on your lungs, diaphragm, or esophagus and now experience upper back pain along with other symptoms including dysphagia (difficulty swallowing) or dyspnea (shortness of breath), you could be experiencing post-thoracotomy pain syndrome. The surgical incision can sometimes lead to pressure on the nerves in the area, leading to severe Pain and other symptoms.


Trauma to the chest, upper back, and shoulders can also cause lower intercostal neuralgia. For instance, if someone falls on their stomach and damages their ribs, they may suffer from intense Pain as well as numbness in their arms because the nerves supplying sensation to those parts of the body are also affected.

Other Causes

Other factors can also lead to intercostal neuralgia, including

  • Pregnancy
  • Abnormal growths like tumors, fractures, herniated discs, or arthritis;
  • Viral infection like herpes zoster (shingles);
  • Idiopathic Pain (meaning without any known cause).
  • Infections
  • Compression of the nerves in your upper back will often result in Pain, especially when bending forward.

[ Also Check: Can Therapy Help Reduce Back Pain? ]

Signs And Symptoms Of This Condition

Intercostal muscles create pressure in your ribs so you can breathe. They contract with each breath you take and expand as you exhale. If these muscles become strained, it will restrict your ability to take a full breath and eventually result in Upper Back Pain from Intercostal Muscle Strain. A variety of issues can cause neuromuscular Pain. Signs and symptoms of this condition may include:

  • Pain that is localized to the upper back on either side of the spine or in the chest or shoulder
  • A sharp stab when moving or coughing.
  • Sharp stabbing pains extend from one side of the upper body to another with deep breaths.
  • Aching muscles are an important sign that something isn't right. Upper back pain from intercostal muscle strain usually manifests as chronic, dull aches across the upper back or chest accompanied by sudden stabbing pains.

[ Also Check: Ergonomic Tips To Prevent Injury ]

How Can It Be Treated?

If you are experiencing any of these symptoms, it is important to know that many treatment options are available to help with your discomfort and get you on your way to feeling better. It is best to seek medical attention if you have been experiencing symptoms for more than a week or two.

  • Lying down often can help relieve pressure in the upper back region and may reduce some of your other symptoms.
  • Pain medication such as acetaminophen (Tylenol) and ibuprofen (Advil) can be taken to ease inflammation.
  • Acupuncture treatments have also been shown to relieve chronic pain symptoms associated with tension headaches, neck aches, lower back pain, and sciatica.
  • Chiropractic care has also proven successful in relieving chronic pains associated with the neck and spine regions by helping muscles heal from their tension or spasms by manually manipulating them into alignment.
  • Massage therapy is another excellent option for those suffering from chronic muscle tension and Pain. Your massage therapist will provide a relaxing experience that aims to soothe your sore muscles while keeping your body healthy overall. Many different types of massages are available to suit your needs, including hot stone massages, aromatherapy massages, deep tissue massages, and more!

When choosing which type of massage to try out, it is best to think about what you need most at this time: relaxation. Pain relief? mental clarity? It can be beneficial to mix up your routine every few weeks to give each type a chance to find the right one for you! Remember that even if one type doesn't work for you, many others can choose from it.

  • Icing an injury is another good technique to use when recovering from muscular Pain. Icing provides cold therapy, which decreases blood flow around the injured area and prevents swelling. To ice an injury places a bag of frozen vegetables or fruit over it with a towel over the top.

Let sit for 10 minutes, then remove the ice pack and repeat until the desired level of comfort has been reached. It is important to note that icing should not be used on open wounds, burns, areas near joints or skin folds, numb areas (that may indicate nerve damage), recent fractures, or anything under the knee. Additionally, patients who have had recent surgery should consult their doctor before applying ice packs.

  • Some people benefit from an anti-inflammatory diet. Some common foods that can help relieve or prevent inflammation include fish (salmon, tuna), flaxseed oil, walnuts, and oranges.


It is important to see a doctor if you are experiencing upper back pain and difficulty breathing. Pain below the ribs can be caused by many factors, including pneumonia and chronic obstructive pulmonary disease (COPD). Upper back or neck pain can be caused by muscle spasms or a pinched nerve in your spine. Either way, it is important to see a doctor for help assessing the cause of your symptoms.

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