The terms pulled muscle and muscle strain refer to an injury that involves an overstretched or torn muscle. A person with a muscle strain in the chest may experience sudden, sharp pain in this area.
Although uncomfortable, a strained chest muscle is usually a minor injury that tends to heal within days or weeks.
In this article, we outline the causes of a strained chest muscle, along with possible treatments. We also explain how to differentiate the symptoms from those of other causes of chest pain.
Intercostal muscle strains are the most common cause of musculoskeletal chest pain, which people often refer to as a pulled muscle.
The intercostal muscles are a muscle group that sits between the ribs and makes up the chest wall.
This muscle group comprises three layers: the external, internal, and innermost intercostal muscles. Together, they stabilize the rib cage and assist with breathing.
Possible causes of chest wall strains include:
- sports injuries from overstretching, muscle fatigue, or performing repetitive and forceful motions
- contact injuries
- inadequate warmup before exercise
- heavy lifting
- poor flexibility
- twisting the torso beyond its normal range
- reaching overhead for extended periods
- overuse of the muscles
- chronic poor posture
- a severe cough
People who injure the muscles in the chest wall may experience:
- pain that increases with movement of the chest or upper spine
- pain that worsens when breathing deeply, sneezing, or coughing
- an area of soreness or tenderness within the chest wall
- upper back pain
A pulled muscle in the chest wall may feel similar to a more serious problem with the heart or lungs.
Knowing the difference between these types of pain can help people seek emergency treatment when necessary.
Other causes of chest pain include:
The pain of a heart attack differs from that of a strained chest muscle. A heart attack may cause a dull pain or an uncomfortable feeling of pressure in the chest.
Usually, the pain begins in the center of the chest, and it may radiate outward to one or both arms, the back, neck, jaw, or stomach.
Pain may last for several minutes, and it may disappear and return in some cases.
Other symptoms of a heart attack include:
- shortness of breath
- breaking out in a cold sweat
A heart attack is a medical emergency. A person should call 911 or their local emergency number if they experience symptoms of a heart attack.
Angina pectoris, or stable angina, is chest pain resulting from coronary heart disease. Angina pectoris occurs when there is not enough blood getting to the heart due to the narrowing or blockage of the arteries.
The symptoms of stable angina are similar to those of a heart attack but may be shorter in duration, typically disappearing within 5 minutes.
These symptoms usually occur after physical exertion and go away after resting or taking medication.
Pleuritis can cause pain that feels like a pulled chest muscle. It is generally sharp, sudden, and increases in severity when taking a breath.
Unlike a strained muscle, pleuritis may cause additional symptoms, such as fever and muscle aches. A person who suspects that they have pleuritis should visit a doctor, who will listen to their lungs using a stethoscope to make a diagnosis.
A person with pneumonia may experience a sharp or stabbing pain in the chest, which worsens when coughing or breathing deeply.
Other symptoms of pneumonia include:
- a cough that produces green, yellow, or bloody mucus
- shortness of breath
- excessive sweating and clammy skin
- appetite loss
A pulmonary embolism (PE) refers to a blockage of the blood vessels within the lungs. The most common cause is a blood clot.
A PE stops blood from getting to the lungs and is, therefore, a medical emergency. A PE may also cause the following symptoms:
- shortness of breath
- a cough that may produce blood
- feeling faint, dizzy, or lightheaded
- rapid heart rate
People who are concerned about a pulled muscle in the chest or other chest pain should visit their doctor, particularly if they are unsure of the cause.
A doctor will ask about their symptoms and medical history as well as any activities that may have caused or contributed to the pain.
If a muscle strain is the cause, a doctor will categorize the injury according to one of the following three grades, depending on its severity:
Grade 1 (mild damage): There is damage to fewer than 5 percent of the individual muscle fibers. Strength and motion are minimally impaired. Recovery generally takes between 2 and 3 weeks.
Grade 2 (more extensive damage): The injury has affected more of the individual muscle fibers, but the muscle is not completely ruptured. There is a significant loss of strength and motion. The injury may take between 2 and 3 months to heal fully.
Grade 3 (complete rupture of the muscle): A doctor may be able to feel a defect within the muscle during a physical examination. In some cases, a person may need surgery to reattach the damaged muscle.
Treatment for a pulled chest muscle depends on the severity or grade of the injury.
Treatment options include the following:
The usual treatment for a chest muscle strain is to reduce pain and swelling by following the "RICE" method:
- Rest: Avoid strenuous activities, especially those that caused or contributed to the muscle strain.
- Ice: Wrap an ice pack in a towel and apply it to the affected area for up to 20 minutes. Repeat several times a day.
- Compression: Wrap a compression bandage around the torso. Ask a doctor or pharmacist for advice on how to wrap the bandage to prevent further injury.
- Elevation: Try to sit upright. Use extra pillows when sleeping to keep the chest elevated.
A doctor may recommend following the RICE procedure for the first 24–48 hours following the injury.
Nonsteroidal anti-inflammatory drugs (NSAIDs), such as ibuprofen, can help relieve pain and inflammation.
For severe or persistent pain, a doctor may prescribe stronger analgesics, muscle relaxants, or both to reduce painful muscle spasms.
Sometimes, a pulled muscle in the chest is due to a persistent cough. Taking cough medicine can help stop coughing fits, minimizing further strain on the intercostal muscles.
In cases where the muscle has become completely ruptured, a doctor may recommend surgery to repair the tear.
A doctor may prescribe a tailored exercise plan to help restore and maintain muscle function, strength, and flexibility.
People should see a doctor if they believe that their chest pain is due to an alternative illness or if they experience:
- fast or labored breathing
- pain that worsens over time or does not respond to pain medication
- severe pain or numbness that lasts longer than 1 hour
- difficulty moving
- weakness or lethargy
- redness or inflammation of the affected area
- a "popping" sound when the injury occurs
The symptoms of a pulled muscle in the chest are commonly due to an intercostal muscle strain.
A variety of home treatment methods, including RICE and pain relievers, can provide symptom relief. If the pain is not manageable at home, a person should speak to a doctor.
Mild strains usually heal within a few weeks, but severe strains can take 2 to 3 months or longer to resolve.