A muscle strain in the chest may cause sharp pains when moving or breathing. They commonly occur due to impact injuries or overuse and are often treatable with rest, pain relievers, and physical therapy.

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 other causes of chest pain.

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Strains occur when a muscle sustains damage from overstretching, twisting, or impact force. Strains are a common sports injury but can also happen in day-to-day life.

Intercostal muscle strains are a common cause of muscular chest pain.

The intercostal muscles sit between the ribs and make up the chest wall. This muscle group comprises three layers, and together, they stabilize the rib cage and assist with breathing.

Possible causes of chest wall strains include:

Muscle strains can cause swelling, pain when using the muscle, muscle spasms, and bruising.

People who strain 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:

Heart attack

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.

Often, the pain begins in the center of the chest and may radiate outward to one or both arms, the back, neck, jaw, or stomach.

Other symptoms of a heart attack include:

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

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

Pleuritis, or pleurisy, refers to inflammation of the lining of the lungs. It most often occurs due to bacterial or viral infection.

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 be associated with additional symptoms, such as fever, coughs, and generalized 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.

Pneumonia

Pneumonia is an infection that causes the air sacs within the lungs to fill with fluid or pus. Viruses, bacteria, and fungi can all cause pneumonia.

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:

Pulmonary embolism

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 reaching the lungs and is a medical emergency. A PE may also cause the following symptoms:

  • shortness of breath
  • sharp pain in the chest that worsens when breathing in
  • 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): A small amount of damage to muscle fibers results in localized pain and a minimal impact on range of motion and muscle function.
  • Grade 2 (more extensive damage): The injury has affected more individual muscle fibers, but the muscle is not completely ruptured. There is a significant loss of strength and motion.
  • Grade 3 (complete rupture of the muscle): A doctor may be able to feel a defect within the muscle during a physical examination. Sometimes, 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:

Rest

The usual treatment for a chest muscle strain is to reduce pain and swelling by avoiding strenuous activity and applying warm, or cold compresses to the area. Doing so may help any muscle strains to heal.

Medication

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.

Surgery

In cases of severe muscle tears, ruptures, and bone damage, a doctor may recommend surgery to repair the tear.

Rehabilitation

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
  • coughing up blood
  • fever and chills
  • 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.