Rib Muscle Strain: Causes, Symptoms, and Solutions

Rib muscle strain

Hello doctor, for the past month, when I lie flat to sleep, I feel my abdomen gradually sinking.
After about one to two minutes, I start to feel a pulling sensation on both sides of the lower ribs (specifically at the protruding part of the lower rib cage, near the abdomen and the sides of the waist).
At this point, a dull pain begins to develop inside the area being pulled, and there is a very strong sense of pressure in the rib area on both sides.
If I sleep on my right side, the left rib area experiences the same issue (while the right rib area feels less affected); the same situation occurs when I sleep on my left side.
This condition severely affects my sleep, and for the past week, I have had to rely on a sedative (Yinmianan) to fall asleep, which is very distressing.
These symptoms only occur when I am lying flat, at an angle, or in a reclined position; I feel completely fine when standing or sitting upright.
I would like to ask the doctor what this condition might be.
Is it possible that this issue is caused by my excessive walking? For the past two months, I have been walking for an hour and a half every day (at least five kilometers), and during this period, I have lost 9-10 kg due to exercise and dietary adjustments.

Henry K, 60~69 year old female. Ask Date: 2018/09/27

Dr. Wang Zhaomin reply Rehabilitation

Based on the symptom description, it is possible that the pain is caused by an oblique muscle strain, which can occur when the muscle is pulled during a change in posture.
Additionally, lying flat may cause a noticeable sinking of the abdomen, and it is advisable to check if the mattress is too soft, as this can negatively impact health.
Furthermore, losing ten kilograms in two months is considered rapid weight loss; it is recommended to maintain a weight loss rate of half a kilogram per week, with a maximum of one kilogram.
Rapid changes in weight can also lead to physical discomfort.
It is advisable to visit a qualified medical facility, such as an orthopedic or rehabilitation department, for an accurate diagnosis.

Reply Date: 2018/09/27

More Info

It sounds like you are experiencing significant discomfort related to rib muscle strain, which can be caused by various factors, including physical activity, posture, and even stress. Let's break down the potential causes, symptoms, and solutions for your condition.

Understanding Rib Muscle Strain
Causes:
1. Physical Activity: Engaging in activities like walking for extended periods can lead to muscle fatigue and strain, especially if your body is not accustomed to such exertion. The sudden increase in physical activity, particularly if you have recently lost weight, can place additional stress on your muscles and joints.

2. Posture: Sleeping positions can significantly affect how your muscles and ribs feel. Lying flat on your back or at an angle may place strain on the intercostal muscles (the muscles between your ribs) and the abdominal muscles, leading to discomfort. If your mattress or pillow does not provide adequate support, this can exacerbate the issue.

3. Weight Loss: Rapid weight loss can lead to changes in muscle tone and body mechanics, which may contribute to discomfort in the rib area. As your body adjusts to a new weight, the muscles may react differently, leading to strain.

4. Stress and Tension: Emotional stress can lead to muscle tension, particularly in the upper body, which may manifest as discomfort in the rib area.

Symptoms:
- Pain: The pain you describe as a pulling sensation in the lower ribs, especially when lying down, is indicative of muscle strain. This pain can be exacerbated by certain positions, such as lying flat or on your side.

- Pressure Sensation: The strong feeling of pressure in the rib area can be a result of muscle tightness or inflammation in the intercostal muscles.

- Sleep Disturbance: The need for sedatives to sleep indicates that the pain is significantly affecting your quality of life.

Solutions and Recommendations
1. Rest and Recovery: Allow your body time to recover from the strain. Avoid activities that exacerbate the pain, particularly those that involve twisting or heavy lifting.

2. Modify Sleeping Position: Experiment with different sleeping positions. Using a supportive pillow or adjusting your mattress may help alleviate pressure on your ribs. Consider sleeping on your side with a pillow between your knees to maintain spinal alignment.

3. Gentle Stretching and Strengthening: Incorporate gentle stretching exercises to improve flexibility in the rib and abdominal area. Focus on stretches that target the intercostal muscles. Strengthening exercises for the core can also provide better support for your ribcage.

4. Heat Therapy: Applying heat to the affected area can help relax tight muscles and alleviate pain. A warm compress or heating pad may provide relief.

5. Consult a Healthcare Professional: If the pain persists or worsens, it is essential to consult a healthcare provider. They may recommend physical therapy, which can help you learn proper body mechanics and exercises to strengthen the muscles around your ribs.

6. Pain Management: Over-the-counter pain medications, such as ibuprofen or acetaminophen, can help manage pain and inflammation. However, consult with a healthcare provider before starting any new medication.

7. Monitor Activity Levels: Since you mentioned that you walk for an hour and a half daily, consider reducing the intensity or duration of your walks temporarily. Gradually increase your activity level as your symptoms improve.

Conclusion
Your symptoms suggest a rib muscle strain, likely exacerbated by recent changes in physical activity and body weight. By modifying your sleeping position, allowing for adequate rest, and incorporating gentle stretching, you may find relief from your discomfort. If symptoms persist, seeking professional medical advice is crucial to rule out any underlying conditions and to receive tailored treatment. Remember, your health and comfort are paramount, so take the necessary steps to ensure your well-being.

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