Your intercostal muscles are attached to your ribs, and they normally contract and move your ribs up when you breathe in air. At the same time, your diaphragm drops lower, and your lungs fill with air. When you have a partial blockage in your upper airway or the small airways in your lungs, air cannot flow freely and the pressure in this part of your body decreases. As a result, your intercostal muscles are sucked in sharply inside your rib cage. These movements are called retractions.
Intercostal retractions occur when the muscles between your ribs are pulled inward. This is also called intercostal recession. These movements indicate that something is blocking your airway. Asthma, pneumonia, and other respiratory diseases can all cause blockage.
If you or someone you are with experiences intercostal retractions, seek medical help immediately—airway obstruction is considered a medical emergency.
Several conditions can cause the airways to become blocked. These are some conditions that commonly cause retractions.
Asthma: This chronic condition causes your airways to become inflamed and narrowed, which leads to wheezing, shortness of breath, and chest tightness. About 25 million people in the United States have asthma, according to the National Heart Lung and Blood Institute (NHLBI).
Pneumonia: This condition occurs when your lungs become inflamed from an infection. It can be very mild in some cases and life threatening in others. It can also lead to serious complications, especially in older people and those who have weak immune systems.
Epiglottitis: This condition occurs when the cartilage that covers the top of your windpipe becomes swollen and prevents air from reaching your lungs. It is considered a medical emergency since it can be life threatening.
These respiratory illnesses mainly occur in children:
Respiratory distress syndrome: This condition occurs when a newborn’s lungs collapse. It causes serious difficulty in breathing. It is common in premature babies since their lungs are not fully developed. It mainly occurs shortly after birth and can lead to brain damage and other serious complications if it is not treated in time.
Retropharyngeal abscess: This is a buildup of pus and other infected material in the back of your child’s throat. It happens mostly in children under 5 years old and requires prompt medical treatment to prevent it from blocking the airways.
Bronchiolitis: This condition occurs when a virus infects the small airways, or bronchioles, in your child’s lungs. It occurs most in babies under six months old and is more common during winter. It is usually treated at home and goes away in about a week.
Croup: This condition occurs when your child’s windpipe and vocal cords become inflamed due to a virus or bacteria. It causes a loud barking cough that can sound worse in children under 3 years old because their airways are smaller. It is usually a mild condition that is treated at home.
Foreign Object Aspiration
This occurs when you inhale or swallow a foreign object that becomes stuck and causes breathing problems. A foreign object that is lodged in your windpipe can cause intercostal retractions. It is more common in young children since they are more likely to accidentally breathe in or swallow a foreign object.
This occurs when something, such as food or medication, triggers a serious allergic reaction. It usually happens within 30 minutes of encountering an allergen. It can constrict your airways and lead to severe breathing problems. It is considered a medical emergency since it can be fatal without treatment.
Since intercostal retractions occur when your airways are blocked, you need to get medical help as soon as possible. Airway obstruction can become a life-threatening condition.
The first step in treatment is helping the affected person breathe again. You might be given oxygen or medications that can relieve any swelling you have in your respiratory system. Let your doctor know as much as possible about your condition, such as how often the retractions have occurred, whether you have been sick, and whether you have any other symptoms. If your child is the one being treated, let the doctor know if your child might have swallowed a small object or if your child has been sick.
When your breathing is stable, your doctor will treat your underlying condition. The methods used will depend upon the condition that caused you to have retractions.
Intercostal retractions should not return when the underlying condition has been successfully treated.
The outlook for the cause of the retractions depends on what the condition is and how serious it is.
You cannot prevent intercostal retractions but you can lower your risk of having some of the conditions that cause them.
You can help prevent viral infections by avoiding contact with people who are sick, washing your hands often, and wiping down the counters and other surfaces in your home if you live with someone who is sick.
Try to avoid coming into contact with things that you are allergic to. This can help reduce your risk of having anaphylaxis.
You can lower your child’s risk of breathing in a foreign object by keeping small objects out of reach and cutting food into smaller pieces that are easier to chew and swallow.