Your intercostal muscles attach to your ribs. When you breathe in air, they normally contract and move your ribs up. At the same time, your diaphragm, which is a thin muscle that separates your chest and abdomen, 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 can’t flow freely and the pressure in this part of your body decreases. As a result, your intercostal muscles pull sharply inward. These movements are known as intercostal retractions, also called intercostal recession.
Intercostal retractions indicate that something is blocking or narrowing your airway. Asthma, pneumonia, and other respiratory diseases can all cause a blockage.
Seek medical help immediately if you or someone you’re with experiences intercostal retractions. Airway obstruction is a medical emergency.
Several conditions can cause a blockage in the airways and lead to intercostal retractions.
Respiratory illnesses common in adults
Some respiratory illnesses are more common in adults, although they do occur in children as well.
Asthma is a chronic condition that causes inflammation and narrowing of the airways. This 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.
Pneumonia 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 adults and those who have weak immune systems.
Epiglottitis occurs when the cartilage that covers the top of your windpipe becomes swollen and prevents air from reaching your lungs. This is a life-threatening medical emergency.
Respiratory illnesses common in children
These conditions most commonly occur in children.
Respiratory distress syndrome occurs when small airways in a newborn’s lungs collapse. It causes serious difficulty breathing. It’s most common in premature babies because they don’t produce a substance called surfactant, which helps keep small sacs in their lungs open. It mainly occurs shortly after birth and can lead to brain damage and other serious complications if the child doesn’t receive prompt treatment.
A retropharyngeal abscess 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 it requires prompt medical treatment and sometimes surgery to prevent it from blocking the airways.
Bronchiolitis occurs when a virus infects the small airways, or bronchioles, in your child’s lungs. It occurs most often in babies under 6 months old and is more common during winter. You can usually treat this at home. If your baby has intercostal retractions or is otherwise working hard to breathe with this illness, seek medical care right away. Bronchiolitis usually goes away in about a week.
Croup occurs when your child’s windpipe and vocal cords become inflamed due to a virus or bacteria. It causes a loud, barking cough. It typically sounds worse in children under 3 years old because their airways are smaller. It’s usually a mild condition that you can treat at home. Though intercostal retractions are not common with croup, if you do see them, seek medical care.
Foreign object aspiration
Aspiration occurs when you inhale or swallow a foreign object that becomes stuck and causes breathing problems. A foreign object lodged in your windpipe can cause intercostal retractions. It’s more common in young children because they’re more likely to breathe in or swallow a foreign object accidentally.
Anaphylaxis 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. This is a medical emergency that can be fatal without treatment.
The first step in treatment is helping the affected person breathe again. You might receive 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 occur, whether you’ve been sick, and whether you have any other symptoms. If your child is the one receiving treatment, let the doctor know if they 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 shouldn’t return once you receive successful treatment for the underlying condition. Conditions such as asthma require you to be vigilant in suppressing your symptoms. Neglecting your underlying condition can cause a relapse of intercostal retractions.
The outlook for the cause of the retractions depends on what the condition is and how serious it is. Monitoring your health and maintaining communication with your doctor will help you avoid any triggers and keep you in good health. If you or your child has a condition that could lead to intercostal retractions, developing an emergency plan can help relieve anxiety and stress.
You can’t 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.