The Best Stretches and Exercises for Intercostal Neuralgia

Pain relief medication can help with symptom management, but physical therapy and gentle exercise may also be beneficial. Remember to check with a healthcare professional before you try any exercises or other at-home therapy, as the wrong approach may make things worse.

“Use pain as a guide when exercising,” says Jason Zafereo, PhD, a professor of physical therapy and the lead physical therapist at the Eugene McDermott Center for Pain Management at UT Southwestern Medical Center in Dallas. “Although pain may temporarily increase when you move, it should never become unbearable, linger after completing an exercise, or worsen the more you do the exercise.”

The pain typically occurs in a band-like formation around the chest and back. It can also affect the skin of the front and back of your torso, roughly between your collarbone and your pelvis.

• Sharp, stabbing, or radiating pain
• A burning feeling
• Aching
• Numbness
• Tingling
• Allodynia, a type of pain caused by something that normally wouldn’t hurt

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If you have intercostal neuralgia, your doctor may prescribe physical therapy to manage the pain, regardless of the root cause.

Experts generally recommend exercise alongside other treatments, which is known as multimodal therapy, such as intercostal neuralgia, says Christopher Robinson, MD, PhD, a pain medicine specialist and an assistant professor in the department of anesthesiology and critical care medicine at the Johns Hopkins School of Medicine in Baltimore.

He explains that exercise can help:

• Reduce muscle tension
• Improve posture
• Decrease nerve compression

He cautions that, while exercise can improve various neuropathic conditions, data supporting its use in intercostal neuralgia is limited.

“There are no clinical trials or systematic reviews and meta-analyses addressing exercise or safety,” he says. “The information is inferred from other research on other neuropathic conditions.”

Physical therapy, on the other hand, has a demonstrated role in treating intercostal neuralgia, says Akshay Bhatt, MD, a pain medicine specialist and a clinical assistant professor in the NYU Langone Health department of anesthesiology, perioperative care, and pain medicine in New York City. He says the techniques include manual therapy and exercises to improve your posture and flexibility.

“Strengthening and postural exercises target thoracic spine stabilization and correct biomechanical dysfunction,” Bhatt says. “They strengthen your back and improve your posture so you can move more easily and comfortably. Maintaining a correct posture may also prevent further pain.”

According to Dr. Zafereo, stretching your chest and side muscles — also known as your pecs and lats — may improve mobility, and strengthening the muscles along your spine (your back extensors) can help with your posture.

He says the following exercises are all suitable for improving your posture, as well as movement in your upper torso. “They act by stretching or strengthening muscles that attach to the thoracic spine, ribs, or shoulder blades.”

Side-Bend Stretch

1. Sit in a chair with your feet on the floor or stand with feet hip-width apart.
2. Lean forward slightly, keeping your ears, hips, and shoulders in a straight line without hunching your back or shoulders.
3. Raise your right arm overhead and bend your upper body to the left, making a reaching motion. Keep your upper body facing forward; don’t twist. Lean into the stretch so that you feel it from your shoulder to your lower back.
4. Hold for 20 seconds. Repeat two more times on this side, and switch sides and do three reps on the left side.

Child’s Pose

1. Kneel on the floor and lower yourself to sit on your knees.
2. Lean forward with your arms outstretched in front of you, keeping your butt on your heels and your forehead on the floor.
3. Move your arms back so they’re parallel with your legs, palms facing up.
4. In this position, relax into the pose and inhale and exhale slowly and deeply for at least eight breaths.

Shoulder Squeezes

1. Sit up straight in a chair, with your arms by your sides.
2. Squeeze your shoulder blades back and together, pulling them down toward your hips.
3. Hold for 5 seconds, then release. If possible, repeat three to five times per day.

Spine Mobilization

Devices such as a foam roller can improve movement in your middle back, says Zafareo.

1. Lie on your back with the foam roller under your upper back and your buttocks raised to keep your back straight.
2. Wrap your arms across your chest and hold your shoulders with your hands.
3. Using your feet, gently roll back and forth across the roller with your upper body.
4. Aim for 10 to 15 repetitions per session.

Deep Breathing and Mind-Body Exercise

1. Sit comfortably.
2. Place one hand on your upper chest and the other below your rib cage.
3. Inhale slowly through your nose. You should feel your stomach rise with your lower hand, and the upper hand should remain still throughout this exercise.
4. Tighten your stomach muscles and feel your stomach lower as you breathe out through pursed lips.
5. Continue for 5 to 10 minutes.

• Intercostal nerve pain can result from an injury, shingles, surgery, and other causes. It takes different forms but often involves a band of pain or sharp, intermittent pain on the torso.
• The pain may be temporary or intermittent, but it can also become chronic. A doctor can prescribe medication to relieve the pain and make movement easier, but stretching exercises, deep breathing, and mind-body exercise, such as yoga, can also help.
• Work with your doctor or a physical therapist to create an exercise plan that will help you manage pain and reduce the impact of intercostal neuralgia on your daily life.