Intercostal retractions


Intercostal retractions is when the muscles between the ribs pull inward. The movement is usually a signthat the person has a breathing problem.

Intercostal retractions are a medical emergency.

Alternative Names

Retractions of the chest muscles


The wall of your chest is flexible. This helps you breathenormally. Stiff tissue called cartilage attaches your ribs to the breast bone (sternum).

The intercostal muscles are the muscles between the ribs. During breathing, these muscles normally tighten and pull the rib cage up. Your chest expands and the lungs fill with air.

Intercostal retractions are due to reduced air pressure inside your chest. This can happen if the upper airway (trachea) or small airways of the lungs (bronchioles) become partially blocked. As a result, the intercostal muscles are sucked inward, between the ribs, when you breathe. This is a sign of airway obstruction. Any diseases or condition that causes a blockage in the airwaywill cause intercostal retractions.

Common Causes

  • Anaphylaxis
  • Asthma
  • Bronchiolitis
  • Croup
  • Epiglottitis
  • Foreign body in the windpipe (See: Foreign object aspiration or ingestion)
  • Pneumonia
  • Respiratory distress syndrome
  • Retropharyngeal abscess

Home Care

Call your health care provider if

Seek immediate medical attention if intercostal retractions occur. This can be a sign of airway obstruction, which can quickly become life threatening.

Also seek medical care if the skin, lips, or nailbeds turn blue, or if the person becomes confused, drowsy, or is hard to wake up.

What to expect at your health care provider's office

In emergency situations, the health care team will first take steps to help you breathe. You may receive oxygen, medicines to reduce swelling, and other treatments.

When you can breathe better, the doctor or nurse will examine you and ask questions about your medical history and symptoms, such as:

  • When did the problem start?
  • Is it getting better, worse, or staying the same?
  • Does it occur all the time?
  • Did you notice anything significant that might have caused an airway obstruction?
  • What other symptoms are there, such asblue skin color, wheezing, high-pitched sound when breathing, coughing orsore throat?
  • Has anything been breathedinto the airway?

Tests that may be done include:

  • Arterial blood gases
  • Chest x-ray
  • Complete blood count (CBC)
  • Pulse oximetry to measure blood oxygen level