Treatment of Intercostal Muscle Strain

Pharmacological Management

Non-steroidal anti-inflammatory drugs (NSAIDs) should be used as part of systemic multimodal analgesia to improve pain control and enhance recovery, as recommended by the American Society of Anesthesiologists 1
Acetaminophen can be used as an alternative or in combination with NSAIDs for pain management, according to the American College of Physicians 2
Opioids should be used cautiously and only for short-term management of severe pain that doesn't respond to first-line treatments, as advised by the American College of Physicians 2

For severe or persistent intercostal pain, intercostal nerve blocks may be considered, as they have shown efficacy in reducing pain scores and opioid consumption in thoracic conditions, with moderate to high strength of evidence 3, 4
Deep serratus anterior plane blocks have demonstrated effectiveness in managing thoracic wall pain with lower pain scores and reduced need for rescue medication, with moderate strength of evidence 4