The levatores costarum are twelve pairs of small fan-shaped muscles on each side of the thoracic spine, arising from the transverse processes of C7-T11 and inserting on the outer surface of the rib immediately below (levatores costarum breves). The lower four muscles may also send a slip to the rib two levels below (levatores costarum longi). They span the costovertebral angle and represent the homologues of the intertransversarii and correspond embryologically to the same dorsal ramus musculature.
| Origin | Tips of the transverse processes of C7 and T1 to T11 (twelve muscles on each side) |
|---|---|
| Insertion | Outer surface of the rib below the vertebra of origin, between the tubercle and angle |
| Nerve Supply | Posterior rami of thoracic spinal nerves (C8-T11) |
| Blood Supply | Posterior intercostal arteries; Lateral branches of dorsal spinal arteries |
| Actions |
|
|---|
They elevate the ribs during inspiration and may assist side-bending and rotation of the thoracic spine.
The levatores costarum are not commonly discussed clinically but contribute to both thoracic spine mobility and rib elevation during deep inspiration. Trigger points in these muscles may contribute to posterior thoracic pain that mimics facet joint or costovertebral joint pain. They are identified during posterolateral thoracotomy and thoracoscopic procedures as they fan across the costovertebral angle. Their innervation by posterior rami distinguishes them from the intercostal muscles which receive anterior rami supply.
Palpated in the costovertebral angle between the transverse processes and the rib angle, approximately 3-5 cm lateral to the thoracic spinous processes. Best assessed with the patient prone.
Myofascial trigger points within the levatores costarum contribute to posterior thoracic and inter-scapular pain, often confused with costovertebral joint or thoracic facet pain, treated with dry needling, massage, and thoracic mobility exercises.
This website uses cookies to enhance your experience. Some are essential for site functionality, while others help us analyze and improve your usage experience. Please review your options and make your choice.
If you are under 16 years old, please ensure that you have received consent from your parent or guardian for any non-essential cookies.
Your privacy is important to us. You can adjust your cookie settings at any time. For more information about how we use data, please read our privacy policy. You may change your preferences at any time by clicking on the settings button below.
Note that if you choose to disable some types of cookies, it may impact your experience of the site and the services we are able to offer.
Some required resources have been blocked, which can affect third-party services and may cause the site to not function properly.
This website uses cookies to enhance your browsing experience and ensure the site functions properly. By continuing to use this site, you acknowledge and accept our use of cookies.
