Back rib pain, often felt in the upper or middle back, can range from minor annoyance to a serious underlying issue. Understanding its origins helps determine next steps.
Musculoskeletal Contributors
Musculoskeletal issues frequently cause back rib pain. Muscle strains or spasms in intercostal muscles (between ribs) or larger back muscles cause discomfort. These result from sudden movements, poor posture, heavy lifting without proper form, or overuse from repetitive motions.
Ligament sprains, involving stretched or torn fibrous tissues, also contribute to back rib pain. Ligaments supporting the thoracic spine or connecting ribs to vertebrae can sprain from twisting or direct impact.
Myofascial pain syndrome involves sensitive muscle points that cause pain, including in the back ribs. Trigger points develop from muscle injury, repetitive strain, or stress.
Poor posture contributes to muscle imbalance and strain in the back and rib cage. Slouching or prolonged sitting stresses muscles supporting the spine and ribs, leading to chronic tension and pain. Correcting posture redistributes weight and reduces strain. Addressing these factors involves rest, physical therapy, and pain management.
Rib and Spine-Related Conditions
Costochondritis is inflammation of cartilage connecting ribs to the breastbone or spine, causing sharp, localized pain worsening with deep breaths or movement. Tietze’s syndrome is a less common costochondritis involving cartilage swelling.
Rib fractures or bruising result from direct trauma (e.g., fall, sports impact) or severe coughing. Pain is sharp and intensifies with breathing, coughing, or twisting.
Herniated discs in the thoracic spine compress nerves, causing pain around the rib cage. This pain may be sharp, localized, or band-like around the chest or back.
Arthritis, like osteoarthritis, affects thoracic vertebrae joints, causing stiffness and back rib pain. This degenerative condition breaks down cartilage, leading to bones rubbing together.
Vertebral compression fractures, linked to osteoporosis, occur when a spinal vertebra collapses, causing sudden, severe back pain extending to the rib area. Spinal deformities like scoliosis (abnormal spinal curvature) contribute to chronic strain and pain by altering back and rib cage biomechanics.
Referred Pain from Internal Organs
Pain from internal organs can be felt in the back rib area, known as referred pain.
Kidney issues (stones or infection) cause sharp pain in the flank, often felt below the back ribs. This pain may radiate to the groin or abdomen, accompanied by fever, painful urination, or blood in urine.
Lung issues cause back rib discomfort. Pleurisy, inflammation of the lung lining, causes sharp chest pain worsening with breathing, also felt in the back. Pneumonia, a lung infection, may also cause chest and back pain with fever, cough, and shortness of breath.
Digestive issues, though usually causing abdominal pain, can refer pain to the back. Conditions like acid reflux, gallstones, or pancreatitis might cause discomfort perceived in the back ribs, though less commonly.
Heart-related pain is primarily felt in the chest but can radiate to the back, arm, or jaw. While rarely presenting solely as back rib pain, any chest pain with back pain requires prompt evaluation.
Shingles, a viral infection, causes intense nerve pain (burning, tingling, or shooting) in a band-like pattern around one side of the body, including the back rib area. This pain typically precedes the rash.
When to Consult a Doctor
Consult a doctor if back rib pain presents with:
Pain follows a significant injury or trauma (e.g., fall, car accident).
Pain accompanies systemic symptoms like fever, chills, or unexplained weight loss, indicating infection or other serious conditions.
Difficulty breathing or shortness of breath occurs with back rib pain.
Pain worsens progressively or doesn’t improve after a few days of rest and self-care.
Pain radiates to other body parts (e.g., arm, jaw), especially with chest discomfort.
Numbness, tingling, or weakness in limbs occurs with back rib pain, indicating nerve compression.
There is sudden onset of severe pain, or pain significantly limits daily activities.
Pain accompanies digestive symptoms like nausea, vomiting, or severe abdominal pain.