Rib pain is discomfort or tenderness felt in the chest area, around the bony cage protecting organs. It ranges from a dull ache to a sharp, stabbing feeling. Reasons for rib pain are diverse, from minor muscle strains to complex medical conditions. Understanding these sources helps recognize why ribs hurt.
Musculoskeletal Causes
Musculoskeletal issues often cause rib pain. Muscle strain is a common reason, occurring when intercostal muscles between the ribs are overstretched or torn. Vigorous coughing, sudden twisting, or strenuous exertion leads to these strains, causing localized pain worsening with movement or deep breaths.
Costochondritis is another frequent musculoskeletal cause, inflammation of cartilage connecting ribs to the sternum. This condition typically causes sharp, localized pain that can be tender to the touch, often mimicking serious chest issues. Costochondritis is generally benign and often resolves, though its exact cause is frequently unknown.
Traumatic events, like rib fractures or bruising, cause significant rib pain. Direct impact, a fall, or severe, persistent coughing results in a cracked or broken rib. These injuries cause intense pain, often worsened by deep breaths, coughing, or torso movement.
Rib pain can sometimes be referred from the thoracic spine (upper and middle back). Disc herniations or inflammation irritate chest wall nerves, leading to perceived rib discomfort. This pain may include back stiffness or radiating pain along the rib cage.
Other Potential Causes
Beyond musculoskeletal issues, other conditions cause rib pain. Pleurisy involves inflammation of the pleura, thin tissue layers separating lungs from the chest wall. When inflamed, these layers rub during breathing, causing sharp, stabbing pain intensifying with deep breaths, coughing, or sneezing.
Shingles, a viral infection from reactivated varicella-zoster, causes significant rib pain. It typically presents as a painful rash, but nerve pain can precede the rash by days or weeks, often following a band-like pattern around the torso. Pain can be burning, tingling, or shooting.
Gastrointestinal issues may be mistaken for rib pain due to proximity to the lower ribs. Acid reflux, where stomach acid flows into the esophagus, causes a burning sensation in the chest extending to the lower ribs. Esophageal spasms, uncoordinated contractions of the esophagus, produce chest pain radiating to the ribs.
Lung conditions cause chest wall discomfort that feels like rib pain. Infections like pneumonia or bronchitis, causing lung and airway inflammation, lead to persistent coughing. This repeated coughing can strain intercostal muscles and irritate the lung lining, causing pain around the ribs.
When to Seek Medical Attention
Seek medical evaluation if serious rib pain conditions are suspected. Immediate medical attention is advisable if rib pain is severe, crushing, or accompanied by concerning symptoms like pain radiating to arm, jaw, or back (indicating a cardiac event), difficulty breathing, shortness of breath, dizziness, or fainting.
Sudden severe rib pain after trauma (e.g., fall, accident) warrants a healthcare visit for fractures or internal injuries. If pain is accompanied by fever, chills, persistent cough, or unexplained weight loss, it could signal infection or systemic illness needing prompt diagnosis. Even without acute symptoms, if rib pain is persistent, unexplained, or interferes with daily activities, consult a doctor.
Understanding Diagnosis and Management
Diagnosis typically involves a physical exam and medical history. During the exam, the doctor may palpate the rib cage to pinpoint tenderness or swelling and listen to lung and heart sounds. Patient pain description (location, intensity, what makes it better or worse) provides clues.
Diagnostic tests are ordered based on suspected cause. X-rays identify fractures or bone abnormalities. For detailed views of soft tissues or organs, CT or MRI scans are used. Blood tests detect inflammation or infection; an EKG rules out heart-related causes if symptoms are present.
Once diagnosed, rib pain management addresses the cause and alleviates symptoms. General approaches include rest and over-the-counter NSAIDs to reduce pain and inflammation. Heat or cold therapy provides relief for muscle strains or bruising. Physical therapy may improve posture and strengthen muscles for some conditions. Specific treatments for underlying conditions, such as antiviral medications for shingles or acid-reducing medications for reflux, are prescribed.