Coughing can cause rib pain due to various factors, from muscle strain to underlying conditions. This article explores common reasons why your ribs might hurt when you cough.
How Coughing Creates Rib Pain
Coughing is a forceful reflex designed to clear irritants from your airways. This action involves several muscle groups, including your diaphragm, intercostal muscles between your ribs, and abdominal muscles. Their sudden contraction generates significant pressure within your chest and abdomen. This intense force can strain the muscles, ligaments, and joints within your rib cage, leading to localized pain.
Specific Conditions Causing Rib Pain When Coughing
Rib pain from coughing can stem from several medical conditions, each affecting different chest structures.
Muscle Strain
Muscle strain is a frequent cause of rib pain from coughing. The intercostal muscles, located between your ribs, help stabilize your upper body and assist with breathing. Forceful or repetitive coughing can overstretch or partially tear these muscles. This results in sharp, localized pain that worsens with movement, deep breaths, twisting, or continued coughing. The affected area may also feel tender to the touch.
Costochondritis/Tietze’s Syndrome
Inflammation of the cartilage connecting your ribs to your breastbone (sternum) causes pain when coughing, a condition known as costochondritis. The pain is often sharp, aching, or pressure-like, intensifying with deep breathing, coughing, or chest wall movement. Tietze’s Syndrome is a rarer form of costochondritis that also causes noticeable localized swelling, typically affecting one upper rib. Both conditions are worsened by the physical stress of coughing.
Pleurisy
Pleurisy, or pleuritis, involves inflammation of the pleura, the two thin layers of tissue that surround your lungs and line the inside of your chest cavity. Normally, these layers glide smoothly past each other during breathing. However, when inflamed, they can rub together, causing sharp, stabbing chest pain that is markedly worse when you breathe deeply or cough. This pain might also spread to your shoulder or back. Pleurisy often arises from viral or bacterial infections.
Bronchitis/Pneumonia
Respiratory infections such as bronchitis and pneumonia can lead to rib pain when coughing. Bronchitis is an inflammation of the bronchial tubes, which can cause a persistent cough and chest soreness. The pain can be directly due to the inflammation in the airways or from the muscle strain caused by violent coughing. Pneumonia, an infection that inflames the air sacs in the lungs, can cause chest pain that worsens with coughing or deep breathing, often described as sharp or stabbing. This pain can be pleuritic if the infection affects the pleura.
Rib Fracture/Stress Fracture
While less common, severe or chronic coughing can lead to a rib fracture or stress fracture. A rib fracture typically presents as strong, localized pain in the chest area, particularly when breathing in or coughing. Stress fractures develop over time from repeated mechanical stress on the ribs; the pain may initially be present only after activity, eventually worsening and becoming sore during breathing and coughing. Risk factors for cough-induced fractures include chronic cough, low bone density, and certain medical conditions.
When to Consult a Doctor
While rib pain from coughing can often be due to less serious causes, it is important to know when to seek medical attention. Consult a doctor if the pain is severe or worsens progressively, or if accompanied by symptoms such as fever, chills, shortness of breath, wheezing, or persistent coughing. Other concerning signs include coughing up blood or discolored mucus, or if the pain does not improve after a few days or weeks. Any new, concerning symptoms or pain that limits daily activities also warrant a medical consultation.