Rib Pain: What You Need to Know

Your ribs protect some of the most important organs in your body. Sometimes, however, the ribs can become injured and cause a lot of pain, especially with breathing and upper body movements. In this article we will go through a few of the most common causes of rib pain.

Anatomy of the Ribcage

The ribs are curved, flat bones that wrap around from our spine to our sternum (breastbone). They are joined to our spine by two joints, and to the sternum by cartilage. The joints at both ends allow for a little movement, allowing the ribcage to expand and contract with the lungs, and also allow for some flexibility at the spine.

Between each rib, there are muscles that expand and contract the ribs, called the intercostal muscles. These muscles are a major contributor to breathing function. As well, the ribs are attachment points for a number of muscles in your back and abdomen that control movement of your arms and your trunk.

Causes of Rib Pain

There are a few different types of injuries that involve the ribs, which we will break down below:

Intercostal muscle strain

The muscles that control your breathing can be susceptible to strain from things like coughing, sneezing, or heavy breathing during an activity. Twisting movements of the upper body or impact to the ribcage can also strain these muscles. An intercostal muscle strain usually presents as a sharp, catching pain while breathing or twisting.

Rib subluxation

A subluxation is when a bone slips slightly out of joint and then returns, causing a straining of the ligaments and other tissue around the joint. This can occur at the joint between the rib and the spine in the back. The symptoms for this injury would be pain with pressure at the affected site and pain with trunk rotation.

Rib fracture

The ribs are both flexible and strong to protect your vital organs. Sometimes, though, with enough force a blow to your ribs can cause a fracture. These injuries can be very painful, but are often not a serious risk for medical complications.

If you are suspecting you have a rib fracture, we recommend that you get in contact with your primary healthcare provider to rule out any medical complications, especially if you have difficulty breathing.

Nerve impingement

The nerves that service the body originate from the spine. In the thoracic spine between your neck and your lower back, these nerves supply the abdomen and areas around the ribcage. If there is an injury to one of these nerves, you can have pain referred to the ribs.

Other causes of pain around the ribs

There are many different organs and tissues beneath your ribcage, which can sometimes mimic symptoms of a regular rib injury:

  • Lung injury, from infection, blood clot, or puncture injury
  • Chest pain from angina or a heart attack
  • Cancer
  • Other organ injury from trauma

If you have a history of cancer or organ disease, or have symptoms other than the common symptoms of rib injury, we recommend that you see your primary healthcare provider to rule out more serious illness.

Treatment for Rib Pain

If you have an intercostal muscle strain or rib injury, most often these injuries just need time and rest to heal. A physiotherapist can help to guide your healing journey to help improve your pain and restore rib function more effectively. Here are some other tips to improve your experience with a rib injury:

  • Bracing: If you have pain with breathing and coughing, consider hugging a pillow to the painful area – this helps to stabilize the injured area and prevents strain during the movement.
  • Posture: Postural exercises can help to improve rib pain, especially if the pain is felt on your back (check out this article on posture).
  • Nerve pinch: If you are experiencing mid-back pain as well as rib pain, this might be an indication of a nerve impingement. A physiotherapist can help improve nerve-related back and rib pain through postural correction and strengthening exercises.
  • Modalities: If indicated by your primary healthcare provider, you may use pain medication as well as heat or cold for short-term pain relief while the rib is healing.

If you have rib pain and want to learn more, book an appointment with us!

About The Author

Jonathan Rankin obtained his MSc in Physiotherapy at McMaster University, and also completed both a BSc and an MSc in Human Kinetics from the University of Ottawa. He has a strong background in exercise, from working as a personal trainer at the University of Ottawa to conducting research on exercise during pregnancy in his master’s degree.

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