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What Causes Rib Pain? Pain Types, Symptoms & Possible Diagnoses

Illustration of a man holding his ribs in pain

Introduction & Summary

The ribs protect some of your body’s most important organs inside your chest—including your heart and lungs. As a cardiologist, I focus on this area of the body and I understand how complex it can be to distinguish between all the vital systems that converge around the ribs when pain appears.

In this article we’ll explore:

What Causes Rib Pain?

There are 12 ribs on each side of your chest, and they run from your spine in the back to your sternum, or breast bone, in the front. They are connected to your breast bone by cartilage, which is a strong but flexible tissue that allows the rib cage to expand during breathing. Muscles called intercostal muscles run between adjacent ribs and help move the chest wall, especially during breathing. Pain in your rib cage can come from any of these components. If you’re experiencing pain between or around your ribs, paying close attention to your symptoms can help you identify the cause.

Symptoms to Watch For

Since there are a variety of causes that can lead to pain in your ribs, it can be helpful to chat with a doctor about any other symptoms you’re experiencing. These symptoms can be clues to what’s causing your pain.

The following are just some of the symptoms that often appear with pain in the ribs:

  • Skin changes outside the ribs, like bruising
  • Pain with breathing, coughing, or sneezing
  • Pain when pressing on the area
  • Difficulty breathing

When you use the K Health app, we’ll ask you about many symptoms related to your pain in order to get a full picture of what’s going on with your health. Here are the most common symptoms our users reported experiencing with their rib cage pain:

  • Flank pain
  • Shoulder pain
  • Shortness of breath
  • Shoulder blade pain

Rib Pain from Coughing

If your ribs hurt when you cough or sneeze, it could be because coughing causes repeated movement of your intercostal muscles, as well as other muscles like the muscles in your abdomen. When you’ve got rib pain from coughing too much, this repeated movement, particularly if it’s frequent and forceful, could result in a pulled muscle causing pain or sore ribs. A cold can also cause pleuritis, which is inflammation of the lining of your lungs and the inner aspect of your chest wall (called pleura).

I hear from many users who complain of cough, but a little less than 1% also experience pain in their ribs with coughing. According to data from over 8,000 health dialogues within the K Health app, women aged 26-55 are 18% more likely to report this type of pain with coughing compared to men of the same age. So while it’s relatively rare, it is more common among women.

Possible Conditions Causing Rib Cage Pain

Our app works by showing you how doctors have diagnosed symptoms like rib cage pain in people like you in the past. But since we’ve had over 8,000 chats with users who reported pain in their ribs, we took a look at the conditions most commonly associated with this symptom

rib pain causes

Here’s what you need to know about the conditions above:

  • Injuries: Musculoskeletal chest pain can be caused by trauma or injury to the ribs, intercostal muscles, or skin and other tissues overlying the ribs. This is very common. Costochondritis, or inflammation of the cartilage that connects your ribs to your breast bone, is another musculoskeletal cause of rib pain.
  • Infections: Infections including upper respiratory infection, bronchitis, or pneumonia can also cause pain in your ribs. In this case, the pain may be caused by the infection itself, a pulled rib muscle from coughing, or by pleuritis, or inflammation of your pleura, the inside chest wall. Other causes of pleuritis include autoimmune disorders, certain medications, or injury to your ribs or adjacent structures.

Other Less Common Conditions

  • Pulmonary embolism: A pulmonary embolism is a dangerous condition and a medical emergency, in which a blood clot gets lodged in the arteries that supply the lungs.
  • Fibromyalgia: Fibromyalgia is a condition associated with musculoskeletal pain in different parts of your body, as well as fatigue and mood complaints.
  • Shingles: Shingles is caused by a viral infection (the same one that causes chicken pox) that results in a painful rash, as well as other symptoms.

Other causes may include a sprain in the muscles of your neck (cervical sprain) or inflammation in your stomach (peptic ulcer disease), parts of your body which are located nearby. Rib or chest pain is also commonly associated with mood disorders, like anxiety. Lung cancer may also cause rib cage pain, although it is a less common cause.

How to Address Your Rib Pain and Possible Treatments

Your rib cage is a collection of bones and tissues, and any of these components can cause rib pain, so it’s important to explore the cause. Anti-inflammatory drugs like ibuprofen can help with pain. If your pain is caused by cough, you can try a cough suppressant. While I always recommend a personal assessment, here are the most common ways people address their pain:

  • Speak to a primary care doctor: Most people with rib cage pain are evaluated by a primary care doctor, who will ask them questions, examine them, and order any appropriate tests, like an x-ray of the ribs.
  • Take over-the-counter painkillers: Try taking anti-inflammatory medications, like ibuprofen (Advil or Motrin) or acetaminophen (Tylenol).
  • Try a cough suppressant: If your pain is associated with a cough, you could try a cough suppressant, such as dextromethorphan (Robitussin) to give your ribs a rest from the coughing motion.
  • Watch for serious symptoms: Rib or chest pain may be a sign of a serious health issue, so it’s important to seek care if you have severe pain, especially if associated with other symptoms like difficulty breathing, fainting, irregular heartbeat, or profuse sweating.

Prevention Tips

Here are some things you can do to avoid or minimize pain in your ribs:

  • Protect your rib cage while it’s injured or hurting. The ribs protect some of your most vital organs, and you want to avoid any movements that could make your pain worse.
  • If you have a cold with a bad cough, try taking a cough suppressant like dextromethorphan and an anti-inflammatory agent like ibuprofen.

How K Health Can Help

Most people with rib cage pain see a doctor, but you could start by doing a free assessment with K Health to learn how people like you with similar rib pain symptoms were diagnosed and treated. Did you know you can get affordable primary care with the K Health app? Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Dr. Edo Paz, MD

Edo Paz is the VP of Medical at K Health. Dr. Paz has two degrees in chemistry from Harvard and an MD from Columbia University. He did his medical training in internal medicine and cardiology at New York-Presbyterian. In addition to his work at K Health, Dr. Paz is a cardiologist at Heartbeat Health, a cardiology practice located in New York City.