Rib Pain

What Causes Rib Pain?

Rib pain, or ribcage pain, could have, literally, dozens of causes. Some are not hard to diagnose. Rib pain from broken ribs or cracked ribs is hard to miss--and you usually know exactly how it got it.

But it may not be so easy to tell what causes rib pain if you have some other condition or disorder. The goal of this article is to help sort out some of the possibilities and recognize rib pain symptoms you can discuss with your doctor. Your doctor will also advise you on the best course of treatment.

Causes of Rib Pain Cracked or Broken Rib Some people say these rib injuries rate extremely high on the pain scale--right up there with childbirth, kidney stones and gunshot wounds. You probably have a broken rib if it hurts to breathe or if the area around the rib hurts a lot when you press it.

Rib Cartilage Injury Your ribs are attached to your breastbone by cartilage. If your ribs or ribcage are pushed out of shape momentarily from a blow, the cartilage can be injured. It might also happen if you were doing pushups too strenuously, or trying to push something heavy. There will be ribcage pain in the area of the injury when pressed, and you may find it painful to laugh, cough, or even breathe. Also see costochondritis, below.

Other Tissue Injuries Since there are lots of muscles, ligaments and tendons in the area of the ribcage, pain will occurs when one of them is strained, torn or stretched. These injuries often result from overuse or pushing the muscles, ligaments and tendons beyond their normal range of capability. Certain movements may hurt, and depending on severity, the injured area may be tender to the touch. 

Bone Related Issues Osteoarthritis Whenever you see the word "itis," you know it has something to do with pain from inflammation. Rib pain from osteoarthritis occurs when the cartilage that attaches the ribs to the breastbone deteriorates with age or is injured. These things cause inflammation, and inflammation causes pain.

Rheumatoid Arthritis This is an autoimmune disease, meaning that the body’s immune system starts to attack itself. When this occurs in the areas that connect the ribs to the breastbone or the spine, rib pain can result.

Osteochondritis The actual name for this condition is osteochondritis dissecans. It occurs when the blood supply to the area at the end of a rib is obstructed. Osteochondritis dissecans is more likely to affect older children, teenagers and young adults, especially if they play sports.

Lung Related Lung Inflammation/Pleurisy  Pleurisy is an inflammation of the lining between the lungs and the ribcage. It's usually due to an infection or a foreign irritant. The pain feels as if it's coming from under the ribcage. This feeling of pain under the ribs can be very acute.

Pneumonia Pneumonia is an infection of the lungs that may be caused by bacteria, a virus, or fungi. It can cause sharp chest and ribcage pain that hurts worse when you take a deep breath or cough.

Tuberculosis or TB  This is an infection that usually starts in the upper part of the lungs. Chest pain that feels like pain under the ribs is typical as the disease progresses, along with fatigue, weakness, weight loss, fever, night sweats and coughing.

Asbestos Exposure Asbestos causes two conditions that include rib pain as a symptom. Asbestosis is a non-cancerous buildup of scar tissue in the lower half of the lungs. Mesothelioma is a cancerous condition, almost caused by asbestos exposure, that affects the pleural lining of the lungs and sometimes the pericardial lining of the heart. Either condition can trigger pain under the ribs.

Cancer Can Lung Cancer Cause Rib Pain? The answer is yes. Pain in the ribcage, the shoulder or upper back may be a symptom of lung cancer. The pain comes from a tumor pressing on the lining of the lungs.

Multiple Myeloma About 70-80 percent of patients with this form of cancer report chest and ribcage pain as a symptom.

Other Possible Causes Costochondritis This is an inflammation of the cartilage that joins the ribs to the breastbone. It can come from an injury, as noted above. It is believed it may also occur because of viral infections, particularly upper respiratory infections. See costochrondritis.

Herpes Zoster Herpes zoster is also known as shingles. It can cause acute chest or ribcage pain before a skin rash occurs. Most people describe this kind of rib pain as a burning pain.

Referred Thoracic Spinal Pain Sometimes there's a pain caused by a problem in the discs, nerves, muscles, facet joints, and ligaments in the spine. These can cause pain anywhere else in the body along the nerve pathways. This "referred pain" can also cause pain under the ribs.

Metastatic Cancer Cancer that starts in organs such as the liver or pancreas can be felt as ribcage pain.

Chronic Steroid Use Steroids have been used to relieve joint pain for decades. But repeated steroid use over a long period of time can cause damage to the body, which sometimes results in pain in the ribs and other places.

Acute Anxiety and Stress These may sometimes cause chest pain or ribcage pain, whether or not the stress contributes to a heart attack.

Also see our related articles on ribcage pain, rib pain causes and pain under the ribs.