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Health

Pain between the ribs

, medical expert
Last reviewed: 04.07.2025
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If you are reading this article, it means that you or your friends or relatives are bothered by pain between the ribs. And since this is so, then, without wasting time on describing the anatomical structure of the chest and its musculoskeletal structure, we will directly move on to listing all the probable causes that may underlie the above pain.

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What causes pain between the ribs?

One of the obvious situations that leaves no doubt about the true cause of painful sensations between the ribs is a fracture of the ribs themselves or one of them. A bruise of the chest or a crack in the rib is also accompanied by pain of varying intensity. A chest X-ray taken using an X-ray machine will help determine the extent of the damage and its severity.

By its nature, pain between the ribs can manifest itself as sharp and dagger-like contractions or be constant and aching. At the moment of rib fracture, the lungs can be injured. Such situations do not go unnoticed. If the injury is serious, then the severity of the general condition will immediately indicate the presence of internal bleeding. Sharp pain when breathing will force the patient to urgently consult a doctor, because it is quite difficult to tolerate such sensations.

Do not reassure yourself that the situation is not as bad as it may seem if after receiving a blow to the chest there is only minor pain between the ribs. A rib fracture is not always accompanied by bone deformation. In closed fractures, when the bone is broken but still retains its original shape, there may be minor multiple lung injuries caused by bone fragments. These complications may not immediately cause any visible symptoms, but over time they will lead to serious consequences. Therefore, in any case, you should visit a traumatologist and take a chest X-ray in order to clearly verify the true state of affairs.

Rib contusions, cracks and fractures are accompanied by pain for a very long time. Healing occurs within a few weeks. Depending on the severity and size of the affected area, sometimes the recovery process can take several months. If internal organs were not affected, then complete recovery occurs without any consequences.

Intercostal neuralgia

A consequence of one or more diseases associated with the spinal column and adjacent organs. For a number of reasons, there is a disruption in the work of the nerve branch and with neuralgia, pain between the ribs is observed along the nerve. Pinching, compression, irritation of the intercostal nerve or nerves occurs due to intervertebral hernias, advanced osteochondrosis, kyphosis of the spinal column in the thoracic region, oncological neoplasms. There can be many reasons why intercostal neuralgia occurs.

Pain between the ribs with neuralgia occurs unexpectedly and, as a rule, is provoked by some external factors, be it an infection, sudden lifting of weights without proper warming up of muscles, prolonged exposure of the body to low temperatures, in other words, hypothermia, poisoning and, of course, back or chest injuries.

Therefore, knowing about the presence of any pathologies in the spine, you should always take care of your health carefully and prudently, avoid provoking situations that can aggravate the situation by adding intercostal neuralgia.

The distinctive features by which one can distinguish neuralgic pain between the ribs from other types of pain are:

  • clear tracing along the nerve, which can be determined by palpating certain points in the spine area (level of the V-XI rib), the scapula, at one of the edges of the sternum. Pain between the ribs extends not only in the intercostal space, but also has an irradiating character, to the shoulder-scapular area;
  • a specific posture of the patient, in which he tries to reduce the pain during breathing and movement by bending the body and shifting the center of gravity to the healthy side. The pain between the ribs increases with any movement, including loud speech, coughing and sneezing, in severe cases even the act of swallowing causes pain;
  • strictly localized in the intercostal spaces, pain intensifies upon palpation;
  • increased pain when changing body position;
  • the presence of additional sensations, such as tingling, numbness and a burning sensation in the chest.

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Pain between the ribs needs to be known, not guessed!

As with any disease, correct diagnosis is very important. Intercostal neuralgia, radiating to the heart, can be perceived as an attack of angina. Here it is important to know the distinctive features of the two types of pain. With neuralgia, the pain between the ribs is constant and does not affect the pulse rate. With angina, the heart rhythm suffers, which can be traced by the pulse rate. The pain between the ribs is cramping, pulsating, arising suddenly and also suddenly subsiding.

It is impossible to palpate and find the exact localization of such pain. When changing the position, the pain does not change its nature, while with neuralgia, the intercostal spaces immediately respond to any change in body position.

Sometimes the pain caused by intercostal neuralgia radiates to the lumbar region, which may suggest the onset of an attack of kidney stone disease.

Tietze's syndrome

The ribs have cartilages at both ends, by means of which they are attached either to the spinal column or to the sternum. In certain unfavorable situations, inflammation of the cartilaginous costal ends occurs. This disease is called Tietze's syndrome. It is not as common as, for example, intercostal neuralgia, but such a disease should always be considered for the purpose of exclusion, in differential diagnostics before making a final diagnosis.

With this type of pathology, pain between the ribs occurs in the front part of the chest, since it is the sternal cartilages of the ribs that are subject to inflammation. The suddenness of the pain, its location near the heart, again makes you think, first of all, about angina. You should always conduct a clear analysis of your sensations, and when you detect pain between the ribs, be sure to measure your pulse, noting the data each time. In this way, you can avoid a critical situation and not miss a true attack of angina.

It is important to remember that cardiac pathologies always occur with a disturbance in the heart rhythm, which can be traced by the pulse beats. All other types of pain do not cause sharp changes in the work of the heart, they can only cause a slight increase in heart rate, which is associated, most of all, with pain shock, if the pain between the ribs is strong, and a feeling of fear.

A distinctive sign that reveals Tietz syndrome is a significant increase in pain in the intercostal space after pressing directly on the sternum.

Hypertonicity of the pectoral muscles and fibromyalgia

Does pain between the ribs appear after heavy physical exertion, learning a new course of exercises in the gym or after severe nervous exhaustion? This indicates an increase in the tone of the pectoral muscles or their excessive stretching. Such pains in the intercostal space have an increasing character, and are most sensitive when moving the upper shoulder girdle in any direction.

Fibromyalgia is characterized by increased pain when raising the arms and rotating the torso.

When constantly in a state of stress, hypertonicity of all types of muscles appears, so one should not exclude the psychological factor in any occurrence of pain. Such problems often occur in people prone to depressive moods, having an increased anxiety background. For such patients, all measures of medical procedures, including massages, therapeutic exercises or manual therapy complexes with pain-relieving blockades, if they bring relief, they will be only temporary. In this case, it will be a more correct decision to conduct complex treatment with the participation of a psychologist and active work on your emotional background.

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How to treat pain between the ribs?

As always, when it comes to treatment, it should be remembered that it should only take place after a full diagnostic examination, identification of the cause and strictly under the supervision of a doctor, with his prescription. The above causes and descriptive characteristics of types of pain, the multiplicity of cause-and-effect relationships indicate the impossibility and groundlessness of self-diagnosis and, especially, self-treatment.

When the first painful sensations appear, depending on the previous events that caused the pain, you should contact specialists such as:

  • therapist;
  • neurologist;
  • traumatologist;
  • pulmonologist;
  • cardiologist.

If your health has never failed up to this point, then you should start your visit to doctors with a therapist. This doctor will help you navigate the situation and give the most accurate recommendations on further actions. He will write out directions to visit the necessary specialists, as well as all the necessary laboratory diagnostic methods, such as general and clinical blood and urine tests (to exclude renal pathologies).

Having received a referral from a general practitioner, including for a cardiogram, the subsequent visit to a cardiologist will be more productive and time will not be wasted. Having all the general tests and necessary instrumental examination methods on hand, visiting all the narrow specialists will be faster and more thorough.

If general laboratory and instrumental analyses are insufficient, specialists may prescribe additional diagnostic methods, such as a CT scan or MRI.

After receiving all the necessary data and establishing an accurate diagnosis, treatment will be carried out according to one of the algorithms that is appropriate in this situation. If the reason for which pain appears between the ribs lies in pathologies of the spinal column, then all measures should be aimed at eliminating this pathology. In the presence of depression, oppression and other psychological disorders, first of all, it is worth starting with restoring the patient's emotional well-being.

As a rule, painkillers, antispasmodics, non-specific anti-inflammatory drugs, warming ointments are used to relieve pain in the intercostal space, in cases where the diagnosis is “myositis of the pectoral muscles” or other diseases for which thermal procedures are indicated.

In case of rib fractures, it is advisable to provide maximum rest to both the affected area and the patient as a whole, for a faster healing process. In this case, a tightening chest bandage, which can be done at home, helps. During a calm exhalation, the chest is fixed with a long towel or other material, wrapping it around the body.

Such a trick will not allow you to take deep breaths, sharp movements, which in turn will provide the injured rib with a relatively stable position. However, it is better to carry out this procedure with the participation of a doctor, so as not to overdo it and not squeeze the chest beyond measure.

Manual therapy courses, therapeutic exercise, and, after serious injuries involving internal organs, spa treatment, allow for more effective restoration of the body.

Pain between the ribs, as a symptom, can disappear very quickly, which, of course, cannot mean a final cure for the original pathology.

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