Pain between ribs

If you are reading this article, it means that you or your friends and relatives are worried about the pain between the ribs. And if this is so, then, without wasting time on the description of the anatomical structure of the chest and its musculoskeletal structure, we proceed directly to the enumeration of all the possible causes that may underlie the above pain.

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What causes pain between the ribs?

One of the obvious situations, which does not cause to doubt the true cause of pain between the ribs, is the fracture of the ribs proper or one of them. A chest contusion or a fracture in the rib is also accompanied by pain of varying intensity. To establish the degree of damage and its severity will allow a chest image taken by means of an x-ray machine.

By their nature, the pain between the ribs can manifest as sharp and dagger fights or to be constant and aching. At the time of the fracture of the ribs, the lungs may 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 see a doctor urgently, because it is rather difficult to endure such sensations.

You should not reassure yourself that the situation is not as bad as it may seem if, after receiving a blow to the chest area, there is only a slight pain between the ribs. Rib fracture is not always accompanied by deformation of the bone. With closed fractures, when the bone is broken, but still retains its original shape, there may be minor multiple lesions caused by fragments of bone. These complications may not immediately give any visible symptoms, and over time will lead to serious consequences. Therefore, in any case, you should visit a traumatologist and take a snapshot of the chest, in order to visually see the true state of affairs.

Rib injuries, 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 healing process can take several months. If internal organs have not been affected, then there is a full recovery without any consequences.

Mejrebernaya neuralgia

The 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 in the nerve branch and in neuralgia, pain between the ribs is observed along the course of the nerve. The pinching, compression, irritation of the intercostal nerve or nerves, occurs due to intervertebral hernia, osteochondrosis in the advanced stage, kyphosis of the spinal column in the thoracic region, cancer tumors. The reasons why intercostal neuralgia occurs can be many.

The pain between the ribs in neuralgia arises unexpectedly and, as a rule, is triggered by some external factors, be it an infection, an abrupt increase in weight, without proper heating of the muscles, prolonged exposure to low temperatures on the body, in other words, hypothermia, poisoning and, of course, back or chest injuries.

Therefore, knowing that there are any abnormalities in the spine, one should always carefully and prudently treat one's health, avoid provocative situations that can aggravate the situation by intercostal neuralgia.

Distinctive features by which you can distinguish neuralgic pain between the ribs from other types of pain are:

• clear tracing along the nerve, which can be determined by palpation of certain points in the spine (level V-XI ribs), shoulder blade, at one of the edges of the sternum. The pain between the ribs spreads not only in the intercostal space, but is also of an irradiating nature, in the shoulder-blade area;
• the patient’s specific posture, in which he tries, by bending the torso and shifting the center of gravity to the area of the healthy side, to reduce pain during breathing and movement. 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;
• strict localization in the intercostal spaces, pain aggravated by probing;
• increased pain when changing position of the body;
• the presence of additional sensations in the form of tingling, numbness and burning sensation in the chest.

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The pain between the ribs you need to know, and not guess!

As with any disease, proper diagnosis is very important. Intercostal neuralgia, giving irradiation to the heart, may be perceived as an attack of angina. 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 pectoris, the heart rhythm suffers, which can be traced by the indications of pulse beats. The pain between the ribs is cramping, throbbing, arising suddenly and also suddenly subsiding.

It is not possible to feel and find the exact location of such pain. When changing posture, pain does not change its character, while in neuralgia, the intercostal spaces immediately respond to any change in body position.

Sometimes the pain caused by intercostal neuralgia, give to the lumbar region, which may suggest the beginning of an attack of kidney stones.

Tietze syndrome

The ribs at both ends have cartilage, through which they are attached either to the spinal column or to the sternum. Under certain unfavorable situations, inflammation of the cartilaginous rib terminations is formed. A similar disease has been named Tietze Syndrome. It occurs not as often as, for example, intercostal neuralgia, but this disease should always be considered for the purpose of exclusion, with differential diagnosis before making the final diagnosis.

In this kind of pathology, the pain between the ribs occurs in the anterior part of the chest, because the sternal cartilages of the ribs are subjected to inflammation. The suddenness of the appearance of pain, its location near the heart, again makes you think, first of all, about angina. You should always carry out a clear analysis of your feelings, and finding the pain between the ribs will certainly measure the pulse, marking the data each time. Thus, you can avoid a critical situation and not miss the true attack of angina.

It is important to remember that cardiac pathologies always come with a heart rhythm disturbance, which can be traced by the beats of the pulse. All other types of pain do not give a sharp drop in the work of the heart, can only cause a slight increase in heartbeat, which is connected, most of all, with painful shock, if the pain between the ribs is strong, and a sense of fear.

A distinctive feature that produces Titz’s syndrome can be considered a significant increase in intercostal space pain after pressing directly on the sternum.

Hypertenus of the pectoral muscles and fibromyalgia

The pain between the ribs appears after heavy physical exertion, learning a new course of exercises in the gym or after a strong nervous exhaustion? This suggests an increase in the tone of the pectoral muscles or their excessive stretching. Such pains in the intercostal space are of increasing nature, most sensitive when moving the upper shoulder girdle in any direction.

Fibromyalgia is characterized by increased pain at the time of raising the arms and turning movements of the body.

If you are constantly under stress, hypertonicity of all types of muscles appears, so you shouldn’t exclude a psychological factor in any occurrence of pain. Similar problems often occur in people prone to depressive moods that have an increased anxious background. For such patients, all measures of medical procedures, including massages, therapeutic exercises or manual therapy complexes with pain-related blockades, if they bring relief, they will only be temporary. In this case, it would be more correct to carry out complex treatment with the participation of a psychologist and active work on your emotional background.

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How is the pain between the ribs treated?

As always, when it comes to treatment, it should be recalled that it should take place only after a full diagnostic examination, identifying the cause and strictly under the supervision of a physician, from his appointment. The above reasons and descriptive characteristics of the types of pain, the multiplicity of causal relationships indicate the impossibility and groundlessness of self-diagnosis and, especially, self-treatment.

When the first pain, depending on previous events that caused the pain, should be addressed to such experts as:

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

If up to this point health has never failed, then you should begin your appeal to doctors with a therapist. It is this doctor who will help to orient yourself in the situation and will give the most correct recommendations for further actions. He will write out directions for visiting the necessary specialists, as well as for all the necessary laboratory diagnostic methods, such as general and clinical analysis of blood and urine (to exclude renal pathologies).

Having received a referral from a therapist, including a cardiogram, a subsequent appeal to a cardiologist will be more productive and time will not be wasted. Having on hand all the general analyzes and the necessary instrumental methods of examination, visits to all narrow specialists will be faster and more thoroughly.

In case of insufficiency of general laboratory and instrumental analyzes, additional diagnostic methods may be assigned as narrow specialists, which may be computed tomography 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 the pain between the ribs is in the pathologies of the spinal column, then all measures should be directed at eliminating this pathology. In the presence of depression, depression and other psychological disorders, first of all it is worth starting with restoring the patient's emotional well-being.

As a rule, pain relievers, antispasmodics, nonspecific anti-inflammatory drugs, warming ointments are used to relieve pain in the intercostal space, in the case when 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 ensure maximum rest, both for the affected area and the patient as a whole, for a faster healing process. In this case, it helps to tighten the chest bandage, which can be performed at home. On a quiet exhale, the chest is fixed with a long towel or other matter, wrapping it around the body.

Such a trick will not allow you to take deep breaths, sudden movements, which in turn will ensure a relatively stable position for the injured rib. However, this procedure is best carried out with the participation of the doctor, in order not to overdo it and not to squeeze the chest beyond measure.

Manual therapy courses, physiotherapy exercises, and after serious injuries in which internal organs were involved, as well as spa treatment, allow the body to be restored more effectively.

The pain between the ribs, as a symptom, can disappear very quickly, which, of course, can not mean the final deliverance from the original pathology.

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