Rib pain

Pain in the rib area can be a signal of many diseases. The term "pain in the area" of the ribs or "pain in the ribs" refers to discomfort directly in the tissue of the paired arched bones, that is, in the walls of the chest.

The bone or cartilaginous tissue of the ribs, fascia and muscles surrounding the ribs, and intercostal nerve endings may hurt. The nature of the pain is similar to cardiac pain - pulling, aching, or sharp, stabbing, so only a doctor, most often a narrow specialist - a traumatologist, orthopedist, thoracic surgeon, neurologist - should differentiate the symptoms and make a diagnosis.

The reasons that can provoke pain in the rib area are the following:

• Trauma, fractures of a rib or ribs.
• Malignant tumors of the ribs.
• Osteoporosis.
• Tietze syndrome.
• Osteochondrosis.
• Pathologies of intercostal muscles and nerves.
• Herniated discs of the thoracic spine.
• Intercostal neuralgia.
• Fibromyalgia.
• Pathological inflammation of the pleura.
• Pleurisy (acute, dry).
• Pleural neoplasms.
• Psycho-emotional pain.
• Pain associated with pregnancy.

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Description of diseases that cause pain in the rib area

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Injuries, fractures and bruises

Injuries and fractures that may be the result of a strong blow, fall. The nature of the pain depends on the severity of the injury and the type of damage.

A bruise causes sharp but not intense pain in the area where the muscle tissue surrounding the ribs is damaged. The most common symptoms are swelling at the site of the impact, a hematoma that is painful to touch. The pain subsides a little and becomes dull and aching. The appearance of the injury does not allow differentiating a bruise from a fracture, so an X-ray is required.

Pain in the rib area may be a consequence of a fracture of a rib or ribs. This is a more serious injury, which signals itself with pain when inhaling, changing position, and when moving. A fracture is characterized by acute pain that spreads to the entire chest, the pain persists for a long time, even after the bone tissue has healed.

Fractures are divided into three groups - cracks, subperiosteal fractures, complete and complex fractures, and comminuted fractures. Pain in the rib area with a crack is the mildest injury in the group of fractures, since the rib retains its integrity and heals fairly quickly. A subperiosteal fracture, in which the rib is injured, but the periosteum remains intact, also heals fairly quickly. A complete fracture is dangerous because of its fragments, which can disrupt the integrity of the lung structure, and a complex fracture, in which several costal arches are injured at once, is also considered a serious injury. In addition to the fact that fractures are accompanied by painful sensations, they can provoke a typical cough with blood, respiratory and cardiac arrhythmia, and even shock. Any fracture - from a crack to a comminuted injury - is considered a complex case that requires not only a medical examination, but also a fairly long treatment.

Tietze's syndrome is a disease of unclear etiology, which develops pathological inflammation of the cartilaginous tissue. Pain in the rib area with Tietze's syndrome is very sharp, intense, often it moves behind the sternum, resembling cardiac symptoms. Quite often, pain with inflammation of the cartilaginous tissue of the ribs is confused with angina, especially if a person tries to diagnose himself and begin treatment. Indeed, the symptom of pain radiating behind the sternum, under the shoulder blade, in the arm or in the neck, increasing and intense, is similar to an attack of angina, but cardiac drugs are not able to relieve it. A differential sign that will help to visually distinguish Tietze's syndrome is slight swelling, puffiness at the site of inflammation, in addition, pain in the rib area can intensify when pressing on the bone, which is not at all typical for angina. The syndrome is diagnosed using examination, orthopedic tests, palpation and X-ray.

Oncological process of bone tissue

Malignant tumors that can cause pain in the rib area are osteosarcomas, which affect people regardless of age. Symptoms of the malignant process are manifested by constant nagging pains that worsen at night when a person takes a horizontal position. Sometimes the tumor develops asymptomatically and begins to manifest itself after a bruise of the sternum, which provokes the growth of a pathological formation. If the bruise is not verified by X-ray, it is treated as a simple household injury, often with warming, which aggravates the oncological process. A large tumor can be noticed during a visual examination: there is swelling at the site of its localization. The main way to confirm or exclude a rib tumor is a biopsy.

Osteoporosis

Osteoporosis, which is most common in female patients, can also be the cause of pain in the rib area. This disease is associated with a pathologically low level of calcium in bone tissue and their destruction. The causes of osteoporosis are varied, but are most often explained by physiological age-related changes - endocrine (menopause), metabolic (impaired absorption of calcium, vitamin D). Osteoporosis develops asymptomatically, so a person does not feel the slightest symptoms of this destructive process. Pain in the rib area with osteoporosis indicates a significant change in the structure of bone tissue, small cracks and irritation of the periosteum that preserves the bone. It is the periosteum that signals a problem with pain, since it contains a large number of nerve pain receptors. Severe, sharp pain with osteoporosis can indicate a pathological fracture, which is provoked by a load that is normal for a healthy person. Bone tissue is so fragile that it can be destroyed by a banal tilt or a sharp turn of the body. Simultaneously with the destruction of the rib bones, the integrity of the spine and the body's skeletal system as a whole is disrupted. Osteoporosis is diagnosed using a standard set of examinations, which includes X-rays and laboratory blood tests.

Osteochondrosis

Osteochondrosis, which is a systemic degenerative inflammatory process that develops in the intervertebral discs. When the nerve bundles are compressed, pain appears, which is most often localized in the back. However, an advanced disease, especially if the deformation of the vertebrae occurs in the thoracic spine, can cause pain in the rib area. Symptoms are chronic, aching pains that are accompanied by a feeling of a "spike in the chest." The pain changes its intensity depending on the posture, physical activity, and thermal conditions (drafts, hypothermia). Osteochondrosis is characterized by a feeling of numbness in the limbs and muscle weakness. Often, pain in the rib area on the left is confused with cardiac pain. The disease is diagnosed by a neurologist, who also prescribes a set of therapeutic measures that can last quite a long time.

Hernia

The intervertebral discs of the thoracic spine are not considered vulnerable, most often a hernia develops in the lumbar region. However, pain in the rib area sometimes indicates a hernia, which is a pathological complication of degenerative changes in the thoracic vertebrae. The pain develops gradually, intensifies and becomes unbearable to the point of loss of consciousness. The pain symptom often radiates to the neck or arm. The diagnosis of a hernia is confirmed or excluded using an X-ray or computed tomography, which is a more accurate and specific examination method. A hernia of the thoracic spine is treated conservatively.

Intercostal neuralgia

It is a common cause of pain in the rib area.

There is quite a lot of muscle and nerve tissue in the spaces between the ribs, the structure of which includes pain receptors. Any irritation or compression of the nerve bundles provokes a pain symptom of varying intensity. The causes of intercostal neuralgia are so diverse that they require a separate detailed description. The nature of neurological pain in the rib area is quite typical - it manifests itself acutely, there is a feeling of "piercing", shooting. The pain can overtake a person at any time of the day and significantly increases with a change in position, movement, bending, turning the body and even when inhaling, coughing or sneezing. Intercostal neuralgia is also characterized by the presence of two points - in the middle of the chest and in the spine. Pain can be caused by compression of the intercostal muscles with deformation of the ribs, muscle strain, with excessive physical exertion. Pain in the rib area caused by neuralgia often goes away on its own and does not require serious specific treatment, except for rest, simple rubbing or warming up. More serious cases, when the pain in the rib area does not go away for a long time, should be treated by a neurologist, who will determine the diagnosis and prescribe medication, possibly massage, a course of therapeutic exercises.

Fibromyalgia

A disease that has recently become more common, although previously fibromyalgia was not a separate nosological unit in the classification reference book. According to statistics, every 25th person suffers from one form or another of fibromyalgia. The etiology of the polyfactorial syndrome has not yet been clarified, but the symptoms have been studied and described in sufficient detail. One of the typical signs of fibromyalgia is pain in the ribs, especially when the muscle tissue of the thoracic region is subject to fibrous degeneration. Stress and psychoemotional trauma provoke an acute painful form of the latent course of the disease. Fibromyalgia is a simultaneous lesion of many muscle groups, including intercostal muscles. Rib pain in fibromyalgia is characterized as bilateral, sensitive to weather conditions. The patient experiences a feeling of stiffness in the chest area, periodic headaches, the process of falling asleep is disturbed, and then sleep in general, coordination suffers and the quality of life is significantly reduced. Diagnosis of fibromyalgia is always difficult, since the symptoms are extremely extensive and non-specific. Pain in the rib area is not the main symptom, but it is worth paying attention to if it is constant, covering the chest. Fibromyalgic intercostal pain is diagnosed by exclusion, then a comprehensive examination is carried out, in addition, there is an approved diagnostic table with disease parameters. Treatment of fibromyalgia is also varied, it depends on the individual properties of the patient's body and the nature of the pain in the ribs. Sometimes it is enough to relieve the pain symptom and prescribe a course of physiotherapy, but sometimes therapy can take longer.

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Diseases of the pleura

Pleural diseases can also be a factor that provokes pain in the rib area. The pleura covers the lungs with a thin, outer layer of connective tissue and the entire sternum from the inside. The pleura contains a huge number of pain receptors, the slightest irritation of which provokes quite severe pain. Dry pleurisy is especially painful in its acute form. The symptoms of dry pleurisy are as follows:

• One-sided pain in the rib area.
• Changes in pain intensity with deep breathing, sneezing and coughing, sudden turns of the body, and during defecation.
• Subfebrile body temperature, with jumps up to 38-39 degrees.
• Transient feverish state in the evening.
• Excessive sweating.
• Dry, frequent, unproductive cough.
• Preference for the side position when in a horizontal position.
• Rapid, shallow breathing.
• Dyspnea.

Dry pleurisy should be diagnosed by a therapist, and then by a pulmonologist using a comprehensive examination, the decisive method of which will be radiography. Treatment involves the prescription of antibiotics, anesthetics and anti-inflammatory drugs.

The tumor process in the pleura can also be accompanied by pain in the rib area.

Oncological pleural process, fortunately, is quite rare, however, even those few cases are worth describing. Painful sensations in pleural tumors are constant, aching, long-lasting, but not sharp, bearable. Localization of pain depends on the place of tumor development, if the formation reaches large sizes, shortness of breath, cyanosis of the skin appear. A tumor causing pain in the rib area can be benign or malignant, this is determined by biopsy.

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Psycho-emotional pain in the rib area

They can be widespread and concern not only pain in the ribs, but also headaches, digestive discomfort. Neurosis, prolonged depression, neurasthenia, hypochondriacal disease are accompanied by muscle spasms, pain in the rib area can develop. Anxiety, in principle, mobilizes many resources of the human body, but a long-term state of anxiety, constant tension begins to act on organs and systems pathologically destructively. Functional or organic lesions in the psychoemotional factor causing rib pain are not detected, but treatment is necessary.

The therapeutic strategy should be developed by a neurologist or psychiatrist.

Pain in the rib area during pregnancy

These are typical sensations of the third trimester, especially if the woman had an asthenic physique before pregnancy. There are no pathologies in the organs and systems of the expectant mother with such pains, as a rule, the pain symptom is caused by the following reasons:

• A significant increase in the size of the uterus, the uterus moves upward and presses on the lower ribs.
• Intrauterine activity of the baby, which moves too intensely.
• The position of the fetus upside down, when the baby rests against the upper cavity of the uterus and the ribs.

The symptoms are not threatening, but if the pain is constant and disturbing, the woman should still see a doctor and undergo additional examination. Usually, recommendations concerning rib pain are not difficult to follow:

• A pregnant woman should remember about correct posture and try to keep her back straight and her shoulders straight.
• Clothing should not be tight or restrict movement and the body as a whole, especially in the chest area.
• You can try to relieve pain in the rib area by raising your arms up while inhaling deeply. Lower your arms while exhaling.
• If the baby is excessively active intrauterinely, the woman needs to take a horizontal position, lie on her side.

Pain in the rib area is a non-specific symptom that may indicate various internal pathologies and functional disorders. If the pain symptom lasts more than a day, you should consult a doctor, even if the pain is tolerable.