Rib pain can be extremely painful and worrying. While it’s important to rule out an emergency, such as a heart attack, most causes are much less concerning. Many painful rib conditions can be helped with gentle care and a little time.
Causes of rib pain
Chest pain should never be taken lightly. Serious causes of chest pain shouldbe excluded first, especially in cases where there is dizziness, exertional pain, radiating pain, fever or a productive cough.
But when that’s done, there are many other potential causes of rib pain. Here are some of them:
1. Costochondritis
This is a common cause of rib pain, in which overuse or trauma triggers inflammation at the junction of the ribs with the sternum (breastbone).
Ribs connect to the sternum via bands of cartilage, which give the ribcage flexibility and elasticity.
Sometimes, this cartilage can become inflamed and painful, particularly where the ribs attach to the cartilage bands (the costochondral joints).
The inflamed cartilage causes pain at the front of the chest. For some, the pain is dull and aching, for others, sharp and severe. The area feels tender to touch.
The pain’s often worse with deep breathing or certain movements, but it’s quite variable.
The causes of costochondritis are unclear. It’s been linked to trauma to the chest wall, overuse from repetitive movements (such as lifting), coughing, and infections.It can affect anyone, including children, but people with psoriatic arthritis are more prone.
The condition is self-limiting, but it can come and go and complete resolution can take from days to months.
A much rarer form of costochondritis, Tietze’s syndrome is similar, but it only affects one of the top four ribs. It also causes puffy swelling, often visible as a small, firm lump in the upper chest.
2. Slipping rib syndrome
This happens when the rib cartilage becomes too flexible, allowing the lower ribs to slip out of place and press on a nerve.
It causes a sudden stabbing, sharp pain around the lower rib margin that then fades to an ache. You might notice a pop or click as the rib slips.
Slipping rib syndrome can happen to anyone, but it’s more likely in people that are hypermobile.
It can easily be misdiagnosed as conditions such as gallbladder disease because of the site and nature of the pain.
Although there’s no definitive way to diagnose slipping rib syndrome, careful palpation can often clarify the situation. You can learn more about manual evaluation in this video.
3. Pregnancy-related rib pain
Many women feel rib pain during the second and third trimesters of their pregnancies, as the uterus grows sufficiently to push up and under the lower margin of the ribs.You may also notice the baby kicking, which can cause discomfort.
Alongside this, hormonal changes in late pregnancy mean a ligamentous softening, allowing the ribs to splay further.
In addition, enlarging breast size can add strain to the chest wall, compounding the situation.
Generally, the pain will subside in the last week or two, as the uterus drops in preparation for the birth.
However, watch out for upper abdominal pain that comes on after eating and radiates between the shoulder blades – this could be gallbladder disease, which is more common in pregnancy.
4. Scoliosis-related rib pain
People with scoliosis have a complex, multi-plane curve and rotation in the spine. This sideways curve affects the position of the ribs – it’s often seen as a ‘rib hump’ on one side as the person bends forward.
As a scoliosis develops, it can impact rib angle and function, causing compression on one side and splaying on the other. This pressure on the ribcage can cause discomfort and pain. If it becomes severe (a Cobb angle of 80° or more), it can compromise lung function, leading to breathlessness.
5. Osteoporosis
In osteoporosis, the bones lose some of their mineral content, making them weaker and more brittle. There’s no pain until a bone fractures, which is often the point of first diagnosis.
Although most common in post-menopausal women, there are other people who might be susceptible. Older men, people with low calcium and vitamin D levels, low bodyweight, smokers, and inactive people (e.g. those who are bedbound) are also at risk.
Rib pain that comes on after a mild trauma, or a bout of coughing, then, may indicate a fractured rib and underlying osteoporosis.
6. Rib sprain or muscle strain
Rib joints can be sprained, just like ankles. You might notice a sharp pain in your back, to one side of the spine, as you breathe deeply.
You may find it’s difficult to find a comfortable sleeping position, as back or side-lying puts pressure on the sore rib.
Falls or sudden bending and twisting movements risks praining ribs or straining the small muscles between them.
How osteopathy can help rib pain
Osteopaths can effectively manage many kinds of rib pain.
We work in harmony with the body to naturally enhance the function of the ribs. We’ll get to the underlying cause of your rib pain by looking at the mechanics of the whole body. We might assess:
- the mobility of the spinal and rib joints
- the way the shoulders move on the ribcage
- the tension and strength of the muscles that connect the ribs to the neck, shoulders, lumbar spine and pelvis
- the tension and function of the diaphragm, and the way you breathe
- your posture
Gentle mobilisation of the ribs and spine to improve mechanics can provide long-term relief from costochondritis.
If you are pregnant, we will look at the way your body is coping with the growing uterus, and how it’s affecting your posture and weightbearing. We can work to help your body adapt to the changes that are happening.
If you have a scoliosis, we can maximise flexibility in your spine and ribs, and work to slow or reduce your curve as far as possible. We have a dedicated scoliosis programme to give you the best possible results.
People who have been diagnosed with osteoporosis can also benefit from treatment. Our techniques can be adapted so that you can be treated safely and comfortably.
Rib pain is often exacerbated by certain movements. And yet, exercise can often help reduce symptoms. Your osteopath can advise you on what would be beneficial and what to avoid.
We can incorporate breathing exercises into your management programme to ensure that you’re using the right muscles in the right way.
Joint sprains and fixations can often be remedied quickly with some well-placed manipulations.
There are multiple ways, then, we can ease the strain and discomfort of rib pain.
Book today and experience relief.