Rib Pain

What is Rib pain?

Rib pain is a condition in which pain is experienced in the ribs on one or both sides. The pain may occur in one or more ribs at the same time. 

What are its main associated signs and symptoms?

Apart from the usual pain in the chest, rib pain may have specific symptoms like:

• In the case of costochondritis, the rib cartilage gets inflamed or swollen and tenderness in the chest region is noted. The pain is felt in the upper ribs and closer to the sternum. However, in its severe form, the symptoms worsen to produce a recurring pain in the lower body. In such a case, medical intervention must be immediately sought.
• Similarly, pleurisy is an inflammation of the linings between the chest wall and lungs. Pain is the most common symptom of the condition. Usually, the issue resolves on its own but in some cases, antibiotic therapy may be recommended. Further, bronchitis i.e., inflammation of the airways, can also cause pain around the rib region.
• Lung cancer also causes pain in the rib or chest area that gets worse on laughing or coughing. This may lead to wheezing, phlegm and shortness of breath.
• In cases of fibromyalgia, the nature of pain is burning, stabbing or aching type.

What are its main causes?

The causes of rib pain range from common to rare conditions that increase chest pain and may be accompanied by stomach pain and fever.

Common causes include:

• Costochondritis.
• Pain in the thoracic spine.
• Sternalis syndrome – a rare syndrome characterised by pain in the chest wall.
• Broken ribs due to injury, sports, accident, assault or fall.

Rare causes are:

• Stress fractures.
• Rheumatoid (swelling or pain in the bone and joints) factors.
• Fibromyalgia - muscle pain and stiffness with joint pain.
• Sickle cell anaemia - lowered oxygen carrying capacity of the blood due to sickle-shaped red blood cells.
• Polychondritis - inflammation or swelling of the cartilage.
• Osteoporosis - postmenopausal decrease in bone density.
• Lupus erythematosus - an autoimmune condition.
• Slipping rib syndrome - a rare condition where the cartilage of the lower ribs slips, thus causing pain.
• Tumours.
• Gallstones.
• Pleurisy.
• Pulmonary embolism.

How is it diagnosed and treated?

The above conditions can be deduced from the symptoms. The doctor may advise you to undergo a variety of tests, like chest X-ray, CT scan, MRI, or C-reactive protein levels, to determine the exact cause.   
Apart from these, the doctor may also recommend:

• Analgesic or painkiller medications.
• Temporary avoidance of physical stress.
• Heat/cold pack therapy.
• Physiotherapy.
• Corticosteroid therapy.

In extreme cases, the doctor may conduct specific treatments for conditions like cancer and broken ribs.

1. National Health Service [Internet]. UK; Broken or bruised ribs.
2. Department of Health Chest injuries and rib fractures. Government of Western Australia [Internet]
3. Minerva Med. 1975 Aug 18;66(54):2679-89. PMID 1153118
4. Australian Family Physician [Internet] The Royal Australian College of General Practitioners; Musculoskeletal chest wall pain
5. Better health channel. Department of Health and Human Services [internet]. State government of Victoria; Rib injuries
6. MedlinePlus Medical Encyclopedia: US National Library of Medicine; Ribcage pain
7. healthdirect Australia. Costochondritis. Australian government: Department of Health