Rib Pain: Possible Causes, Symptoms, Diagnosis and Treatment

It is a symptom of a wide variety of other diseases, disorders, and conditions that range from mild to very serious.

Rib pain can occur in any age group or population and can be described as a “stabbing in the rib area.”

Only a thorough medical evaluation can determine if rib pain or any other type of chest pain is caused by a rib cage condition or by another condition that occurs within the chest.

Because it is so difficult to determine what might be causing your rib cage pain, medical help should be sought immediately.

What is the rib cage?

The ribs are long, thin bones that curve around the chest to create the rib cage.

The rib cage helps support the entire skeleton and also contains and protects the thoracic cavity (thorax) and its contents, including the lungs, heart, and other major structures of the respiratory and cardiovascular system.

The rib cage also protects some organs and structures of the digestive, nervous and lymphatic systems.

The rib cage consists of 24 ribs, 12 on each side.

The top 10 ribs on both sides of the body are attached to the thoracic spine (middle of the back) and the breastbone (breastbone) through joints and ligaments.

The two lower ribs are attached by ligaments to the spine, but not to the sternum, and are sometimes called “floating” ribs.

Causes of rib pain

In general, rib pain makes it difficult to breathe deeply, twist the body, or put pressure on the chest.

Pain in the rib or chest wall can be alarming, as sometimes rib pain can be a sign of something more serious, such as a heart attack, collapsed lung (pneumothorax), or even cancer.

Cancer that starts in any area of ​​the body and then spreads to the lungs, called metastatic lung cancer, is a deadly condition.

However many different conditions can cause pain, such as a pulled muscle, or even esophageal conditions, including gastroesophageal reflux disease.

Rib pain can also be a symptom of more serious conditions, such as broken ribs, osteoporosis, bone cancer, or pleurisy.

The most common cause of rib pain from broken ribs is falls, traffic accidents, and sports contingencies.

Many causes of rib pain are associated with injury or inflammation of the muscles, cartilage, and ligaments in the rib cage and mid-spine area.

Most cases of rib pain can be due to a relatively mild condition that is fairly easy to treat, such as tightness of the rib cage from the cough associated with the common cold or from daily muscle tension and are not related to serious conditions.

These usually resolve with minimal treatment, others represent more serious conditions that require immediate attention.

Symptoms of rib pain

Pain associated with the rib region can be sudden or slow to develop, constant and intermittent, sharp or dull, and can cause labored and painful breathing.

Rib pain can be attributed to many underlying injuries or medical conditions.

Costochondritis or Tietze syndrome is characterized by inflammation of the cartilage in the rib cage.

It usually occurs in the costo-sternal joint, which is the cartilage that joins the upper ribs with the sternum.

Pain due to costochondritis ranges from mild to severe and the symptoms seen are tenderness and pain to the touch and in severe cases the pain radiates to the extremities.

Lung cancer causes pain that is aggravated by coughing, laughter, or just deep breathing.

Other symptoms that may occur include a cough accompanied by phlegm or blood, shortness of breath, and wheezing.

Pulmonary embolism is a serious condition that can damage the lungs and other organs due to the reduction of oxygen in the blood.

In addition to pain in the rib cage, pulmonary embolism can cause the following symptoms:

  • Short of breath.
  • Fast breathing.
  • Cough, including coughing up blood.
  • Anxiety.
  • Daze.
  • Perspiration.
  • Irregular heart beat


Because there are many causes of rib pain, the doctor will make a diagnosis of the underlying cause through a physical examination and supported by imaging scans, such as X-rays to highlight bone fractures.

An MRI gives the doctor a detailed view of the rib cage and the surrounding muscles, organs, and tissues.

If the pain is chronic, your doctor may order a bone scan.

A doctor usually orders a bone scan if he feels that bone cancer may be causing the pain.

For this test, the doctor will inject a small amount of a radioactive dye called a tracer.

A special camera is used to scan the body for the marker. The image from this camera will highlight any abnormalities in your bones.


Rib pain treatment options will depend on the level of pain and the severity of the injury or underlying condition.

The doctor might suggest:

Home care

Injuries, such as a stretched muscle or a bruised rib, often heal over time.

Rest and using a cold compress on the area is suggested to reduce swelling.

If you are in significant pain, you can also take over-the-counter pain relievers, such as acetaminophen (Tylenol).


If the underlying problem is related to organs such as the esophagus, the heart, the lungs, it should be referred to a specialist.

Integral medicine

These holistic treatments can include acupuncture, massage, among others.

Pain control

Pain can be controlled with the help of anti-inflammatory drugs if discomfort continues, long-term pain relief (such as steroid injections) can be offered.

Physical therapy and rehabilitation

Supervised exercise and therapy can often help you recover faster and prevent re-injury.

Stabilization of the rib fracture

Broken ribs are quite common, but they can take anywhere from 6 weeks to 6 months to heal.

Stabilization of the rib fracture may require a surgical procedure where titanium plates are attached.


If bone cancer is causing the pain, the doctor will discuss treatment options based on the location of the cancer, whether it has spread, or whether any abnormal growth is present.

The doctor may suggest surgery to remove the abnormal growths.

In some cases, surgical removal is not possible or may be too dangerous.

In these cases, the doctor may choose to reduce them using chemotherapy or radiation therapy.

Once the growth is small enough, it can be removed surgically.