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Pain on top of ribs: 6 possible causes of rib cage pain

6 possible causes of rib cage pain

Rib cage pain is a common complaint that can result from many factors, ranging from a fractured rib to lung cancer. The pain may be sudden and sharp or dull and aching.


Many cases of rib cage pain are not linked to serious conditions and resolve on their own or with minimal treatment. Others, however, are medical emergencies requiring immediate intervention.

There are many possible causes of rib cage pain. A doctor will diagnose the underlying cause by a physical examination and imaging scans.

Common reasons for rib cage pain include:

1. Injury

Injury to the chest from falls, traffic collisions, and sports-related contact is the most common cause of rib cage pain. Types of injury include:

  • broken ribs
  • bruised ribs
  • fractured ribs
  • pulled muscle

Rib cage pain that begins following injury is typically diagnosed with an X-ray to highlight bone breaks and fractures. MRIs and other scans can detect soft tissue damage.

2. Costochondritis

Costochondritis or Tietze’s syndrome is another common cause of rib cage pain.

This condition is characterized by inflammation of the cartilage in the rib cage. It usually occurs in the cartilage that joins the upper ribs to the sternum, an area called the costosternal joint.

Rib cage pain due to costochondritis ranges from mild to severe. Symptoms include tenderness and pain when touching the chest area. Severe cases can lead to pain that radiates down the limbs, or pain that interferes with daily life.

Some cases of costochondritis resolve without treatment, while others require medical intervention.

3. Pleurisy

Pleurisy, also known as pleuritis, is an inflammatory condition that affects the linings of the lungs and chest.

The pleura are thin tissues that line the wall of the chest and the lungs. In their healthy state, they smoothly slide across one another. However, inflammation causes them to rub, leading to significant pain.

Since the advent of antibiotics, pleurisy is much less common than it was. Even when it does occur, it is often a mild condition that resolves on its own. Pleurisy usually lasts from a few days to 2 weeks.

Other inflammatory conditions of the lungs, such as bronchitis, may also cause pain around the rib cage.

4. Cancer

Lung cancer is the second most common cancer in the United States.

One of the symptoms of lung cancer is rib cage pain or chest pain that gets worse upon breathing deeply, coughing, or laughing. Other symptoms to look out for include coughing up blood or phlegm, shortness of breath, and wheezing.

The outlook for lung cancer is poorer than other forms of cancer and is the leading cause of cancer death among both men and women. People with early-stage lung cancer have a better chance of being cured, highlighting the importance of early intervention.

Metastatic lung cancer, or cancer that begins in one area and spreads to the lungs, is a life-threatening condition. It will also cause pain in the rib cage or chest.

5. Fibromyalgia

This is a chronic condition, causing pain throughout the body. Fibromyalgia is estimated by the American College of Rheumatology to affect between 2-4 percent of people, up to 90 percent of whom are women.

The pain associated with fibromyalgia may be burning, throbbing, stabbing, or aching. These pains are commonly felt in the rib cage, although any part of the body can be affected.

Some research suggests that non-specific chest pain, including rib cage pain, is the most common co-existing condition that leads to hospital admission in people with fibromyalgia.

6. Pulmonary embolism

A pulmonary embolism (PE) is when an artery going into the lungs becomes blocked. The blockage is often caused by a blood clot that has traveled up from one of the legs.

As well as rib cage pain, PE can cause the following symptoms:

  • shortness of breath
  • rapid breathing
  • coughing, including coughing up blood
  • anxiety
  • lightheadedness
  • sweating
  • irregular heartbeat

PE is a serious condition that can damage the lungs and other organs due to reduced oxygen in the blood. Anyone who experiences the symptoms of PE should see a doctor.

The National Heart, Lung, and Blood Institute estimate that 30 percent of people who develop PE will die if they do not receive treatment. Fortunately, a quick diagnosis and treatment can prevent complications.

The rib cage consists of 24 ribs, 12 on either side, and it shields the organs of the chest, including the heart and the lungs, from damage.

The ribs are attached to the breastbone, which is the long bone that runs down the center of the chest. They are attached at the front, by cartilage, which is a firm yet flexible tissue. At the back, they are attached to the spine.

The liver is located at the lower end of the rib cage on the right and the spleen is on the left. Both are given some protection by the rib bones. The gallbladder and kidneys lie just below the rib cage.

If any of the components of the rib cage, including the bones or cartilage, or the organs nearby are affected by injury or illness, a person will have pain in or near the rib cage.

Rib cage pain may occur in the chest, below the ribs, or above the naval. As there are several different causes of rib cage pain, the symptoms can vary. As a result, the pain may be:

  • sharp
  • dull
  • aching
  • sudden
  • slow to develop
  • constant
  • intermittent
  • worse when breathing in or moving

Other symptoms affecting the rib cage can include:

  • bruising
  • tenderness
  • difficulty breathing

Rib cage pain can be attributed to many underlying injuries or medical conditions. A person should always consult a doctor in any case of unexplained rib cage pain.

If the pain or pressure in the chest is severe and breathing becomes difficult, a person should seek emergency medical treatment, as these symptoms could indicate a heart attack.

Pictures, symptoms, causes, and treatments

The ribs can become bruised or broken after a traumatic injury to the chest. Generally, treatment for broken and bruised ribs involves relieving pain.

The ribs are flexible bones that make up the rib cage. These bones protect important organs in the chest, including the heart, lungs, and spleen.

It is essential to have a doctor assess any rib injury to ensure that it is not severe and has not damaged internal organs.

Share on PinterestA person with a bruised rib may have pain at the site of the injury and trouble breathing.
Image credit: amyselleck

Symptoms of a bruised rib include:

  • trouble breathing
  • pain at the site of the injury
  • pain with movements like breathing or coughing
  • muscle spasms around the rib cage
  • irregular appearance of the rib cage
  • feeling or hearing a crack at the time of the injury, if a rib has broken

The skin at the site of the injury may bruise as a result of ruptured blood vessels. When these vessels rupture, blood can pool in surrounding tissues.

However, the bones may bruise without any visible injury or bruising on the skin.

The most common cause of a bruised rib is trauma to the chest.

This trauma can result from falls, sports injuries, motor vehicle accidents, crush injuries, or assaults, for example. People with osteoporosis can fracture a rib by having a violent coughing episode.

Trauma to the ribs or chest can also cause soft tissue injuries involving the muscles and cartilage. For example, forceful twisting or coughing can strain or pull the intercostal muscles, which allow for the flexibility of the rib cage.

Also, pregnant women can be more susceptible to rib fracture and injury, particularly in the third trimester, due to the growing uterus.

Share on PinterestTo help diagnose a bruised rib, a doctor may perform a physical examination to assess the area.

To diagnose a bruised rib or rib fracture, a doctor will take detailed notes about the injury and the aftermath, including the person’s symptoms.

They will also perform a physical examination to assess the site of the injury and listen to the heart and lungs. Evaluating a person’s breathing is essential.

The doctor may perform a chest X-ray with emphasis on rib detail to see if a rib bone is broken. However, bruising does not always show up on X-rays.

A person might undergo other tests to differentiate a fracture from a muscle or soft tissue injury.

Doctors do not treat bruised or broken ribs in the same manner as a broken arm or leg because rib bones cannot be cast or splinted.

Doctors typically leave bruised or broken ribs to heal on their own. However, in special circumstances, such as when there are multiple fractures or breaks in the rib cage, doctors recommend surgical intervention.

Otherwise, the primary goal of treatment for a bruised or broken rib is pain relief.

If the pain is severe, a person may not be able to breathe as deeply, which can cause a buildup of mucus in the lungs.

Ways to treat bruised and fractured ribs at home include:

  • applying an ice pack wrapped in a cloth to help reduce inflammation
  • taking over-the-counter pain relievers and anti-inflammatory medications
  • resting
  • avoiding any activity that can make the pain worse

A person can try gently stretching the muscles in the shoulders and chest wall, but it is important to avoid movements that make the pain worse.

Usually, rib injuries heal on their own. Bruised and broken ribs heal in a similar way and typically get better within 3–6 weeks. If a person is not feeling better in a few weeks, they should contact their doctor, who may request more testing.

Chest wall injuries, including bruised or broken ribs, are a common cause of chest pain in children. These injuries often result from car accidents, blows, or falls, such as on bicycle handlebars.

To promote healing from a bruised or broken rib, encourage the child to rest, use cold and hot packs, give pain relievers as directed, and suggest gentle stretching.

Contact the doctor if the child has a fever, trouble breathing, abdominal pain, or dizziness or lightheadedness.

Share on PinterestIf symptoms of a fever or a worsening cough are present, a person should talk to a doctor.

Consult a healthcare provider if these symptoms are present:

  • shortness of breath
  • worsening pain in the chest or abdomen in the days or weeks after the injury
  • a fever
  • a new or worsening cough

Any of these symptoms could indicate a potentially severe condition.

Also, see a doctor if there is no general improvement after a few weeks.

A bruised rib usually results from an injury such as a fall or a blow to the chest, which may happen while playing sports, for example. Rib fractures occur in the same way.

Bruised ribs are often painful, but over-the-counter pain relievers and ice packs can help.

The bruising may take several weeks to heal. If symptoms have not improved within a few weeks, contact the doctor, who may request further testing. A bruised or broken rib can sometimes affect lung health.

Pain in the region of the ribs. What can pain in the ribs indicate?

Rib pain is treated by different specialists (traumatologist, neurologist, orthopedist, etc.), but successful results are achieved only with a holistic approach based on consideration of the disorders that have arisen in conjunction with other body systems.

Causes of pain in the ribs

The most common causes of pain syndrome are:

  • traumatic injuries of the chest, when the integrity of the tissues of one or more ribs is violated;
  • Tietze’s syndrome, which is characterized by inflammation of the cartilage of the ribs, manifested by sudden sharp pain;
  • intercostal neuralgia, in which pain occurs due to pinching of nerve endings by muscles and increases with a change in position, as well as with inhalation and exhalation;
  • osteochondrosis, manifested by chronic aching pains, and pain intensifies during sudden movements and after hypothermia;
  • intervertebral hernia of the thoracic spine, which can be suspected by acute stabbing pains that occur in the form of “lumbago” and radiate to the neck and arm;
  • Fibromyalgia – pain in this condition is caused by damage to the intercostal muscles, noted on both sides of the chest, aggravated by weather changes, the patient also notes stiffness of the chest after waking up.

Inflammatory diseases of the pleura, neoplasms, and cardiovascular diseases also lead to pain in the ribs. Pain syndrome of a psychogenic nature is less commonly diagnosed.

Features of diagnosis and treatment

When complaining of rib pain, the posturologist assesses the following using functional diagnostic methods:

  • the tone of the muscular corset of the back and chest;
  • the symmetry of the chest, the volume of its movements;
  • condition of the ligamentous apparatus and fascia;
  • condition of the surrounding bone and muscle structures.

The Center for Clinical Posturology does not treat the pain syndrome itself, but eliminates the entire chain of disorders that led to pain. The work of a specialist begins with the search for the underlying root cause of pathological changes, identifying the structure, the dysfunction of which led to the appearance of pain in the ribs and restriction of chest mobility.

Complex therapy includes modern methods of physical rehabilitation, health-improving gymnastics, reflexology, massage techniques and manual therapy, physiotherapy. To restore the normal functioning of the chest, it is necessary to create and consolidate the conditions under which this will occur without the help of analgesics. Using gentle techniques, the doctor eliminates pathological tension and blocks that support dysfunction and “force” the muscles to work unevenly. The work is carried out both in the pain zone and in remote regions, which is associated with the need for correction at all levels of the postural system.

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What diseases cause pain in the right hypochondrium

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Each of us at least once faced with a rather banal symptom, pain under the ribs. The editors of Meds.ru decided to find out in what cases there are painful sensations of this nature.

Pain under the ribs on the right side indicates pathological processes, injuries or diseases of the internal organs located under the diaphragm behind the two lower ribs on the right. Pain in this place is common, because there are vital organs, nerve endings, blood vessels. The liver and gallbladder, part of the colon and duodenum, the tail of the pancreas, one kidney and adrenal gland, loops of the thin esophagus are “concentrated” here.

Types and differences

Acute and chronic forms are divided according to the degree of intensity. The nature of the pain indicates the “culprit” of its occurrence. Specialists share several types:

  • aching pain in the right hypochondrium;
  • acute;
  • baker;
  • blunt;
  • stabbing;
  • night;
  • compressive;
  • pulsating;
  • arching;
  • pulling.

Unpleasant sensations appear suddenly or gradually due to an unhealthy lifestyle. Severe intense pain requires immediate medical attention. In any case, if undesirable symptoms appear, it is better for the patient to contact a gastroenterologist or therapist.

Causes of pain in the right hypochondrium

Main causes of pain are diseases of the biliary tract and liver pathologies. Major pathological conditions:

  • hepatitis of various origins;
  • cirrhosis;
  • tumor, malignant or benign;
  • helminthiasis;
  • fatty degeneration;
  • liver failure;
  • poisoning with toxins;
  • cholelithiasis;
  • lack of circulation due to cardiovascular diseases;
  • colitis and intestinal infections;
  • cholecystitis;
  • kidney disease;
  • rib fractures;
  • intercostal neuralgia;
  • appendicitis;
  • peptic ulcer;
  • pancreatitis.

After that, pain appears in the right hypochondrium

Certain factors influence the development of painful sensations. Other symptoms appear that indicate a malfunction in the body – heaviness in the stomach, nausea, weakness, upset stools, impaired appetite, fever.

After eating, the production and promotion of bile along the biliary tract is accelerated, blood flow to the liver increases, and peristalsis increases. Therefore, food, especially fatty and plentiful, provokes the appearance of pain. The nature of pain sensations differs in the sources that caused it.

After significant physical activity, the body also malfunctions. Strong overload, especially after eating, will lead to intercostal pain. Stress is another cause of pain.
During pregnancy, mainly in the third trimester, pain on the right side is not uncommon. This is due to the stagnation of bile and the expansion of the biliary tract. Taking hormonal contraceptives sometimes provokes unpleasant stabbing pains at the end of the menstrual cycle.

What to do

Pain in the right side requires a visit to a doctor. You can not self-medicate, because serious problems are hidden behind different types of pain. Taking painkillers worsens the patient’s condition, is the culprit of internal bleeding. If you experience discomfort on the right side, you need to call a doctor or
self-refer to the hospital for diagnosis.

It is important to determine the source of painful manifestations. To do this, an ultrasound examination is performed, clinical blood and urine tests are taken, and, if necessary, an x-ray of a given area is performed. If required, a consultation with a surgeon, cardiologist, endocrinologist, neuropathologist is appointed. After the diagnosis is made, therapy is carried out by a specialized specialist. Treatment is most often carried out with the help of drugs. Cholecystitis requires surgery. Effective dietary nutrition, avoidance of spicy, fatty and spicy foods. The attending physician will prescribe the necessary drugs and talk about the principles of proper nutrition, depending on the identified disease.

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