What does ribs mean for your pleasure


Humans have a total of 12 pairs of ribs, of which the top seven pairs are each directly connected to the sternum via a costal cartilage. On the spine, the ribs are connected to the vertebral bodies through the costal joints. Nerves and vessels run along the inside of the lower edge of the ribs.
Find out more about the topic here:Pinched nerve on the ribs

So rib pain can either from the ribs or yours cartilaginous portion go out. The cause of rib pain can therefore come from the joints and the ligaments there, or it can be triggered by the nerves that run very close to the ribs.

Since pain is usually very uncharacteristic, there are also orthopedic causes inflammatory or Other diseases as the cause. Other symptoms are indications of non-orthopedic causes of rib pain.

Are you interested in this topic? Read more about this at:Pain between the ribs

Causes of Rib Pain

Rib pain after a broken rib

The most common disease and cause of rib pain is the Broken rib(Rib fracture).

The broken rib is a common injury in the chest area. One or more rib bones are injured. A series of ribs fractures is when more than three ribs are broken.

In most cases, a rib fracture occurs as a result of a fall with direct impact.

Typical symptoms are pain over the affected rib, which gets worse when you inhale and exhale deeply, cough and move. In addition to rib pain, skin emphysema is often seen over the fracture, and occasionally a crunch can be heard when pressure is applied to the fracture.

However, similar symptoms can also occur Bruised ribs(Rib contusion)which in most cases was more likely to be caused by blunt trauma.

Simple rib fractures are usually treated conservatively and heal without complications.

Read more on the topic:Pain when the rib breaks

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Rib pain after a diaphragmatic hernia

The diaphragm is a respiratory muscle and anatomically separates the chest (thorax) from the abdomen. In the case of a diaphragmatic hernia (Diaphragmatic hernia) there is an enlarged opening in the diaphragm through which - depending on the location of the hernia - Abdominal organs in the rib cage push.

Most often, the diaphragmatic hernia is found where the esophagus (Esophagus) leads into the abdomen or stomach. So there is naturally an opening there. If this expands, the stomach, for example, if it is very full, can slide through the enlarged opening into the chest.

Since the stomach lies below the left costal arch, pain can be felt in this area with a diaphragmatic hernia if the Stomach wedged in the gap becomes.

Depending on the size of the break and the proportion of abdominal organs in the chest, the lungs can be displaced so that next to Pressure pain and pain in the ribs Symptoms like Shortness of breath may occur.

An operation on the diaphragmatic hernia is only carried out if it causes considerable discomfort.

You can read more information on this topic here: Diaphragmatic hernia

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Who am I?
My name is Dr. Nicolas Gumpert. I am Specialist in Orthopaedics and founder of Dr-Gumpert.de and work as an orthopedist Lumedis
Various television programs and print media report regularly about my work. On HR television you can see me live every 6 weeks on "Hallo Hessen".
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To be in the Orthopedics To be able to treat successfully, a thorough examination, diagnosis and a medical history are required.
In our very economic world in particular, there is not enough time to thoroughly grasp the complex diseases of orthopedics and thus initiate targeted treatment.
I don't want to join the ranks of "quick knife pullers".
The aim of all treatment is treatment without surgery.

Which therapy achieves the best results in the long term can only be determined after looking at all of the information (Examination, X-ray, ultrasound, MRI, etc.) be assessed.

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Rib pain during pregnancy

During pregnancy, the abdominal muscles that attach to the ribs are stretched further and further due to the increasing space requirements of the unborn child. This stretch exerts a permanent, increasing pull on the ribs, especially in the area of ​​the costal arch.

The pain that arises in this way usually occurs suddenly and repeatedly throughout the day.

About from the eighth month of pregnancy the top pole of the uterus is often in the area of ​​the costal arch and thus exerts pressure on the rib cage that can cause pain in the ribs.

Are you interested in this topic? Read more about this at:Pain in the ribs during pregnancy

Rib pain when coughing

When coughing, air is expelled from the lungs in an explosive manner, for example to remove foreign bodies or mucus from the airways. During this process, the muscles of the chest wall are used to "express" the chest and thus the lungs. Since a cough is the fastest movement a person can make, many different muscle groups in the chest are involved.

The muscle groups involved have to perform a great show of strength in order to achieve the necessary speed of tension. Patients with chronic or prolonged cough, for example in the context of a bronchitisoften have chest pain because the muscles of the chest wall are overloaded from the constant coughing.

This muscular pain can easily be mistaken for rib pain because the muscle fibers used for coughing run along the chest wall between the ribs. Other muscle groups such as the chest muscles or the back muscles are also required for coughing and sometimes start on the ribs.

It is difficult to clearly differentiate between rib pain and muscle pain at the point where the muscle attaches to the rib. In rare cases, patients with osteoporosis or in cancer patients with metastases in the ribs, a strong cough also leads to one Broken rib to lead.

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Metastases as a possible cause of rib pain

There are some malignant tumors that can cause bone metases when cancer cells spread. Examples are breast cancer, prostate cancer, bronchial carcinoma and renal cell carcinoma.

In addition to other bones, the tumor cells can also affect the ribs and lead to changes in the bone structure there.

Bone metastases in the ribs provoke various symptoms, in particular Pain. Those affected often describe the pain in the ribs as deep drilling. The pain is typically permanent and does not improve with rest. This leads to a significant decrease in the quality of life.

Furthermore, bone metastases can cause pathological fractures, i.e. the formation of bone fractures without force on the bones. Metastases In the ribs, sufferers often cause great suffering, so that adequate pain therapy is urgently indicated in order to alleviate the symptoms as much as possible.

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Inflammatory causes


Shingles (Herpes zoster) is caused by the renewed activation of varicella viruses. These viruses are responsible for childhood chickenpox and can be present in the after infection Nerves of the spinal cord linger. If there is a weakened immune system (e.g. in old age, due to cancer, HIV etc.) exists, these viruses can be reactivated and cause inflammation of the nerve endings.

This is expressed in severe pain and usually only occurs on one half of the body. The pain is accompanied by spread Rashes and blisters, which often appears in the area from the 5th to 7th rib.

Therefore, the pain of shingles is often more mistakenly perceived than rib pain. Therapy should definitely be given with ibuprofen for the pain and with extensive shingles with an antiviral drug such as Acyclovir.

You can read more information on this topic here: Shingles


The pleura (Parietal pleura) and the lung membrane (Visceral pleura) are thin skins and are separated by a small, liquid-filled gap. Everything together is called the pleura. The pleura lines the rib cage from the inside, the pleura is around the outside of the lungs.

These skins are primarily used for breathing and ensure that the skins slide against each other without problems, for example when the chest and lungs expand during inhalation. At a pleurisy (pleurisy) these skins become inflamed.

Pleurisy usually occurs as a result of other conditions such as one viral or bacterial pneumonia, bronchitis, tuberculosis or lung cancer.

Since the inflamed pleura rests against the chest, symptoms such as Fever, cough, and exhaustionThere is also no rib pain that can be felt all over the chest. The pain in the ribs is usually aggravated during breathing. Treatment for pleurisy depends on the cause.

You can read more information on this topic here:pleurisy

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ankylosing spondylitis

In patients with ankylosing spondylitis ossify the rib joints as part of their illness. This can cause breathing problems and rib pain.

For more detailed information, see:Ankylosing spondylitis - causes, symptoms and therapy

Illnesses as further causes

Tietze syndrome

In rare cases, rib pain occurs due to a Inflammation of the rib and sternum joint (Sternocostal joint) the 2-4 rib unclear cause.

The disease manifests itself as pain in the joints. This disorder is also called Tietze syndrome or Chondroosteopathia costalis designated. A regional circulatory disorder or mechanical irritation factors are suspected.

Treatment is with painkillers, the prognosis is good: the swellings heal on their own over a period of several days to months.

Read more on this topic at:Tietze syndrome

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Thoracic Outlet Syndrome

In rare cases, a Cervical rib be fully trained. As a result, nerves and blood vessels in the arm can become trapped when the arm is raised. The consequences are sensory disturbances, circulatory disorders, possibly also paralysis of the arm when moving overhead. This clinical picture is called Thoracic Outlet Syndrome (TOS).

Read more on this topic at:Thoracic outlet syndrome

Can that also be an indication of lung cancer?

Rib pain in isolation is not and should not be a symptom of lung cancer no panic cause.

Symptoms such as coughing, breathing sounds, chest pain and difficulty breathing are significant indications of a disease of the respiratory system.

Regardless, rib pain can be a symptom of metastatic lung cancer (malignant growth in the lungs) be. Skeletal metastases can settle in the ribs and cause rib pain and pathological rib fractures.

With the next article, you will be well educated about the signs of lung cancer. Read more about this under: How do you recognize lung cancer?

Rib pain by localization


Pain in the upper pairs of ribs one to four in the area of ​​their attachment point on the sternum can be caused by a swelling go hand in hand and are then calledTietze syndromedesignated. The cause of this rare form of precisely localized rib pain in the front of the sternum (sternum) is a inflammation one or more Rib-sternum joints (Sternocostal joints).

Sudden pain in the front ribs after an accident or fall can be an indication fracture of the sternum or a rib or a Bruised ribs be.

In addition, a pregnancy be the cause of rib pain.

Right vs. Left

Rib pain on the right or left side of the chest (thorax) can through a Torn muscle fiber between the ribs caused by chronic cough, which permanently stresses and overloads the muscles of the chest wall.

Also a bad posture or Incorrect exercise in sports can cause muscle pain in the rib area. The right and left sides of the chest can be affected Latissimus dorsi muscle(widest back muscle), which is often to be increased in a special form through strength training, or the Serratus anterior muscle(anterior sawtooth muscle).

After an accident with an impact on the now painful side, if there was pain in the ribs, one side of the chest would also be on one side Bruised ribs or thinking of a broken rib. A broken rib should be ruled out by an X-ray if it is suspected, and a bruised rib is treated by taking painkillers.

This topic could also be of interest to you: Right Rib Pain - What Do I Have?


The cause of rib pain at the back of the back is in many cases a blockage of the costal vertebrae. The costal vertebral joints can be blocked by incorrect loading or incorrect posture of the chest and their mobility restricted.

Trigger for a Rib blockage can be carrying a heavy bag on one side, incorrect posture when working at a desk, tense back or chest muscles, rotating the upper body too quickly during exercise or blocking a thoracic vertebra.

Absence of the spine its own curvatures (Lordosis and kyphosis) or if they are too flat, this can also lead to a blockage of the ribs or thoracic vertebrae.

The pain with a rib block is mainly in the area of ​​the transition to the spine, but can also radiate into the sides of the chest or even stretch forward to the sternum. Other symptoms may include pain in the cervical spine, shoulder, or arm, depending on the blocked rib.

The pain of a rib block is always there breath dependent, because with every breath the ribs in the two costal vertebrae are rotated to allow the chest and lungs to expand. At the to cough, Sneezing, moving the arm on the affected side, or putting pressure on the chest may increase the pain of a rib block.

The treatment of a rib block consists of the so-called "straightening" and subsequent movement exercises, which are intended to promote mobility and strengthen the muscles.At times it can be useful to take pain medication.

It is important to know that the symptoms of a Rib blockage may resemble a blockage of a thoracic vertebra, which is why a thorough physical examination should have taken place prior to the adjustment.

Please also read our topic:This is the correct way to resolve a rib block

Under the chest

Pain just below the chest can be rib pain, which in turn can be triggered by a variety of causes (Rib blockage, vertebral blockage, muscle tension, rib bruise, etc.). Chest pain can also be caused by a Inflammation of the mammary gland (mastitis) caused.

Pain that is not felt under the chest but below the chest is often caused by a disease in the abdomen. The stomach contents may flow back into the esophagus (Esophagus), that as heartburn can be perceived in the area between the costal arches.

Read more on this topic at: Pain under the chest

Situations in which the rib pain occurs

While breathing

Next direct injuries to the ribs can also cause rib pain when breathing Irritation or injury to muscles and nerves that are involved in the raising and lowering of the rib cage. It is therefore often difficult for the layperson to differentiate the origin of the pain.

Come next to the rib pain too to cough (with or without expectoration), A sore throat, tiredness and fever add to this bronchitis or lung infection as the cause in question.

Further information on this topic can be found at:Pain under the ribs when breathing

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When moving

If rib pain occurs when moving, there can be various causes. For one is one wrong movethat leads to a muscle strain as a possible reason. Ribs and thoracic vertebrae can also become jammed due to incorrect lifting, for example, which can be expressed in rib pain.

On the other hand, injuries like Bruises or breaks be responsible for rib pain on the ribs during movement.

If rib pain occurs repeatedly when moving, especially behind the breastbone and on the left side, which disappears again at rest, a doctor should definitely be consulted. This could be a Circulatory disorder of the coronary arteries (Coronary heart disease) act that absolutely must be dealt with.

After the sport

Mostly have rib pain after exercise muscular tension as the cause. Either the muscles between the ribs or the abdominal muscles can cause rib pain.

Overloading the muscles during sport due to strenuous training and a lack of breathing technique can lead to pain that persists after sport. The pain is particularly felt when breathing in, as the tense muscles do not allow the chest to widen.

Therefore, one should make sure to adapt the training to the respective fitness level so that the muscles do not cramp during the sport. It is also possible that a insufficient stretch leads to tension and sore muscles after exercise.

In weight training it can happen that due to incorrect movement or excessive stress Intercostal nerve irritated or jammed. One then speaks of one Intercostal neuralgiawhere there is rib pain that lasts after exercise and possibly for several days to weeks afterwards.

More symptoms

Rib pain is generally expressed in Chest pain. This pain can either be permanent (chronic) or suddenly (acute) occur.

As chronic rib pain repetitive pain that lasts longer than six months is used. They can also vary in intensity.

Rib pain that comes directly from the ribs usually has one bruise or one fracture as the cause. This means that the pain is easy to localize and can usually be felt at a specific point.

Rib bruises or fractures are particularly painful when inhaling deeply or coughing or when external pressure is exerted on the painful area. If surrounding structures such as muscles or nerves are affected, a sharp, localizable pain can usually be identified here as well.

If the rib pain comes from internal organs such as the heart, lungs or upper abdominal organs, the pain is usually dull and diffuse, so not exactly localizable.

In general, rib pain often goes with you Oppressive- or Tightness which is particularly noticeable when inhaling.

But also with one severe cold Constant coughing can cause sore muscles in the muscles in the chest area. This can also cause pain during coughing.

More about this on our website:Rib pain when coughing

Rib pain with back pain

Rib pain can be accompanied by back pain. The rib pain can be triggered, among other things, by back problems, for example if a rib-vertebral joint is dislocated.

Other possible causes in the area of ​​the back are acute illnesses such as a disc prolapse, Malformations, for example scoliosis, and muscular causes.

Pulled muscles in the back can cause both back pain and rib pain. Muscle strain is a common clinical picture that typically arises as part of excessive exercise.

For rib and back pain, a Visit to the orthopedic surgeonto find the correct diagnosis.

Difficulty breathing with pain in the ribs

Occasionally, rib pain can go hand in hand with shortness of breath.

One possible cause for the occurrence of both complaints is the so-called Tietze Syndrome -a chondropathy of the costal cartilage at the base of the sternum.

With this disease of unknown cause, those affected suffer from severe pressure painful swelling in the area of ​​the anterior chest. The pain in the ribs comes suddenly, can spread to the arms and cause shortness of breath.

Another possible cause of the occurrence of rib pain and shortness of breath is one pleurisy. Severe pleurisy causes excessive build-up of fluid in the chest, which can even cause shortness of breath. Shortness of breath is a serious symptom that definitely needs clarification.

You can read more about this topic in the next article: Causes of shortness of breath

Rib pain with tension

Tension is typically caused by a Overloading the muscles.

Many different muscle groups have their insertion in whole or in part on the ribs. Mention should be made of the chest and back muscles, but the abdominal muscles are also attached to the ribs.

Improper loading or incorrect posture can cause these muscles to tense up and shorten, which exerts a permanent pull on the attachment point on the rib. This pull can cause pain in the area of ​​the affected rib, but it can also radiate into the course of the muscle and therefore complicate the exact localization.

Other possible causes are Blockages in the spine or in the rib joints, an overload of the muscles during sport and bad posture.

Tension in the rib and back muscles can trigger severe rib pain, which usually gets worse when you inhale and exhale, cough and strain.

Are you more interested in this topic? Read more about this at:Tension

Stomach pain as a possible accompanying symptom

Left rib pain in particular can be accompanied by stomach pain.

Symptoms can be an indication of a Stomach disease, Pancreatic disease or one Heart attack because a heart attack is not always associated with the typical symptoms. Especially in women, a heart problem can manifest itself with pain in the upper abdomen.

If stomach pain and rib pain occur together, one should see a doctor to find and treat the cause.

You can read more information on this topic under: Stomach Pain - Symptoms, Causes, and Therapy

Diagnosis of rib pain

To find out where the rib pain is coming from, you need to various causes be excluded. So can an external Palpation of the ribs already leading away when it comes to a broken rib. An inspection of the body can also provide information if the rib pain is caused by, for example, a Posture or Tension to be triggered.

X-rays can on the one hand represent a broken rib, on the other hand, pneumonia, for example, which can cause rib pain, especially when coughing and breathing in, can be seen in the X-ray image.

Most important, however, is one exact anamnesis, from which many causes can be excluded. As detailed below, information about the localization of pain and eventual Concomitant symptoms already narrow down the causes of the pain.

Rib blockage

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Treatment of rib pain

Depending on the disease underlying the pain in the ribs, it must be treated accordingly. If there is a broken rib, the focus is on pain therapy, if it is a complicated fracture, surgery may be necessary.

Intercostal neuralgia, tension and strains are also dealt with Painkillers how NSAIDs (Ibuprofen or Diclofenac) treated. In addition, a gentle strengthening of the muscles and physiotherapy should take place.

If the pain is caused by bacterial pneumonia, it will usually be Antibiotics prescribed.


With the taping, a bandage can be attached to painful parts of the body, which supports the healing and symptoms of orthopedic injuries.

Taping on the torso and ribs can be used for muscle tension, but also for bruised ribs and is intended to relieve rib pain by relieving the affected rib or muscles through tensile forces. To do this, the tape is affixed along the ribs or muscles.

The tape can be attached independently by the orthopedic surgeon at home or, better, by someone else, following the appropriate instructions.

If you have any further interest in this topic, then read our next article below: Tape bandage

Duration of rib pain

The duration of the rib pain is depending on the cause. If the rib pain is a symptom of bronchitis or pneumonia, it will be approx. one to two weeks disappeared again after healing.

If it is a broken rib, the pain may decrease up to six weeks drag on until the fracture heals.

Intercostal neuralgia, in which a nerve is irritated or inflamed, can still develop after months noticeable and cause pain, especially when inhaling, even if the nerve is no longer pinched.

Which doctor treats rib pain?

Basically, rib pain can be traced back to various causes. The Family doctor is suitable as the first contact with a doctor to have a detailed discussion about the complaints and to do a physical examination.

Then, depending on the suspected diagnosis, a visit to the Orthopedic surgeons be indicated, especially with problems of the musculature and the skeletal system.

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Anatomical excursus for those particularly interested

I-XII ribs 1-12 -
Costa I-XII
(I-VII) True ribs -
Costae verae
(VIII-X) false ribs -
Costae spuriae
(XI-XII) rudimentary ribs -
Cost. fluctuantes

  1. Rib head - Caput costae
  2. Rib neck - Collun costae
  3. Rib humps -
    Costal tuberosity
  4. Rib body - Corpus costae
  5. Rib head joint -
    Articulatio capitis costae
  6. Sternum - sternum
  7. Vertebral bodies -
    Corpus vertebrae
  8. Costal cartilage -
    Cartilago costalis
  9. Rib-sternum joint -
    (Sternocostal joint)
  10. Rib-vertebral body joint -
    (= Point 5.)

You can find an overview of all Dr-Gumpert images at: medical illustrations

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Quality assurance by: Dr. Nicolas Gumpert | Last change: 03.04.2021