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Pain around the ribs and back can be caused by a number of conditions that affect the bones, muscles, and even lungs.
Some causes of pain around the ribs and back include:
- A bruised or broken rib
- A bruised rib is one in which small blood vessels are torn and leak blood under the skin but the rib bone is not fractured
- A broken rib is one in which the rib is fractured
- Injury to the chest may be caused by:
- Falls
- A blow or hit to the chest; common in sports
- Severe coughing
- Costochondritis
- A common form of inflammation of the cartilage where ribs attach to the breastbone (sternum)
- Frequently occurs on just one side
- Causes of costochondritis are unknown and may involve several factors such as:
- May also be a feature of a more widespread disorder such as:
- Fibromyalgia
- Psoriatic arthritis
- Ankylosing spondylitis
- Reactive arthritis
- Rheumatoid arthritis
- Lupus
- Inflammatory bowel disease (IBD), such as ulcerative colitis and Crohn's disease
- Tietze's syndrome
- Inflammation of the costochondral cartilages of the upper front of the chest that involves swelling of the joint
- Differs from costochondritis due to the presence of swelling (costochondritis is not associated with swelling)
- Pleurisy (pleuritis)
- Inflammation of the pleura, the membranes that surround and contain the lungs and separate them from the chest wall, diaphragm, and heart
- Causes of pleurisy include:
- Infections from viruses, bacteria, fungi, parasites, or tuberculosis
- Certain cancers
- Hole in the lung (pneumothorax)
- Collagen vascular diseases
- Injury to the chest such as bruised or broken ribs
- Gastrointestinal disease, such as pancreatitis or peritonitis
- Reactions to certain drugs
- Uremia
- Blood clot in lung (pulmonary embolism)
- Radiation therapy
- Sickle cell disease
- Asbestos
- Human immunodeficiency virus (HIV)
- A complication of heart surgery
What Are Symptoms of Pain Around the Ribs and Back?
Pain around the ribs and back may be accompanied by other symptoms, depending on the cause.
Symptoms that may accompany pain around the ribs and back due to a bruised or broken rib may include:
- Intense pain in the chest area
- Pain may be worse when inhaling, coughing, or sneezing
- Swelling or tenderness around the affected ribs
- Bruising on the skin
Symptoms that may accompany pain around the ribs and back due to costochondritis and Tietze's syndrome may include:
- Localized pain and tenderness in the front of the chest that may:
- Be variable, often sharp
- Be confused with heart pain
- Last from hours to weeks
- Cause difficulty sleeping
- Redness, tenderness, and warmth
- Tietze's syndrome also causes swelling over the ribs and cartilage near the breastbone (sternum)
Symptoms that may accompany pain around the ribs and back due to pleurisy (pleuritis) may include:
- Chest pain
- Most common symptom
- Can range from sharp, stabbing pain, to a dull ache, or a burning sensation
- Usually worse when inhaling deeply, sneezing, coughing, or moving
- Less when taking shallow breaths or lying on the painful side
- Cough
- May be dry or may contain sputum or blood
- Shortness of breath
- Shallow, rapid breathing
- Fever (depends on the cause)
How Is Pain Around the Ribs and Back Diagnosed?
The cause of pain around the ribs and back is diagnosed with a patient history and physical examination. Depending on the suspected cause, tests may include:
- X-ray
- Computerized tomography (CT) scan
- Electrocardiogram (ECG)
- Echocardiogram (“echo”)
- Pulse oximetry
- Thoracentesis: removal of fluid from around the lung
- Blood tests to check for infection or certain proteins that could indicate a heart attack
What Is the Fastest Way to Relieve Rib Pain?
Treatment for pain around the ribs and back depends on the cause.
Most of the time, a bruised or broken rib will heal on its own within two to six weeks. Home remedies to help relieve pain and speed healing of pain around the ribs and back due to broken or bruised ribs include:
- Rest
- Stop activity that causes pain
- Protect the injured area
- Ice the affected area regularly to reduce swelling
- After two to three days, if swelling is gone, use a heating pad on low
- Take over-the-counter (OTC) pain medicines
- Sleep sitting up for the first few nights if possible
- Breathe normally
- Walk around and move the shoulders to help you breathe
- Cough when you need to
- Avoid:
Treatment for pain around the ribs and back due to costochondritis and Tietze's syndrome may include:
- Rest
- Stop activity that causes pain
- Protect the injured area
- Ice the affected area regularly to reduce swelling
- Take over-the-counter (OTC) nonsteroidal anti-inflammatory drugs (NSAIDs)
- Local lidocaine analgesic patch (Lidoderm) application
- Cortisone injections
Treatment for pain around the ribs and back due to pleurisy (pleuritis) includes:
- Over-the-counter (OTC) and prescription pain relievers
- Corticosteroids
- Antibiotics to treat bacterial infections that cause pleurisy
- Blood thinners to dissolve blood clots that cause pain
- Thoracentesis to drain pleural fluid from around the lungs
- Chest tube to drain the air in a pneumothorax or to drain infection
- Stopping medication that is causing the pain
- Never stop taking a prescribed medication without first talking to your doctor
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https://www.nhs.uk/conditions/broken-or-bruised-ribs/
https://www.nhsinform.scot/illnesses-and-conditions/muscle-bone-and-joints/conditions/costochondritis
https://www.uptodate.com/contents/pleuritic-chest-pain-the-basics?search=pleurisy&source=search_result&selectedTitle=1~150&usage_type=default&display_rank=1