Pain in the ribs, upper back or chest can be scary! It can also be frustrating, confusing and irritating. If your ribs hurt, working out why your ribs hurt is important. You may need to rule out serious issues and you may require a practitioner to help get you moving and comfortable again… But, you may be able to deal with it from home (once you know it isn’t organ related)

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Why Do My Ribs Hurt?

4 Common Causes & How to Spot Them

Have you ever had that sharp catch in your ribs when you twist, breathe deeply—or even just sit for too long? Rib pain can feel scary, frustrating, or just plain weird. But more often than not, it’s a combination of things that’s totally fixable.
Hi, I’m Alexis Weidland, osteopath and co-founder of BlossomingMe and Healthy Learning Lounge. Join me as I work through the most common patterns I see in clinic, and what might be going on in your body right now.

Muscular

📍 Let’s start with muscular causes of rib pain. This usually feels like a dull ache or a pulling sensation. When you move or when you stretch .

It’s often linked in tension in the intercostal muscles, the little muscles between each of your ribs or from the lats or the serus anterior, which goes into your, shoulder blades, or even your abdominal oblique muscles, which sit like this. Especially if you’ve been twisting or coughing or even lifting un unevenly. The pain might increase when you reach or take a deep breath. But it generally feels like it’s sort of surface level tension and you can replicate it when you push the right spot.

Inflammation

📍 What about inflammation? Things like costochondritis or inflammation of the cartilage, connecting the ribs to the sternum here and up through here.

This causes a sharp, localized pain that can make you think, ah, is it heart pain? Especially if it’s quite central in your chest. It can be a stabbing pain and often very intense. . When you make any movements, when you cough, when you sneeze, or even when you breathe. In fact, it can feel very similar to what it’s like to have a broken rib.

It’s tender to touch and it may flare with stress, with illness, especially with coughing with repetitive upper body strain such as heavy lifting, or even with deep breathing. People often describe it as a sharp and intense and even burny or hot pain. The pain is localized to the area around the sternum where the cartilage of the rib connects the rib to the torso via the sternum.

Joint

📍 Now, let’s look at joint dysfunction. This happens when a rib gets sort of stuck or pulled by certain, usually sudden and demanding movements like lifting and reaching, and even painting the ceiling, it leads to the rib joints where they connect to the vertebrae at the back, sitting slightly off their correct position, causing irritation of the ligaments and the nerves, as well as tight muscles and restricted movement, which also triggers pain.

This often shows up as a deep, sharp pain when the rib is sort of forced to move, such as when turning. Breathing can also cause pain and it’s generally worse with either breathing in or breathing out. It might feel like a jab under the shoulder blade or it might wrap right around the rib and it can even feel like it tight band around your waist.

This can be disconcerting as it can also make you feel like you can’t breathe properly and even like there’s a pressure on your chest. Which can feel scary as this could indicate that it’s a heart issue. It’s a good place to note here that if you’re unsure, it’s always worth getting checked out by your gp.

If the pain’s affecting your breathing and the pain does not change by moving position, it’s worth a trip to emergency.

So these are the common types of pain, but what are the common causes of them?

Posture and Breathing Causes

📍 Posture and breathing patterns are a huge contributor. If you sit for hours with rounded upper back, then your rib cage gets compressed at the front and the depth of your breathing has to become affected.

It places extra pressure on the diaphragm, which then does not have the space to descend as it normally would. This reduces both, your ability to breathe deeply and the diaphragm supportive function on the digestive system, as well as signaling to your brain that something is wrong. Over time, this shallow upper chest breathing that eventuates plus restricted postures, causes muscles of and around the rib cage to tighten less mobility of the ribs and an inability to comfortably stand tall.

The chronic tension created through your upper back, your neck, your chest affects the way that your shoulders, neck, and head sit and function. And this increases the risk of shoulder conditions, upper back pain, neck pain, headaches, and even jaw dysfunction, stress.

Stress Causes

📍 Have you ever noticed that feeling where you can’t breathe properly?

It’s really not easy to relax, is it? Breathing is obviously essential, to survival, and when it’s restricted for any reason, but especially if you can’t tell what the reason is or if it feels like this is never going to end, it’s really difficult not to feel anxious. So when a situation occurs that breathing is affected, especially long term, even if relatively mildly, your brain will view this as a threat and you will feel stress, fear, and even anxiety.

Along with this, you will have increased muscle tension due to the overuse of the muscles that shouldn’t be used for breathing and activation of tension in the muscles where you generally hold your stress. This negatively affects the ability of your diaphragm and the thoraco lumbar fascia at the back here to transfer movement and energy forces from your upper and lower body, plus, the altered way of breathing affects your oxygen levels and your circulation. All of this can leave you feeling fatigued, having generalized discomfort and less ability to move freely, as well as brain fog.

Referred Causes

📍 And finally, there’s referred pain.

Your pain may not be coming from the musculoskeletal system at all.

Heart

It might be from the heart. Pain is generally at the front and more centralized. It can often feel quite deep and you can even feel it at the back. And it’s usually associated with a heaviness on the chest and a reduced ability to breathe. And you could get pain into the shoulder. But it can present differently for different people, including feeling more like heartburn and indigestion, especially in women.

Gallbladder

It’s usually right sided pain of the lower ribcage area, and it often is like start, stop, spasm type pain.

It’s more commonly felt after heavy or fatty meals.

Heartburn/Indigestion/Heartburn – GERD

Reflux in the stomach is usually a centralized burning, and it’s usually under the rib cage

Lungs

This is generally felt like a dull ache, on breathing. And it’s sort of similar to when you run harder and faster and longer than you’re generally comfortable with.

When to Seek Medical Help

So if your pain comes on suddenly without any clear reason, like you didn’t recently do lots of heavy lifting or twisting or gardening or painting and especially if the pain does not change when you move positions or if it seems to be getting worse, you really want to rule out your organs. So this is best then to go and see a gp.

If the situation seems to be intense and does not settle, or you’re highly concerned or your breathing is actually affected, then call an ambulance – better to be safe.

If it is not organ related or an emergency

At Home

If you are confident that your pain has a musculoskeletal component. You can start by

• gently mobilizing your rib cage
• breathing deeply and
• performing techniques that help your nervous system to relax.

These are all things that can be done at home to help, to provide relief, and to improve your mobility.

A Practitioner

Seeking a qualified manual therapist like an osteopath, chiropractor, physiotherapist, or massage therapist who performs a proper assessment before treating can be extremely helpful in many cases.

Are you Improving?

Whether you try at home mobility and breath work, or seek the help of a professional. It’s important to track your progress. If things are not improving within around three sessions or a week with self-care, then it’s worth going to see a practitioner or to get the GP to get things further checked out.

What Now

If your rib cage pain has been confusing or lingering, there’s likely more than one layer involved.

If organ involvement seems unlikely and you want to work through things yourself. But you’d really like the guidance and support of an expert of an experienced practitioner. That’s exactly why I created the Rib Cage Reset mini course. It’s a gentle, guided way to explore your rib mobility, release tension, and restore your breathing and posture patterns that support your entire nervous system.

If you’re interested to find out more, then click the link below and let’s start helping your ribs move and feel better from the inside out

Click the Button Below for my RibCage Reset min-course

Interested in further reading?

1. 1. Slipping Rib Syndrome
   2. Slipping Rib Syndrome Symptoms
   3. Costochondritis
   4. Costochondritis Review
   5. Musculoskeletal Chest Wall Pain
   6. More Serious Causes of Rib Pain

About Blossoming Me

BlossomingMe offers a fully integrated approach to your wellbeing. Located on Sydney’s Upper North Shore. Sarah is our Cranio-sacral and Remedial Massage Therapist and health and lifestyle coach. She can help relieve those problematic knots, tightness and other specific ailments to promote a healthy recovery. These complementary massage therapies can be combined to suit your needs, and include: craniosacral therapy, shiatsu, acupressure, reiki, remedial, swedish, and body-mind-massage. 

Our qualified Osteopath, Alexis, offers a drug free, minimally invasive, “hands on” treatment focusing on the musculoskeletal system with its associated muscles, tendons, ligaments, membranes, bones and joints. Alexis takes a functional approach. This means that she focuses on the way a component (body part, tissue or group of tissues) performs its role, as well as the way the body works, performs and integrates as a whole. Our team can support you to improve your posture and therefore your overall health.