Pain Around Ribs and Back: Understanding Symptoms

Understanding the Thoracic Spine

Pain around the ribs and back often originates from issues in the thoracic spine. Because the spine and rib cage are closely connected, problems in one area can easily cause pain in the other.

The thoracic spine is the middle of your back, located between the neck and lower back. It consists of 12 vertebrae, labeled T1 to T12, each connected to a rib. These vertebrae and ribs form a cage that protects vital organs like the heart and lungs.

The thoracic spine helps support the rib cage and assists with breathing. Ribs attach to the vertebrae at two joints, allowing them to move as you breathe in and out. The intercostal muscles, found between the ribs, also play a key role in expanding and contracting the chest cavity for breathing.

Common Causes of Pain Around Ribs and Back

Costochondritis

Costochondritis, also known as Tietze’s Syndrome, is the inflammation of the cartilage that connects the ribs to the breastbone. This can result from injury, repetitive strain, or sometimes without a clear cause.

According to the AAFP, costochondritis most commonly affects adults between the ages of 40 and 50, with a slightly higher occurrence in women. 

• Sharp, stabbing chest pain that can radiate to the back
• Pain worsens with deep breaths, coughing, or physical activity
• Tenderness in the affected area

• Rest and avoid activities that cause pain
• Apply warm compresses to the affected area
• Over-the-counter pain relievers

Muscle Strain

Muscle strains happen when the muscles between the ribs (intercostal muscles) are overstretched or torn. This can occur from heavy lifting, sudden movements, or intense physical activity.

Muscle strains are among the most frequent injuries people encounter, according to the Cleveland Clinic.

• Sharp, severe pain in the rib and back area
• Stiffness and difficulty moving
• Pain worsens with movement or breathing

• Rest and avoid activities that exacerbate the pain
• Apply ice or heat to the affected area
• Over-the-counter pain relievers
• Physical therapy for severe cases

Lung Conditions

Lung conditions like pulmonary embolism, pleurisy, and lung cancer can cause pain around the ribs and back. These conditions are serious and require immediate medical attention.

• Sharp chest pain that may spread to the back
• Shortness of breath
• Persistent cough
• Unexplained weight loss

If you experience these symptoms, seek medical attention immediately. Early diagnosis and treatment are crucial for these conditions.

Thoracic Disc Bulge

A thoracic disc bulge occurs when the discs between the vertebrae protrude out, pressing on nerves. This can cause pain around the ribs and back, often described as a burning or electrical sensation.

• Rest and avoid strenuous activities
• Over-the-counter pain relievers
• Physical therapy
• In severe cases, surgical intervention

Rib Facet Pain

Rib facet pain occurs when the joints connecting the ribs to the spine are damaged. This can cause localized pain that worsens with movement or deep breaths.

• Rest and avoid activities that cause pain
• Apply ice or heat to the affected area
• Over-the-counter pain relievers
• Physical therapy

Fascia Injury

Fascia is the tough tissue covering the ribs. When injured, it can cause pain and allow too much rib movement, leading to upper back pain that wraps around the ribs. This can occur due to injury or overuse, resulting in sharp pain that worsens with deep breaths.

• Rest and avoid activities that cause pain
• Apply ice or heat to the affected area
• Over-the-counter pain relievers
• Physical therapy

Muscle Trigger Points or Tendinopathy

Trigger points are tight areas in muscles that can cause pain around the ribs and back. Tendinopathy is a condition where tendons become injured and worn out.

• Rest and avoid activities that cause pain
• Apply ice or heat to the affected area
• Over-the-counter pain relievers
• Physical therapy

Diagnostic Methods

Proper diagnosis is essential to determine the exact cause of rib and back pain. Misdiagnosis can lead to ineffective treatments and prolonged discomfort. Accurate diagnosis ensures that the underlying issue is addressed, whether it’s a muscle strain, a more serious condition like a lung problem, or a spinal issue.

To diagnose the cause of rib and back pain, healthcare professionals use various methods:

• Physical Examination: The doctor will check for tenderness, swelling, and any signs of injury. They may also ask about your medical history and any recent activities that might have caused the pain.
• X-ray: An X-ray can reveal fractures, dislocations, and other structural abnormalities in the ribs and spine.
• MRI (Magnetic Resonance Imaging): An MRI provides detailed images of soft tissues, including muscles, ligaments, and intervertebral discs. It’s useful for detecting conditions like herniated discs or muscle injuries.
• CT Scan: A CT scan offers a more detailed view of the bones and can help diagnose fractures or other bone-related issues.

These diagnostic tools help doctors identify the exact cause of pain and develop an effective treatment plan.

Effective Treatment Options

Treating pain around the ribs and back involves a combination of methods tailored to the underlying cause of the pain. Proper treatment should address the specific issue, whether it's a muscle strain, a structural problem, or an internal condition. Here are some effective options:

Home Remedies

For mild to moderate rib and back pain, home remedies can provide significant relief:

• Rest and Posture Correction: Resting allows the body to heal while maintaining proper posture can prevent further strain on the back and ribs.
• Hot/Cold Compresses: Applying a hot or cold pack to the affected area can reduce inflammation and alleviate pain. Use cold compresses for acute injuries and hot compresses for chronic pain or muscle stiffness.
• Over-the-Counter Pain Relief: Non-prescription pain relievers can help manage pain and reduce inflammation. Always follow the recommended dosage and consult with a healthcare provider if needed.

Medical Treatments

For more severe or persistent pain, medical treatments may be necessary:

• Prescription Medications: Stronger pain relievers or anti-inflammatory drugs may be prescribed to manage severe pain.
• Injections: Steroid injections can reduce inflammation and provide pain relief. Platelet-rich plasma (PRP) injections promote healing in damaged tissues.
• Surgical Options: In rare cases, surgery might be required to correct structural issues or remove damaged tissue. This is usually considered when other treatments have failed.

Physical Therapy

Physical therapy plays a vital role in treating rib and back pain. It helps restore movement, improve strength, and reduce pain. A tailored exercise program can prevent future injuries.

Common exercises and techniques:

• Stretching exercises to improve flexibility
• Strengthening exercises for the back and abdominal muscles
• Postural training to ensure proper alignment
• Manual therapy techniques to relieve pain and improve mobility

By combining these treatment options, individuals can effectively manage rib and back pain and improve their overall quality of life. Always consult with a healthcare professional before starting any new treatment.