The rib pain that occurs in the chest can be attributed to a variety of causes. A distinction should also be made between short-term pain and prolonged, chronic rib pain.

What are rib pain?

Infogram to the pain regions, course and development of pain as well as the intensity levels in pain perception. Click on the image to enlarge.

The rib pain is called chronic if it lasts more than six months or if the patient complains of recurring pain. About one third of patients with rib pain suffer from a chronic illness. In contrast to the acute rib pain, the chronic symptoms often have no special warning function with respect to another disease, but represent a separate disease.

According to the source of the rib pain two subgroups are distinguished: The pain originating directly from the rib area can be triggered for example by bruises or broken ribs. Of all twelve pairs of ribs and thoracic vertebrae, the pain may originate as well as from the sternum. The second group involves rib pain, which is due to diseases of chest organs or tissue located near the ribs.


Rib fractures or rib bruising are usually caused by heavy impact or falls. But it is also possible an inflammatory change.

In the so-called Tietze syndrome, the rib or sternum cartilages are noticeably swollen and trigger the rib pain. There is also the possibility of ossification of the rib joints, which can not only lead to rib pain, but also to respiratory distress. The rare Thoretic Outlet Syndrome (TOS) describes rib pain, which is often caused by a congenital, one- or two-sided anomaly of the cervical rib. This anomaly can z. B. cause rib pain during movements of the arms.

However, the rib pain can also be due to osteoarthritis (joint wear), to a rheumatic disease (a chronic inflammatory disease due to a malfunction of the immune system) or to scoliosis. Scoliosis occurs when the spine is bent laterally and vertebrae are twisted at the same time.

Diseases with this symptom

  • arthrosis
  • Tietze Syndrome
  • rheumatism
  • Rippenprellung
  • scoliosis
  • Rippenbruch

Diagnosis & History

At the beginning of each treatment for rib pain, a thorough root cause analysis must first be performed, including a thorough examination of the body and a precise determination of the duration and type of pain.

Most acute ribs pain will go by itself without further action after a few days. However, if pain persists for more than a week, the doctor will conduct a closer examination. Simple palpation can often already diagnose a broken rib. Also suitable are X-ray or ultrasound examinations, computer or magnetic resonance tomography and, in individual cases, so-called bone scintigraphy, with which the metabolism of a bone can be examined.

The course of the rib pain depends largely on the individual disease. Bruises, for example, lead to very strong, but not very long-lasting rib pain. However, rib fractures can lead to secondary pain if a rib injures internal organs such as the spleen or lungs.

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The body tissue, which swells due to fractures or bruises, can lead to permanent and intense pain. Concerned persons see themselves strongly in their efficiency as well as mobility restricts. Accurate examination must quickly determine the exact cause of ongoing illness. Superficial injuries are not always the reason for intense discomfort. A breakthrough or injury to the organs themselves can cause long-term complications.

Liver, spleen, lungs and the upper part of the stomach are impaired in their function. Depending on their location, patients develop fears of dangerous, but non-existent diseases. Last but not least, the increased heartbeat and a shallow breathing to avoid pain fuel the fear of a heart attack. As inflammation progresses, water retention in the tissue collects between the lungs and the pleura.

At the same time, the swollen tissue exerts additional pressure on the surrounding organs and sustainably increases the suffering pressure. If the symptoms are not due to an external mechanical reaction, fever, loss of appetite and nausea are the most common symptoms. In addition to the risk of manifesting a neurosis, the patient's quality of sleep may suffer in the long run.

Even small movements in bed can intensify pain intensively. As a consequence, unnatural postures are taken to protect. In the long term, these burden the back health and lead to further distortions or blockages of the musculoskeletal system. Bacterial infections can spread to the whole body without proper treatment and threaten the patient's life.

Treatment & Therapy

The diagnosis made on the basis of the rib pain then determines the therapy later on. If there is no way to eliminate the cause of the pain, the treatment will be limited to pain therapy.

Pain-relieving medicines can be used for this purpose or, in individual cases, a local anesthesia of the aching rib area can be made, which, as a side effect, can also improve blood circulation and thus inhibit the inflammation.

Only on a bruise based rib pain are usually treated only with pain preparations. Deviating from the procedure for other fractures is in a rib fracture fixation z. B. not required by a plaster cast.

All other causes of rib pain are combated by treatment of the underlying disease. In some diseases (such as scoliosis) is a physiotherapeutic treatment into consideration. As a rule, TOS is also initially treated conservatively with targeted physiotherapy. Only in the case of unsuccessful physiotherapeutic efforts, a rather complicated operation may be performed, removing ligaments and / or cervical ribs.

The Tietze syndrome, if severe rib pain is present, treated with analgesic drugs. In osteoarthritis comes in addition to the pure pain therapy and physiotherapy measures z. As a simple measure such as the cooling of the affected breast area, but possibly also the administration of cortisone preparations for the rib pain into consideration.


The possibility of preventive measures for rib pain depends on the type of underlying diseases. In case of danger-prone occupations or sports, z. B. the ability to wear protective clothing that prevents shock or fall injuries. If rib pain relies on a particular disease, at least an aggravation of the pain can be counteracted by treating this disease. An early examination of prolonged rib pain allows a timely diagnosis, on the basis of which otherwise possibly imminent complications can be avoided.

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