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Rib Pain | Osteopathy | Surrey Hills | treatment for rib pain

7 Causes of Rib Pain

Rib pain can be a very debilitating injury and has a variety of causes.  With the movement of the ribcage essential for breathing and associated spinal mechanics, rib pain is often a secondary pain to spinal issues. Often a stabbing sensation with breathing and movement, it is terribly hard for the sufferer to manage alone and very much worth an assessment to determine the cause of each unique case of rib pain. There are a number of rib related structures that can be irritated such as the cartilage attaching the rib to the sternum (breast bone) or the 2 separate joints attaching the rib to the spina column. A gentle approach to the injury is initially what’s required with the use of ultrasound, massaging the inflamed muscles in the area and gently mobilising the affected joints.

Causes of rib pain

Rib pain can have various causes, ranging from minor injuries to serious medical conditions. Some common causes of rib pain include:

Rib Injuries

Injuries to the ribs, such as fractures or bruises, can cause severe pain. This can result from a direct blow to the chest or from repetitive stress, such as from coughing or sneezing.


Costochondritis is a painful condition that occurs when the cartilage that connects the ribs to the breastbone becomes inflamed. This can cause sharp pain in the chest, often on one side, and the pain may worsen when breathing deeply, coughing, or moving the torso.

The exact cause of costochondritis is often unknown, but it is believed to be related to trauma or injury to the chest, or to repetitive motions of the upper body. It can also occur as a result of a respiratory infection or due to underlying medical conditions such as rheumatoid arthritis.

Muscle Strain:

Rib muscle strain is a common injury that occurs when the muscles between the ribs, known as intercostal muscles, are stretched or torn. This can result in sharp pain in the chest, particularly when taking deep breaths, coughing, or sneezing. Rib muscle strains often occur as a result of sudden twisting or bending motions, or from overuse of the muscles due to repetitive activities.


Osteoporosis is a condition in which the bones become weak and brittle due to loss of bone density. This can increase the risk of fractures, particularly in the spine, hips, and wrists.

Rib pain can be a symptom of osteoporosis, particularly if a fracture or injury has occurred. Rib fractures can be painful and can lead to difficulty breathing or moving, and may even puncture a lung in severe cases. Fractures of the ribs can cause severe pain and discomfort and usually take around 6 weeks to settle down.

Treatment for rib pain caused by osteoporosis may involve pain management, rest, and rehabilitation to help improve bone density and prevent further fractures. Medications such as bisphosphonates or hormone therapy may be used to help increase bone density and reduce the risk of future fractures.

Physical therapy with our Osteopaths may  help improve posture and balance, which can reduce the risk of falls and fractures. Strengthening exercises, weight-bearing activities, and resistance training can be beneficial in improving bone density and preventing future fractures.

Lung Conditions:

Rib pain can be a symptom of pneumonia and pleurisy, two conditions that affect the lungs and can cause chest pain. This is because the lungs are located behind the rib cage and the illness refers pain to the ribs.

Pneumonia is an infection of the lungs that can cause inflammation and fluid build-up, leading to chest pain and discomfort. The pain may be felt in the front or back of the chest and may worsen with breathing or coughing.

Pleurisy, also known as pleuritis, is inflammation of the lining of the lungs and chest wall. This can cause sharp pain in the chest that may worsen with deep breathing or coughing.

Treatment for pneumonia and pleurisy typically involves addressing the underlying cause of the condition, such as antibiotics for pneumonia or anti-inflammatory medications for pleurisy. Pain management may also be necessary to help alleviate discomfort.

Rest and hydration are also important components of treatment, as both conditions can be exhausting and may cause fatigue. In severe cases, hospitalization may be necessary to provide supportive care and monitoring.

Gastrointestinal Issues:

Some gastrointestinal issues, such as acid reflux or gastritis, can cause pain that may be felt in the chest or rib area. This is know as referred pain and diagnosis is made by looking through the whole clinical picture.


Shingles is a viral infection caused by the varicella-zoster virus, which is the same virus that causes chickenpox. Shingles typically presents as a painful rash or blisters that appear in a specific pattern on one side of the body, often on the trunk or face.

Shingles can also affect the nerves that run along the ribs, causing pain in the chest or back. This is known as herpes zoster intercostal neuralgia. The pain can be severe and may be described as burning, stabbing, or shooting in nature. Other symptoms may include sensitivity to touch, itching, or numbness.

Treatment for shingles typically involves antiviral medications to help reduce the severity and duration of the infection. Pain management is also a key component of treatment, as the pain associated with shingles can be quite severe. Over-the-counter pain medications such as acetaminophen or ibuprofen may be used, or prescription pain medications may be necessary for more severe cases.

It is important to seek medical attention if you suspect shingles as there is an opportunity in early stages for anti-viral medication.

What you should do about rib pain

If you are experiencing persistent or severe rib pain, it is important to seek medical attention to determine the underlying cause and receive appropriate treatment. 

THE GOOD NEWS is many rib issues are spinal referred pain and then the rib becomes stiff and tight when moving. This is often the reason for pain on breathing when there is no other likely cause.

How to treat rib pain

The treatment for rib pain depends on the underlying cause of the pain. Here are some general recommendations that may help:

  • Rest: Avoid activities that cause pain, especially those that involve twisting, lifting, or bending.

  • Ice or Heat Therapy: Applying ice or heat to the affected area can help reduce inflammation and alleviate pain. We find the best way is to test what feels best for you. The shower is a great place to start for heat, but if the issue was traumatic you may prefer ice.

  • Pain Relief Medications: Over-the-counter pain medications such as paracetemol or ibuprofen may help relieve pain and reduce inflammation.

  • Deep Breathing: Taking slow, deep breaths can help expand the rib cage and improve breathing, which can reduce pain. 

  • Gentle Exercise: Once the pain has subsided, it’s important to gently stretch muscles and mobilise the joints around the affected area to prevent further injury. We can definitely assist you with that!

If your rib pain is severe or persists despite these measures, it’s important to get it checked out so book in with one of Osteopaths for assessment.

When it comes to rib pain, our osteopaths will use a variety of techniques to work on alleviating the pain and improve the stiffness of the rib cage. For example, we may use soft tissue techniques such as myofascial release or trigger point therapy to release tension in the muscles surrounding the rib cage. We also may also use joint mobilization techniques to help improve the mobility of the rib joints.

It is also important to assess the patient’s posture and breathing mechanics to identify any imbalances or dysfunctions that may be contributing to the rib pain. So you can continue to work on the issue outside your treatment, you will be recommended specific exercises or stretches to help correct these issues and prevent further pain or injury.

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