Have you ever had rib pain? Bluntly put, it hurts like Hell — it’s painful to breathe, painful to lay on the injured side, painful to roll in bed, painful to reach for something. Basically, every movement hurts.
What causes rib pain?
- Broken or bruised rib
- Strained intercostal muscle between the ribs
- A rotation of a thoracic vertebrae (upper back) causing a shift of the rib either forward or backward
Where do you feel rib pain?
Rib pain can be felt in the form of:
- Upper back pain
- Chest pain
- Neck pain with inability to turn head to one side
- Side pain
A basic anatomy lesson
Your thoracic cage is made up of 12 pairs of ribs, your sternum or chest bone, and 12 thoracic vertebrae. The thoracic cage acts as armour for your most vital structures – your heart, lungs, and largest blood vessel, the aorta. In the front of your body, ribs 1 through 7 are attached to your sternum and ribs 8 through 10 are attached to cartilage at the bottom of the sternum. They all wrap around your body to attach to your thoracic vertebrae 1 through 10. Ribs 11 and 12 are known as floating ribs as they only attach to thoracic vertebrae 11 and 12 and have no attachment in front.
Respiration is initiated through your diaphragm, which is situated between your thoracic cage and your abdomen. During respiration, your lungs and rib cage expand, the ribs separate via the intercostal muscles, and then come back to resting position when you exhale.
What can you do to relieve rib pain?
Medically speaking, there is nothing you can do (besides take pain medication). Physical Therapy, on the other hand, can be extremely helpful. Here are a few methods we use to treat rib pain:
Fractured or bruised ribs
For fractured or bruised ribs, there is gentle manual therapy and kinesiotape.
Strained intercostal muscle or side pain
A strained intercostal muscle will not allow the ribs to separate like they need to during respiration, which causes pain. Treatment requires a more deep tissue form of manual therapy, which can be uncomfortable, and kinesiotape.
Upper back or chest pain
These usually go hand-in-hand, requiring hands on techniques to the involved thoracic vertebrae and rib.
Neck pain with inability to turn to one side
This is usually caused by an elevated 1st rib, and rotation of the 1st thoracic vertebra. This usually requires a manual technique to settle. For reference, your back 1st rib is just below your neck and the front 1st rib is just underneath your collarbone (clavicle).
Gentle movement exercises
Gentle movement exercises allay fear of movement and begin improving movement of the thoracic cage.
Breathing exercises are used to mobilize the thoracic cage which can be done lying on your back with your knees bent and in sitting. Here are a couple of methods:
- Diaphragm Breathing. Diaphragm breathing is done by placing your hand on your upper abdomen (diaphragm), and breathing into that hand as deeply as you can tolerate, exhale slowly
- Bucket handle breathing:. To practice bucket handle breathing, place your hands on your sides/lower rib cage, breathe into your hands expanding your rib cage out, and exhale slowly.
Like any soft or bony tissue injury in the body, nature takes at least 4 to 6 or more weeks to heal, so the above treatments will not get rid of your pain 100%, but it will allow you to move, breathe, sleep and function better with less pain and return you to the activities you love to do sooner.
Now that you can see a PT without a prescription, don’t suffer with rib pain! Come in as soon as you can for relief.
Thanks for the tip on rib pain
As I have had it got three days!
Thank you for this article. In terms of pain medications for rib pain, I have been taking ibuprofen 600 mg every 4 – 6 hours. Does this slow healing for soft tissue injuries or bone fractures in the ribs? I am in such bad pain since I had a fall that I cannot go without the IBU and tylenol is not touching the pain at all at 650 mg.
Mary T Oltmans says
I have a floating rib which causes crazy pain. I want to discuss this with you.