Your rib cage consists of 12 pairs of curved ribs that are evenly matched on both sides. Men and women have the same number of ribs. It’s a myth that men have one less pair of ribs than women.
Your ribs serve a vital purpose in protecting the organs in your chest cavity. Although your ribs are sturdy, they can be vulnerable to injuries and other diseases that can cause rib pain.
Here’s a look at the role your ribs play and the types of conditions and injuries that can lead to rib pain.
The top seven pairs of your ribs connect directly to your sternum, sometimes referred to as the breastbone. Your sternum is located in the front center of your chest.
Strips of costal cartilage connect your ribs to your sternum. This cartilage is flexible enough to allow your ribs to expand when you inhale and then contract when you exhale. These ribs, known as true ribs, also connect to your spine in the back.
The 8th, 9th, and 10th rib pairs don’t connect directly to your sternum, but they are connected to each other by cartilage that attaches to the costal cartilage of the 7th rib pair. These ribs also attach to your spine in the back.
The 11th and 12th rib pairs are the lowest in the rib cage. They don’t reach around to the front of your body. Instead, these shorter ribs, also called floating ribs, extend from the spine out to your sides.
Your ribs essentially serve two main purposes:
- They protect your heart, lungs, and other organs and tissues in your upper body. They also provide some protection for your liver and kidneys.
- They provide structure and support to the bones and muscles in your chest, shoulders, and back.
Rib pain can affect anyone at any age. In some cases, the pain may feel sharp and stabbing. Or, it may feel like a dull, throbbing ache. The type of pain you experience can help determine its cause.
Rib pain can have many causes. It can be due to injury, disease, or other complications. Some of the more common rib pain causes include:
- musculoskeletal causes, such as injuries that result in bone fractures, or strained muscles or ligaments
- organ-related causes, particularly heart or lung issues
- gastrointestinal conditions that can affect your digestive tract
- cancer causes, particularly lung or bone cancer
Let’s take a closer look at each of these potential causes and how they may cause pain in your ribs or chest.
An injury to your ribs or the soft tissue of your rib cage can cause considerable pain. Just breathing in and out can hurt. Some common causes of muscle or bone pain affecting the ribs include:
- Broken ribs: Even a hairline fracture of a rib can cause sharp pain that gets worse when taking a breath or bending over. Coughing, sneezing, or laughing can also cause sharp, shooting pain from the site of the break. With a broken rib, you may also notice redness or swelling near the break.
- Strained muscle: A strain happens when a muscle is pulled, stretched, or partially torn. A strain of the intercostal muscles can cause pain, swelling, muscle tightness, and difficulty breathing. These muscles are located between your ribs and keep your ribs attached. The pain may come on suddenly or gradually, and it’ll get worse when you stretch, twist, breathe deeply, sneeze, or cough.
- Costochondritis: Costochondritis is inflammation of the cartilage between your ribs. Pain is typically felt in the upper and middle areas of your ribs on either side of the sternum. The pain may also radiate to your back or abdomen, and it can feel worse if you stretch or breathe deeply.
- Arthritis: The two main types of arthritis — osteoarthritis and rheumatoid arthritis — typically affect joints in your hands, knees, hips, and neck. But these inflammatory conditions can affect any joints, including those connecting your ribs to the spine or sternum.
Chest pain is the most common symptom of a heart attack. Other symptoms of a heart attack can include:
- pain in your jaw, neck, back, shoulders, or arms
- shortness of breath
- lightheadedness or dizziness
A heart attack isn’t the only heart-related condition that can trigger pain that feels like it’s coming from your chest or ribs. Other heart-related causes of chest pain include:
- Angina: When your heart muscle isn’t getting a sufficient supply of oxygen-rich blood, you may experience bouts of chest pain. Angina is sometimes a precursor to a heart attack, and it should be evaluated by a doctor.
- Heart valve disorders: A heart valve disorder happens when one of your heart’s four valves isn’t able to do its job properly. Typical symptoms include dizziness, heart palpitations, chest pain, shortness of breath, and fatigue. In mild or moderate cases, you may not have any symptoms, or they may be subtle.
- Myocarditis: Myocarditis is a condition that’s caused by the inflammation of the heart muscle, sometimes triggered by an infection. It can affect anyone at any age and can develop without any symptoms. If symptoms are present, they can be flu-like and include fever, joint pain, an aching feeling in the chest, fatigue, and shortness of breath.
- Pericarditis: Pericarditis is the inflammation of the thin fluid-filled sac that surrounds your heart, called the pericardium. Pain can come on suddenly in the middle or left side of the chest, and it may radiate to your neck shoulders, arms, or jaw. Other symptoms can include a low-grade fever, shortness of breath, fatigue, and swelling in your legs and feet.
Diseases that affect your lungs can cause soreness and discomfort in your rib cage as breathing becomes more difficult. Some of the more common lung-related problems that can cause rib pain include:
- Asthma: Asthma is an inflammatory condition of the airways. Symptoms develop when the lining of your airways becomes inflamed and swells and the muscles around your small airways tighten, which obstructs airflow in your lungs. This can cause tightness in your chest, wheezing, shortness of breath, and coughing.
- Bronchitis: Bronchitis happens when the bronchial tubes that carry air into your lungs from the trachea become inflamed and swollen. This condition often starts with coughing, a sore throat, and chest tightness, but it can then lead to shortness of breath and fatigue.
- Pneumonia: Pneumonia is an infection of one or both lungs. It can cause chest pain that’s worse when you breathe or cough. Other symptoms include fever, chills, shortness of breath, and a cough that often produces mucus. Pneumonia can be life threatening if not treated.
Pain in the ribs or chest can also be caused by gastrointestinal conditions, or issues related to your digestive tract. Some of the most common conditions that may cause rib or chest pain include:
- GERD: Gastroesophageal reflux disease (GERD) is a condition in which stomach acid backs up into the esophagus. This can cause heartburn in the middle of the chest and other symptoms, such as difficulty swallowing.
- Peptic ulcer: A peptic ulcer is a condition marked by sores on the lining of the stomach, lower esophagus, or small intestine. The most common symptom is a burning pain that can occur around the ribs or extend down into the abdomen. Other symptoms can include black or tarry stools, nausea, changes in appetite, and unexplained weight loss.
- Hiatal hernia: More common among adults who are over 50 years old, a hiatal hernia occurs when part of the upper stomach pushes up against and through an opening in the diaphragm and into the chest cavity. These hernias often don’t cause symptoms, but when they do, you might experience chest pain, heartburn, and difficulty swallowing.
In its earliest stages, cancer often has no symptoms. But as it progresses, signs of the disease can develop quickly. Rib pain associated with cancer is usually the result of:
- Bone cancer: Bone cancer is a less common type of cancer, but it can affect any bone in your body, including your ribs. It can begin with a tumor that first forms in a rib bone, or it may occur after originally forming in another organ and later spreading to the ribs.
- Lung cancer: There are several different types of lung cancer, but when large enough, all of them tend to cause chest pain, coughing, wheezing, shortness of breath, and fatigue.
If you’ve suffered an injury or trauma that’s caused rib pain, it’s important to get medical attention as soon as possible. In some cases, if a rib is severely fractured, it could puncture your lung or cause other complications.
Also, if your rib or chest pain is accompanied by the symptoms outlined below, don’t hesitate to get medical care. It could be a symptom of a heart attack or another heart-related condition that needs treatment. These symptoms include:
- chest tightness
- pain in other locations, such as the upper abdomen, shoulder, back, arm, neck, or jaw
- shortness of breath
- dizziness or lightheadedness
Rib pain that develops slowly and has no other symptoms should still be evaluated by a doctor. You may have strained a muscle or ligament without realizing it, or it could be the early stages of a more serious health condition.
Both men and women have 12 pairs of curved ribs. Your ribs help protect the organs in your chest cavity, and also provide structure and support to your upper body.
Although your ribs are sturdy, they can be vulnerable to injuries and conditions that can cause rib or chest pain. There are a wide variety of issues that can cause pain in and around the ribs. These include:
- musculoskeletal causes
- heart- or lung-related causes
- gastrointestinal conditions
- cancer causes
If you have rib pain caused by an injury or pain in your chest that’s accompanied by other alarming symptoms, it’s important to get medical care as soon as possible.