Pain Around Rib Cage: Causes, Symptoms, Treatment Complications

The rib cage comprises ribs that are placed in curves around the chest and join with the help of soft tissues at the breastbone in the front and the spine at the back. The vital organs like heart, lungs and other related structures are well protected inside the rib cage.

Pain around rib cage can be dull aching or sometimes even sharp as if being stabbed. It usually occurs in the area of the rib cage and around it or below the chest. It is often experienced as discomfort or pain in the area surrounding the rib cage.

There are various causes for pain around rib cage and the presentation of symptoms also varies according to the cause. In most of the less severe cases, the pain around rib cage results from strained muscles due to coughing, overstretching or postural changes. However, sometimes the pain around rib cage can be severe and may be due to more serious causes, which needs immediate evaluation. It is necessary to seek medical opinion for a thorough evaluation to identify the exact cause of pain around rib cage and begin appropriate treatment in time.

Pain around rib cage can appear after a fall, after being injured or sometimes without any obvious explanation. The pain around rib cage can appear immediately after the physical injury or may develop a little later. Injury to the rib cage area ranges from muscle strain to a rib fracture, which could need immediate medical attention; hence it is important to evaluate the pain in time and take the necessary action.

As a general consideration, in physical injuries of the ribs, the pain worsens with increased physical movements like bending or twisting. These movements may not necessarily cause pain in case if pain around rib cage is due to other reasons like respiratory system or simple muscle spasms.

Some Of The Common Causes Of Pain Around Rib Cage Include:

• Injuries to the rib or chest like bruising, crack or fracture of the rib can cause pain around rib cage
• Inflammation, strain or spasms of the muscles supporting the rib cage
• Inflammation of the cartilage or soft tissue in the middle of the rib cage at the breast bone, which is called as costochondritis is also known to cause pain around rib cage.
• Pain, tenderness and stiffness of muscles like in fibromyalgia can cause pain around rib cage
• Rib cage pain could be due to diseases of the bones like osteoporosis
• Diseases of the lungs like inflammation of the lung lining (pleurisy), bronchitis, COPD or other respiratory conditions can cause pain around rib cage
• Cardiovascular conditions like coronary artery disease, cardiac anomalies, etc also can cause pain around rib cage
• Malignancies like bone cancer, lung cancer and others
• Rib cage pain could be due to Gastrointestinal causes like gastro-esophageal reflux disease (GERD), hiatus hernia, peptic ulcer, etc.

Pain around rib cage in itself is a symptom of an underlying problem or disease. The associated symptoms can help in understanding the cause of the pain around rib cage and proper treatment can be planned. It is important to make a note of other symptoms, which can be co-related with clinical examination for proper diagnosis.

Associated symptoms vary depending on the underlying cause of pain around rib cage. There may be abdominal pain, nausea, vomiting in case of gastrointestinal causes of rib cage pain. Fever, body aches or cough, may be present in case of respiratory infections leading to pain around rib cage. Rib pain may sometimes also extend to arms, shoulders or to the back. Pain around rib cage may be increased with movement of shoulders; twisting or bending of the body.

Symptoms like sharp pain on breathing, difficulty in breathing, changes in skin, nail or lip color, dizziness or changes in level of alertness may need immediate medical attention.

Depending on the history, associated symptoms and clinical examination, your physician may order investigations like

• An X-ray to detect fracture or other bony changes
• An MRI to detect further details of the bone, surrounding tissues, abnormal growth or a bone scan if cancer is suspected.
• Other laboratory tests may be ordered for respiratory infections or other causes.

The treatment modality for pain around rib cage too depends on the cause and the precise diagnosis. For injury to the muscles causing pain around rib cage, anti-inflammatory medications and cold compresses may be given. Treatment for fractured ribs includes rest, immobilization and sometimes a bandage or splint may be advised. For other causes of pain around rib cage, appropriate medications to treat respiratory infections, lung diseases and gastrointestinal problems are given.

As the cause for pain around rib cage vary, so do the outcome and possible complications if left untreated. Some of the possible complications of pain around rib cage include injury to internal organs, cardiac arrest, respiratory failure, reduced oxygen supply and shock.

Whatever may be the cause; timely evaluation, early diagnosis and appropriate treatment can help in reducing the risk of life threatening complications that can arise out of unattended cases of pain around rib cage.