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Can stress and anxiety cause rib pain?

Rib pain can be caused by a variety of factors, including injuries, muscle strains, joint inflammation, and medical conditions affecting the ribs or surrounding tissues. Additionally, research indicates that stress and anxiety may also contribute to rib discomfort in some people.

Overview of rib pain

The ribs are long, curved bones that protect the lungs, heart, and other internal organs. They are attached to the spine in the back and the sternum (breastbone) in the front. The ribs move with each breath, expanding the chest cavity to allow air into the lungs.

Pain originating from the ribs or surrounding muscles and tissues is common. Some potential causes include:

  • Injuries – Fractures, bruises, dislocations
  • Muscle strains – Overuse, poor posture, injury
  • Joint inflammation – Arthritis, injury, infection
  • Medical conditions – Shingles, pneumonia, pleurisy, cancer

Rib pain can range from mild to severe depending on the underlying cause. It may be sharp and stabbing, dull and achy, or feel like a muscle strain. The pain may be localized or felt across a larger rib area. Depending on the location, it may get worse with breathing, movement, coughing, or laughing.

Can stress and anxiety contribute to rib pain?

Research indicates that psychological and emotional factors like stress and anxiety can sometimes play a role in triggering, contributing to, or exacerbating rib pain, even when no clear physical cause is found. Some key points about the potential connection:

  • Stress and anxiety can increase muscle tension, which may result in muscle strains or spasms in the rib area.
  • They have been associated with flare-ups of pain in chronic pain conditions that can affect the ribs, like fibromyalgia.
  • They may alter pain perception and sensitivity in some people.
  • In severe cases, prolonged anxiety could potentially contribute to hyperventilation or changes in breathing mechanics that could strain or irritate the ribs.
  • They are also linked to increased inflammation throughout the body, which could theoretically affect the rib joints and tissues.

However, experts warn against assuming that rib pain is “just stress” when an undiagnosed medical condition may be the underlying cause. It’s important to consult a doctor to identify or rule out physical issues first.

How might stress and anxiety contribute to rib pain?

Researchers have identified several potential ways psychological factors may contribute to discomfort or pain in the rib area in some cases:

Increasing muscle tension

When the body is under stress, muscles often tense up as part of the “fight or flight” response. Chronic stress keeps muscles tight and tense for extended periods. This static contraction can cause fatigue, spasms, or strain in the muscles supporting the shoulders, neck, chest, and ribs. The persistent tension may result in localized soreness or pain.

Exacerbating chronic pain conditions

Studies indicate that emotional stress and anxiety can increase the frequency and intensity of flare-ups in chronic pain conditions like fibromyalgia that may cause rib pain. The precise mechanisms are unclear but likely involve a combination of increased muscle tension, inflammation, and pain signaling abnormalities in the central nervous system.

Altering pain perception

Research shows that anxiety, depression, and other emotional factors can decrease pain tolerance and threshold in some individuals. There are complex links between mood, emotions, pain signaling pathways in the brain, and the body’s natural pain modulation mechanisms. In those prone to sensitization, daily stressors may potentially amplify painful signals from the ribs and surrounding tissues.

Contributing to hyperventilation

In severe cases, uncontrolled anxiety could lead to episodes of hyperventilation and breathing too rapidly or deeply. This alters the mechanics of breathing and rib cage movement, which may irritate or strain the muscles and joints between the ribs. It may also provoke spasms of the respiratory muscles.

Increasing inflammation

Some studies indicate that chronic stress and anxiety may promote increased levels of inflammatory compounds like cytokines in the body. In theory, higher inflammation could potentially contribute to rib pain in those with joint, muscular, or neuropathic pain conditions affecting the rib area.

When to see a doctor

It’s important to consult a doctor for an examination and testing if you experience ongoing rib pain, especially if accompanied by other concerning symptoms. This will help determine or rule out any underlying medical issues requiring treatment. Seek prompt medical attention if you have rib pain along with:

  • Difficulty breathing or shortness of breath
  • Fever, chills, or sweating
  • Unexplained weight loss
  • Cough, chest congestion
  • Chest pain that worsens with deep breaths
  • Injury such as trauma or fall

Make an appointment with your doctor if the rib pain:

  • Persists beyond a few days
  • Worsens or interferes with daily activities
  • Spreads across a larger rib area
  • Is accompanied by swelling or visible bruising

Rib pain without an obvious physical cause may also warrant medical evaluation to identify or exclude underlying conditions that may require treatment.


To diagnose the cause of rib pain, doctors may:

  • Take a medical history
  • Ask about symptoms
  • Conduct a physical exam of the chest and ribs
  • Order imaging tests like x-rays or CT scans
  • Do bloodwork to check for signs of infection
  • Order other tests to exclude issues like pneumonia, pleurisy, etc.

They will also consider and evaluate emotional factors like stress and anxiety that may be contributing. Let your doctor know if you have been under significant stress lately or struggle with chronic anxiety.


Treatment will depend on the diagnosed cause of the rib pain. Some options may include:

  • Pain medication – Over-the-counter or prescription
  • Antibiotics – If infection present
  • Physical therapy – Gentle stretches and exercises
  • Chiropractic care – Rib manipulation or mobilization
  • Rib bracing – For fractures or support
  • Surgery – For severe injuries
  • Lifestyle changes – Rest, apply ice or heat
  • Stress management – Therapy, relaxation techniques

If anxiety or stress is contributing, developing better coping strategies, therapeutic techniques like cognitive behavioral therapy, and medications in some cases may help relieve these factors and reduce pain episodes.


Some tips that may help prevent potential stress or anxiety-related rib discomfort include:

  • Practicing relaxation techniques like meditation, deep breathing, yoga
  • Getting regular exercise and stretching
  • Improving posture and ergonomics
  • Taking frequent breaks from repetitive tasks
  • Using heating pads or ice packs preventively
  • Considering cognitive behavioral therapy for anxiety issues
  • Avoiding tobacco use

Seeking prompt treatment for injuries, strains, or respiratory illnesses may help prevent longer term complications involving the ribs. Learning stress management strategies and maintaining physical and mental health can also be beneficial.


For rib pain caused by clear injuries, infections, or medical conditions, the outlook depends on the diagnosis and response to appropriate treatment. When caught early, these issues often resolve fully with little lasting impairment.

In other cases where physical causes are less obvious, psychological components like chronic stress and anxiety likely need to be addressed as well for optimal pain relief and improvement in symptoms. This may require commitment to lifestyle changes, therapies, and developing long-term anxiety coping techniques.

With a multifaceted approach tailored to the individual, many people with rib discomfort related to or exacerbated by stress and anxiety achieve significant symptom reduction and improved quality of life.


Research indicates that stress and anxiety can serve as contributing factors to rib pain development and flares in some people. Potential mechanisms include increased muscle tension, alterations in pain signaling, exacerbation of chronic pain conditions, hyperventilation, and higher inflammation. If you experience persistent or worsening rib pain, have a doctor evaluate you to identify or rule out any medical issues requiring treatment. Be open with your doctor about your stress levels and mental health. Addressing any contribution from these psychosocial factors, along with physical causes, provides the best prospects for relief.