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How do you know if rib pain is muscular?

Rib pain can be caused by a variety of conditions, some minor and others more serious. Determining whether rib pain is muscular or something else is important to get proper treatment. There are several ways to help figure out if rib pain is coming from the muscles or another source.

What are the symptoms of muscular rib pain?

Muscular rib pain has some characteristic symptoms:

  • The pain feels like a stabbing, sharp ache in the rib area that gets worse when breathing deeply or coughing.
  • It is often felt along the side, in the lower ribs.
  • The pain may radiate along the ribs or into the upper abdomen.
  • It tends to be sporadic, coming and going rather than constant.
  • Pain and tenderness can be felt when pressing along the ribs.
  • The pain may reduce with rest, massage, or application of heat.

Muscle pain generally feels worse when the muscles are contracted and may ease up when relaxed. The pain is localized to the muscle tissue itself rather than feeling internal.

What causes muscular rib pain?

There are a few common causes of muscular rib pain:

  • Overuse: Rib muscles can become strained due to repetitive overuse. Activities involving heavy lifting, bending, twisting, reaching can overwork the rib muscles.
  • Injury: Blunt trauma from an accident, fall, or blow to the chest can bruise or strain the rib muscles. Fractured ribs can also cause muscle spasms.
  • Poor posture: Slouching, hunching over, or constantly sitting at a desk can tighten chest and rib muscles, leading to pain.
  • Coughing: Prolonged bouts of coughing from colds, flu, or respiratory disorders can strain the rib muscles.

How is muscular rib pain diagnosed?

If rib pain persists, it’s a good idea to see a doctor. They will perform a physical exam and ask about symptoms. A doctor can diagnose muscular rib pain by:

  • Pressing along the ribs to pinpoint areas of tenderness – this indicates strained muscle fibers.
  • Checking range of motion – reduced movement points to tight, painful muscles.
  • Palpating the ribs and torso to rule out a fracture or other injury.
  • Considering risk factors like repetitive activities that could cause muscle overuse.
  • Ordering imaging like x-rays or CT scans if a fracture, bone lesion, or other injury is suspected.

Blood tests may also check for elevated muscle enzymes from damaged muscle tissue. Conditions like costochondritis which cause rib cartilage inflammation can cause similar muscular symptoms.

How is muscular rib pain treated?

The good news is muscular rib pain often improves with some simple home treatments:

  • Rest from any activities making the pain worse.
  • Ice packs applied to the tender rib areas to reduce inflammation.
  • OTC pain medication like NSAIDs to relieve pain and swelling.
  • Heat from hot packs or warm showers to encourage blood flow.
  • Stretching and massage to loosen tight chest and rib muscles.

Doctors may also recommend prescription muscle relaxers for severe muscle spasms. Physical therapy can help strengthen the rib muscles and improve posture. Make sure to avoid any movements that exacerbate the pain. See a doctor promptly if pain persists for over 1-2 weeks to check for complications.

How is muscular rib pain different from other causes?

There are some key differences between muscular rib pain and discomfort from other medical conditions:

Muscular Rib Pain Other Causes
Occurs sporadically, worsens with movement Persistent, constant pain
Local tenderness concentrated along ribs Pain felt internally in chest or upper abdomen
No other associated symptoms May have fever, cough, nausea, breathing problems
Not affected by breathing Pain worsens when inhaling
Improves with rest and massage Not significantly helped by rest or position changes

When to see a doctor

Make an appointment with your doctor if you have any of the following:

  • Rib pain that persists longer than 1-2 weeks
  • Pain that worsens or changes character
  • Difficulty breathing or intense pain when inhaling
  • Pain that interferes with sleep or daily activities
  • Fever, chills, cough, or unexplained weight loss
  • Known injury like car accident causing rib pain

Seeking prompt medical care rules out complications like pneumonia, fractures, lung disorders, or cancer which can involve rib pain. Always report severe, intense rib pain that takes your breath away as this may indicate a medical emergency.

When can rib pain indicate something serious?

While most rib pain results from harmless muscle strain, certain serious medical conditions can also cause rib pain. Seek immediate medical care for rib pain along with:

  • Shortness of breath, rapid heart rate, sweating
  • Fever over 101 F (38.3 C)
  • Chest pain that radiates into the arm, back, neck or jaw
  • Dizziness, fainting, nausea
  • Coughing up blood
  • Known trauma to the chest like from a car accident

These signs may indicate heart attack, pulmonary embolism, pneumonia, flu, fractures, or other conditions needing emergency treatment. Rib pain that becomes severe very suddenly may be a warning sign not to ignore.

Can muscular rib pain be prevented?

It’s not always possible to prevent rib muscle strains, but some proactive measures can help lower your risk:

  • Warm up properly before exercise and sports.
  • Maintain good posture during sitting and standing.
  • Avoid slouching and do regular chest stretches.
  • Limit repetitive overhead motions and heavy lifting.
  • Build up strength gradually when starting new activities.
  • Rest when fatigued to avoid overexertion.

Making sure to breathe fully and not hold your chest in a tight position for long periods can also help. Some people are more prone to rib strains due to poor flexibility. Addressing posture problems and muscle imbalances with physical therapy can make strained ribs less likely.


Rib pain is often just the result of minor strained muscles that improve within a few days or weeks. Pay attention for any localized pain along the ribs that changes with movement or breathing. Muscular rib discomfort generally responds well to rest, ice, OTC medications, and massage. See a doctor for any severe, persistent, or worsening rib pain to check for medical complications requiring treatment. Promptly seek emergency care for sudden, severe rib pain along with breathing problems, fever, or other concerning symptoms that could signal a serious medical issue. With proper precautions and treatment, most cases of strained intercostal muscles causing rib pain resolve without complications.