Rib, Chest and Upper Back Pain Causes


When people feel pain in the chest area, they often fear the worst. While it is important to be aware of symptoms that may indicate serious problems like a heart attack, it is also good to know that there are many causes of chest and rib pain that do not involve the heart.

Intercostal Muscle Strain

There are muscles in between the ribs called intercostal muscles. There are two sets: the internal and external intercostals. These muscles help to stabilize the chest wall and allow movement of the upper torso. Like any other muscle, the intercostals can be strained when you perform a strenuous activity or from repeated movements like twisting or bending.

When a muscle is strained, it undergoes tearing and inflammation. Strained muscles are often tender to the touch. It is characteristic of torn rib muscles to cause sharp pain when inhaling or sneezing. Muscle strains heal with a day or two of rest usually, but since the intercostal muscles are used with every breath we take, they may take a little longer to recover.

Costovertebral Joint Dysfunction

12 pairs of ribs attach to the thoracic spine in the upper back. The joint that attaches the rib to the vertebra is called the costovertebral joint, and there is one on each side of every thoracic vertebra. When a vertebra becomes misaligned (subluxated), the costovertebral joint also becomes misaligned. This can cause inflammation and stiffness of the joints. Pain may radiate throughout the upper back and ribcage, particularly if nerves that run along the ribs are irritated by the joint.

Thoracic joint problems are relatively rare, considering that this spinal segment doesn’t move very much. It is more likely a concern for someone who has suffered a blow to the upper back or who engages in regular activity that demands high levels of twisting. It is also possible that poor posture could result in strain to the thoracic joints. Chiropractic care can help realign the spine.


Costochondritis is a poorly understood medical condition characterized by inflammation of the cartilage connecting the ribs to the sternum. Most of the time a cause for the condition is not found. A few known causes are infection from a surgical procedure, tumors, strain from lifting or severe cough, a hard blow to the chest and arthritis.

Pain from costochondritis generally affects people on the left side and at more than one rib level. It is worsened by coughing and deep breaths. Treating the condition depends on its cause. Antibiotics can help if an infection is the cause. Stretching and rest may be helpful in the case of strain. Anti-inflammatory medications may be prescribed. Generally the condition in itself is not dangerous, but it could point to a serious cause and requires medical attention.

Whenever you have pain in your chest, it should be taken seriously. However, it is important to be aware of all potential causes, not just the most serious ones.