You likely feel concerned when you experience chest pain. This discomfort can be confusing, especially since over half of all chest pain presentations in emergency departments are non-cardiac.
This rib pain location chart offers a practical guide. It helps you quickly identify possible reasons for your rib discomfort based on where you feel the pain. This chest pain location chart is for informational purposes only. It is not a substitute for professional medical advice.
Key Takeaways
- Rib pain can come from many sources. These include muscle strains, nerve issues, or problems with other organs.
- The location of your rib pain helps identify its cause. Upper, mid-chest, side, lower, and back rib pain each point to different problems.
- Look for other symptoms like pain type, swelling, or a rash. These clues help you and your doctor understand the pain.
- Seek medical help for severe chest pain. Also get help if you have trouble breathing or if pain spreads to your arm or jaw.
Understanding Chest Pain Sources
To understand your rib pain, you first need to know about the structures in your chest. This foundational knowledge helps you identify where your discomfort might come from.
Rib Cage Anatomy
Your rib cage protects vital organs in your chest. It forms a strong bony and cartilaginous structure. The rib cage consists of several key parts. You have 12 pairs of ribs, making 24 total. The sternum, or breastbone, sits in the front of your chest. It has three parts: the manubrium, corpus sterni, and xiphoid process. Your ribs also connect to the thoracic vertebrae in your back.
Ribs have different classifications. The upper 7 pairs are true ribs. They connect directly to your sternum with cartilage. The 8th, 9th, and 10th pairs are false ribs. They connect indirectly to your sternum. The last 2 pairs are floating ribs. Their cartilaginous ends lie free in your body wall. Each rib has a head, neck, tubercle, and shaft. The rib cage also includes intercostal muscles between the ribs. These muscles help you breathe. Nerves run along your ribs, too.
Common Pain Categories
Rib pain can come from many sources. One common source is your musculoskeletal system. This includes injuries like falls, traffic collisions, or sports. These can lead to broken or bruised ribs. You might also pull muscles in your chest. Costochondritis is another musculoskeletal issue.
This is inflammation of the cartilage that joins your upper ribs to your sternum. Fibromyalgia is a chronic condition. It causes widespread musculoskeletal pain, including in your ribs. Osteoporosis can also weaken your bones. This makes your ribs prone to fractures.
Nerve-related issues can cause rib pain. For example, nerve compression from a rib fracture can cause discomfort. Infections can also lead to rib pain. Upper respiratory infections, bronchitis, or pneumonia can cause pain. This pain might come from the infection itself or from muscle strain due to coughing. Pleurisy, an inflammation of the lung lining, also causes sharp pain when you breathe.
Sometimes, pain in your ribs comes from other organs. Kidney stones can cause pain in your side that radiates to your ribs. Lung cancer can cause rib or chest pain. This pain often worsens when you breathe deeply, cough, or laugh. A diaphragmatic spasm can also cause sudden, intense rib pain.
Rib Pain Location Chart: What Your Pain Means
Understanding the specific location of your rib pain helps you identify its possible cause. This rib pain location chart guides you through different areas of your chest. It helps you understand what your discomfort might mean.
Upper Rib Pain
Pain in your upper rib area can stem from several sources. You might experience muscle strain in your pectoralis or intercostal muscles.
These muscles are in your chest and between your ribs. Costochondritis is another common cause. This condition involves inflammation of the cartilage connecting your ribs to your breastbone. It often affects the cartilage segments of your 2nd to 5th ribs. You feel reproducible tenderness without swelling.
Tietze syndrome is similar to costochondritis but rarer. It causes musculoskeletal chest pain and swelling at the front and top part of your chest wall. It usually affects only one of your top four ribs. You might notice localized swelling, often at the 2nd or 3rd rib junctions.
Other causes of upper rib pain include issues with your cervical spine or nerve impingement. These conditions can send pain signals to your upper chest. Pain from thoracic spine or costovertebral joints can also cause discomfort in this location. Sternalis syndrome is another musculoskeletal cause.
Mid-Chest and Sternum Pain
Pain in your mid-chest and around your sternum, or breastbone, often points to specific conditions. Costochondritis frequently causes this type of pain. It affects the cartilage where your 2nd to 5th ribs meet your breastbone. You might feel a low ache in your chest near the affected ribs. This pain can become sharp or stabbing when you move your chest or torso. Movements like deep breathing, coughing, sneezing, or twisting can worsen this pain. You might also feel tightness or have trouble catching a complete breath. The pain can increase with physical activity or when pressure is applied to your chest, like from a seatbelt.
Tietze’s syndrome also causes mid-chest pain, typically affecting the 2nd and 3rd rib junctions. A sternal fracture or muscle strain in your chest can also cause pain in this location. Sometimes, pain in this area comes from other organs. Acid reflux or GERD can cause irritation and pain, often called heartburn, after you eat.
Respiratory conditions like pleurisy, bronchitis, or pneumonia can also cause sternum pain. Pleurisy causes sharp pain when you breathe. Anxiety and panic attacks can make you feel a tight pain in your chest muscles. A heart attack is a serious condition. It can cause chest pain, often described as a constriction around your whole chest. This pain can also appear specifically in your sternum.
Side Rib Pain
Pain in your side rib area can result from various issues. Intercostal muscle strain is a common cause. These muscles sit between your ribs. Vigorous activities like sports, weightlifting, or abruptly twisting your torso can strain them. You might feel sudden pain after lifting, coughing, or throwing motions. Reaching, lifting while twisting, or even a fall can cause this strain.
A rib fracture or bruise can also cause significant pain in your side. Pleurisy, an inflammation of the lung lining, causes sharp pain when you breathe. Shingles, a viral infection, can cause a painful rash that follows a nerve path around your side.
Sometimes, internal organs refer pain to your side ribs. Kidney issues, including infections, can cause flank pain. This pain might feel like a rib problem.
Kidney pain usually sits deeper and higher in your back. Conditions like hepatitis or fatty liver disease can cause a dull ache under the right rib cage. This pain can radiate to your back. Gallstones can cause intense pain under the right rib cage. This pain can extend to your back. Gallbladder pain often wraps around to the front right side beneath your ribs.
Lower Rib Pain
Pain in your lower rib area can be tricky to diagnose. Slipping rib syndrome is one specific cause. This condition happens when the cartilage of your lower ribs (usually the 8th, 9th, or 10th) becomes hypermobile.
It can slip and irritate nerves. You might feel intermittent pain in your lower ribcage. A “Hooking Maneuver” helps diagnose this. A doctor slides fingertips under your costal margin and lifts. If this reproduces your pain, it suggests slipping rib syndrome. Muscle strain in your obliques or diaphragm can also cause lower rib pain.
Referred pain from internal organs is also common in this location. On your right side, conditions affecting your liver or gallbladder can cause pain under the right rib cage. On your left side, you might experience pain under the left rib cage from several sources. An enlarged spleen can cause discomfort and pain under the left rib cage. A ruptured spleen is a medical emergency.
It causes tenderness and pain under the left rib cage. Gastritis, an inflammation of your stomach lining, can cause pain in your upper abdomen near the left rib cage. Kidney stones or infections can cause pain under the left rib cage, even though kidneys are on either side of your spine.
Pericarditis, inflammation of the sac around your heart, can cause a dull ache or stabbing pain under the left rib cage. This pain often worsens when you lie down. You might also feel pain under the left rib cage from issues with your pancreas or colon. This pain under the left rib cage can be quite concerning. Therefore, if you have persistent pain under the left rib cage, you should seek medical advice. Understanding the cause of pain under the left rib cage is important.
Back Rib Pain
Pain in your back rib area can come from musculoskeletal issues. Intercostal muscle strains or injury can affect one or both sides under your rib cage. This causes wide-ranging pain.
Muscular tension or strain, often from heavy lifting or prolonged stress, can also cause back rib pain. Costochondritis can sometimes cause referred pain to your back. Fibromyalgia, a long-term condition, can cause body-wide pain, including in your ribs. Osteoporosis can weaken your bones.
This leads to micro-fractures in your ribs, causing substantial pain in your back. Strains or sprains in the muscles and ligaments connected to your rib cage also cause pain. Rib injuries, like fractures or contusions from falls or direct blows, cause sharp pain around your lower rib cage that radiates to your back.
Kidney-related conditions can also manifest as back rib pain. Kidney infections (pyelonephritis) and chronic kidney disease (CKD) can cause back pain. A urinary tract infection (UTI) can progress to a kidney infection. This results in severe back pain with fever and chills.
Polycystic kidney disease (PKD) can cause pain in your lower back. Kidney cancer may cause a persistent dull ache from the middle of your back to the bottom of your ribs. Kidney stones, mineral deposits in your kidneys, can cause pain that radiates to your ribs.
This pain can extend to the rib area because your kidneys are located beneath part of your rib cage. Shingles can also cause a painful rash and nerve pain in your back rib area.
| Rib Area | Location Description | Possible Causes | Notes / Symptoms to Watch |
|---|---|---|---|
| Upper Front Ribs | Just below the collarbone and upper chest | Costochondritis, muscle strain, coughing strain, rib fracture | Pain increases with deep breaths or pressing on rib joints |
| Middle Front Ribs | Center chest area near breastbone | Costochondritis, cartilage inflammation, GERD, anxiety tension | May feel sharp or pressure-like; may worsen with movement |
| Lower Front Ribs | Bottom of rib cage above abdominal area | Rib contusion, liver or gallbladder issues (right side), spleen issues (left side) | Persistent pain on one side may indicate organ involvement |
| Upper Side Ribs | Side of chest under armpit | Muscle strain (intercostal muscles), bruised ribs, shingles | Pain worsens with twisting, reaching, or coughing |
| Middle Side Ribs | Mid-chest flank area | Muscle strain, rib fracture, nerve inflammation | May feel sharp especially with rotation or deep breathing |
| Lower Side Ribs | Side of rib cage above hips | Kidney issues (back side), oblique muscle strain | Pressing or bending to the opposite side may increase pain |
| Upper Back Ribs | Upper back near shoulder blades | Thoracic spine misalignment, muscle spasm, posture strain | Pain may radiate into shoulders or neck |
| Middle Back Ribs | Mid-back along rib cage | Nerve compression, muscle strain, rib joint dysfunction | Pain may worsen when arching or twisting the back |
| Lower Back Ribs | Lower back near the waist | Kidney pain, muscle strain, thoracic spine issues | If accompanied by fever or urinary changes → seek medical care |
Accompanying Symptoms and Clues
When you experience rib pain, other symptoms can help you understand its cause. These clues guide you and your doctor toward an accurate diagnosis.
Pain Characteristics
The way your pain feels provides important information. You might feel a sharp or dull pain.
| Condition | Pain Characteristic |
|---|---|
| Muscle Sprains/Strains | Sharp or Dull |
| Intercostal Neuralgia | Intense burning or Sharp |
| Shingles | Acute, Sharp, and Stabbing |
| Costochondritis | Acute and Sharp |
You might notice pain when you breathe, cough, or move.
- Traumatic injury to your rib or forceful coughing can cause ribcage pain. This pain often occurs when you take deep breaths.
- Inflammation of your intercostal muscles, which expand and contract during breathing, can lead to ribcage pain. This typically happens when you take deep breaths.
- Costochondritis, inflammation of the cartilage connecting your ribcage to your breastbone, causes pain during deep breathing, coughing, or sneezing. This can feel like a sharp pain under the left rib cage or on the right.
Physical Signs
You can also look for physical signs. Swelling, redness, or tenderness to touch can indicate a problem. If you feel reproducible pain when someone touches the area, moves your chest, or when you take a deep breath, it often points to musculoskeletal chest wall pain. This is especially true if you feel pain under the left rib cage or any other rib area.
- Palpation should focus on five major areas: anterior muscle tenderness, costosternal/xiphoid junction tenderness, paraspinal tenderness, joint-play restriction, and end-play restriction.
- Your greatest discomfort might be at the costochondral joint at the level of your second rib.
- Pain can reproduce with palpation to the anteromedial aspect of your left ribs 2–4, the left side of your sternum, and the corresponding costochondral joint. This can help pinpoint the exact location of your rib pain.
Other Symptoms
Other symptoms can also give clues. You might have a fever, chills, or a rash. For example, shingles causes a rash that appears in a specific pattern on your body.
This rash can come with severe neuropathic pain, which may include rib pain. A shingles rash typically shows on one side of your torso, including the rib area. It is uncommon to find this rash on areas like your knees or elbows. If you have a rash with pain under the left rib cage, consider shingles.
Urgent symptoms require immediate medical attention. These include shortness of breath, dizziness, or chest tightness. If you experience severe pain under the left rib cage with these symptoms, seek help right away.
When to Seek Medical Help
You need to know when to get medical help for your rib pain. Some symptoms mean you should see a doctor right away. Others mean you should get checked if they do not go away.
Urgent Warning Signs
Some signs mean you need immediate medical care. These are serious. If you have severe chest pain, do not wait. This pain might feel like pressure or tightness in your chest. It can feel like someone is squeezing your chest. This type of pain can also spread to your arms, neck, jaw, back, or stomach.
These are signs of a potential heart attack or other serious cardiac event. You might also feel pressure or tightness in your chest instead of sharp pain. Pain in your arms, jaw, neck, or back can also point to a heart attack. Heartburn, indigestion, nausea, or vomiting can also be signs of a heart attack.
You should also seek help if you have severe, persistent, or worsening rib pain. Difficulty breathing or shortness of breath is a red flag. If your chest pain spreads to your arm, jaw, or back, get help.
Fever or chills can mean an infection. Dizziness, confusion, or feeling faint are also urgent symptoms. These symptoms can mean a serious cardiac issue or other life-threatening problem. Musculoskeletal issues, like costochondritis, can cause sharp, localized chest pain.
This pain often feels worse when you press on the area or move. This can closely resemble heart-related discomfort. Do not try to confirm chest pain on your own if you have these symptoms.
Persistent Pain Concerns
Sometimes, your rib pain is not an emergency, but it does not go away. If your rib pain lasts for a long time, you need to see a doctor. Rib pain is persistent if it lasts longer than six months. This means you should get a medical evaluation.
Untreated rib injuries can get worse over time. They can turn into chronic pain conditions. Serious conditions like lung cancer or a pulmonary embolism can cause persistent rib pain. These need quick treatment.
If you cannot breathe deeply because of pain, part of your lung might collapse. This can lead to pneumonia. Scar tissue can also form. This can cause chronic pain and limit how you move. Do not ignore concerning chest pain that lasts a long time.
Post-Injury Pain
You should always see a doctor if you have rib pain after an injury. Many things can cause rib injuries. These include blunt trauma, like from car accidents, assaults, or falls. Motorcycle accidents are also a common cause. Sports injuries or even severe coughing can cause rib injuries.
After trauma, you should manage your rib pain with medicine. Doctors often suggest a mix of pain relievers. You can start with simple over-the-counter options. These include ibuprofen or paracetamol. Stronger pain medicines like Codydramol or Co-codamol can also help. You usually take these for a few days to several weeks until the pain gets better.
This rib pain location chart helps you understand potential causes of your rib discomfort. While this guide offers helpful insights into various types of rib pain, it is not a diagnostic tool.
For any persistent rib pain or concerning chest pain, you must consult a healthcare professional. They provide an accurate diagnosis and a personalized treatment plan for your specific rib issues. Proper medical evaluation is vital for any ongoing rib pain. Your rib health is important. Do not ignore any new rib pain.
FAQ
What is costochondritis?
Costochondritis is inflammation. It affects the cartilage that connects your ribs to your breastbone. You feel localized pain. It often worsens with movement or pressure.
Can stress cause rib pain?
Yes, stress can cause rib pain. High stress levels lead to muscle tension. This tension can affect the muscles around your rib cage. You might feel tightness or discomfort in your chest.
When should I worry about rib pain?
You should worry about rib pain if it is severe. Seek help if you have trouble breathing. Also, get medical care if the pain spreads to your arm or jaw. These are urgent warning signs.
Is rib pain always serious?
No, rib pain is not always serious. Many times, it comes from muscle strain or minor injuries. However, you should always get new or persistent pain checked by a doctor. They can give you a proper diagnosis.
