Rib pain is a characteristic of discomfort directly in the chest wall, not inside it. Their source can be the ribs (cartilaginous or their bone part), muscles and fascia adjacent to the ribs, intercostal nerves. These sources will be discussed in the article. Pain in the ribs can be sharp and aching-constant, stabbing, dagger, pulling and reminiscent of a driven stake. They can be constant companions or appear at certain moments: during physical exertion, sudden or awkward movements, uncomfortable postures, etc.
Only a specialist can understand all this variety of symptoms and manifestations. Therefore, it is not necessary to postpone a visit to the doctor if the pain bothers, for example, only on the right, according to the principle: "this is not the heart, and there is nothing to worry about." Any pain is unfavorable, and it is necessary to find out its nature.
Rib like bone
The rib itself is an arcuate flat bone that connects the spinal column and the sternum, forming the frame of the chest. It is attached to the spine by a condyle - a spherical end. Ribs at the sternumconnect in pairs, but not all.
There are 12 pairs of edges in total, of which the first seven are considered true or real. They are connected to the chest. The other 5 pairs are referred to as false ribs, because they have no connection with the sternum, but are fastened only to each other. The last 2 pairs of 5 are connected only to the spine - free ribs. For some reason, some women have a rather dismissive attitude towards these ribs. They calmly remove them to create a narrow waist for themselves, but nature does not create anything in vain, and such a decision is not the best solution.
Ribs are the backbone of the chest
There are a lot of anomalies of the ribs and sternum, as well as the chest, and they are not so rare. For example, the very shape of the ribs may be abnormal - spade-shaped bones, split like a fork, perforated or fused, underdevelopment of the sternal ends, etc.
Anomalies in the number of ribs - the absence or extra units. The sternum and the shape of the chest itself may also be abnormal.
Rib injuries
Ribs can be injured during falls, bumps, and pain in such a place is the first symptom. Local symptoms include: swelling, swelling, bruises, abrasions.
It hurts to touch the injury site. In the area of rib fractures, it can stab when trying to inhale.
Pain at the site of the bruise appears on palpation and is associated with the load, and with relaxation it subsides.
If the pleural sheets are damaged, pneumothorax develops. The intensity of pain depends on the degreethe severity of the injury: when bruised, it is sharp, but not strong, it can occur on any side, quickly turns into aching, and then disappears completely. It is not always possible to clearly distinguish between a bruise and a fracture. Therefore, it is better to take an x-ray.
A broken rib is a more serious thing. Pain occurs when inhaling, during movements. They are much more intense, longer and can become spilled. There are 3 types of rib fractures:
- A crack is just a broken rib. Considered the lightest degree of damage.
- Subperiosteal Fracture - The rib is fractured but the periosteum is intact, no debris.
- Complete fracture of the rib - dangerous for its fragments, which can damage internal organs.
A patient with a suspected fracture should be taken to the emergency room and x-rayed. Gypsum is not applied to the ribs, but only a tight bandage is made, which will limit the respiratory excursion of the lungs and reduce pain. Then the injured area heals faster. For complex fractures with fragments, when the lungs or pleura are damaged, surgery is required.
Tietze Syndrome
This phenomenon also causes pain in the ribs. This is costal chondritis - a disease whose etiology has not been elucidated. Pathology manifests itself in inflammation of the costal cartilages (one or more). Most often this is the 2nd and 3rd rib.
Inflammation is usually aseptic. The pain in the syndrome is very sharp and sharp. They are marked not quite in the ribs themselves. There is pain between the ribs in front of the sternum, so they can be confused with an angina attack. Sometimes an uncomfortable feeling canarise on the sides of the sternum and radiate to the arm, neck, under the shoulder blade.
Of additional symptoms, an inflamed costal area can be noted. When you press on the sternum or adjacent cartilage, the pain intensifies. For angina pectoris, this is, of course, uncharacteristic. An x-ray is prescribed for diagnosis.
Anterior chest wall syndrome
Pain appears after a heart attack, with myositis, humeroscapular periarthritis. It has a diffuse character over the entire surface of the chest wall, especially at the level of the 2nd - 5th rib.
Malignant tumors
Osteosarcoma of the ribs is diagnosed more often than others - at almost any age. Signs of the disease: constant aching, stabbing and pulling pains, which often bother at night. Sometimes the course can be asymptomatic, and after minor injuries, it suddenly reappears.
In the place of pain there may be irregularities, swelling, a bump at the site of the tumor. Biopsy required for diagnosis.
Osteochondrosis of the thoracic spine
It is quite rare, because this part of the spine does not experience particularly heavy loads.
Osteochondrosis of the spine in general is a degeneration of the intervertebral discs. The beginning of the pathology is observed in the pulp, then the entire disc and adjacent vertebrae are affected. There is compression of the nerve roots, they become inflamed and severe pain occurs. Not only the back can be affected, but the whole arm to the fingertips. At the same time, the pains are sharp, shooting, depending on the movements.
Bhyperesthesia is noted in the affected areas. In addition, there is a feeling of numbness, burning, "crawling" in the zone of innervation of the spine.
More common is pain between the ribs in front of the center, while the person describes their sensations as "a stake in the chest." Pain always tends to increase with hypothermia, freezing in one position for a long time, with sudden and awkward movements.
If osteochondrosis causes pain between the ribs on the left side, then the pathology may also resemble ischemia.
Osteoporosis of the ribs
Osteoporosis is a pathology of Ca deficiency, in which there is an increased destruction of the bone and a decrease in its ability to recover. Pain in the ribs is a typical symptom. More often the disease occurs in older people and for a long time does not give symptoms at all, as long as the bones are strong enough. But then there are pains between the ribs and in the back, and they are associated with the fact that the lack of Ca leads to many microscopic fractures that irritate the periosteum. She reacts quickly because of the many nerve endings in her. People do not sleep well due to pain, their mood decreases. For diagnosis, x-rays and blood biochemistry are performed.
Pain in the ribs with pathologies of the spine
Painful manifestations in this case originate from the spinal roots on the right and left and approach the ribs. There are also 12 pairs of roots, they run along the lower edge of the corresponding rib, covered with fascia and pleura. Encircling the chest, contain sensitive receptors and, with somediseases of the spine can give pain in the ribs.
Herniated disc
Herniated discs in the thoracic spine are relatively rare. Pain is localized not only between the ribs, but also in the back, in the region of the heart.
Rib algias are not very intense at first, but with the progression of the pathology they become unbearable, in the form of lumbago. According to the localization of the hernia, only pain between the ribs on the right or left, and sometimes on both sides, can be noted. It often radiates to the neck, arm, accompanied by paresthesias (numbness, tingling), muscle atrophy.
Sometimes an attack resembles angina pectoris, but an ECG will help establish the difference. Pain in the ribs with intervertebral hernias depends on movements, coughing, staying in a certain position. Diagnostics - MRI, CT. Treatment is carried out by a neurologist.
Intercostal neuralgia
Intercostal neuralgia is irritation or pinching of the intercostal nerves. The reasons may be different. The pain is sharp, stabbing, lasts in different ways. It is aggravated by any change in posture, movement, coughing and sneezing. Usually 2 most painful points are palpated: one of them is located near the sternum and gives pain between the ribs in the center, and the second is near the spine. Most often, algia is short-lived and goes away without much treatment.
Muscle pain in ribs
Such pains are aggravated by inhalation and movements - bending forward or backward, movements in the shoulder joints. Occur in the pathology of the intercostal muscles.
Pectoral hypertonicity
Pain in the intercostal space occurs due to increased muscle tone as a result of physical overload. A characteristic feature is increased pain in the side between the ribs during movement. With too much physical exertion and stretching of the muscles, pain in the intercostal and pectoral muscles may appear - krepatura. Its causes in such cases are due to the accumulation of lactic acid in the muscles, the pain goes away on its own and does not require treatment. In such cases, you should only review the training schedule.
Fibromyalgia
Fibromyalgia is accompanied by muscle hypertonicity, but the very etiology of this behavior of muscle tissue has not been elucidated. With fibromyalgia, the localization of pain between the ribs is in the middle and increases only when moving the arms up or turning the torso. Typical morning pain. Fibromyalgia in one in four people can affect different muscle groups.
One more feature: pain between the ribs on the left and right at the same time, that is, the lesion is bilateral. It can also hurt and dizzy, sleep is lost. Symptoms worsen when the weather changes, that is, there is meteosensitivity.
Pain in the ribs in diseases of the pleura
Pleura is a thin connective tissue film that envelops the lungs from the outside, and the chest from the inside. Her illnesses give pain in her ribs because she is very closely adjacent to them, and she has a lot of nerve endings.
Acute dry pleurisy
Dry pleurisy is an inflammation of the pleura without exudate. Pain in the ribs is usually unilateral, during coughing, deep inspiration or tension, they increase. Generalhe alth worsens, body temperature is elevated. In the evenings, there is increased sweating, shortness of breath. Characterized by dry cough. To reduce pain, a person tries to lie on the affected side, then it subsides.
Tumours of the pleura
Tumours of the pleura are benign or malignant tumors. They are quite rare. The pain in this case, as a rule, is constant, aching and for a long time the patient is not particularly worried. There may be pain between the ribs on the left, on the right, i.e., it is localized directly where the tumor itself is located.
Psychogenic pains
Pain in the ribs can occur in depressive states and in neuroses. In this case, discomfort may occur due to increased tension in the muscles of the chest or be pseudo-pain.
Rib pain during pregnancy
Rib pain can also occur in late pregnancy. It is not associated with pathology, but with such factors:
- The increase in the size of the pregnant uterus, which grows upward and begins to press from the inside on the lower ribs.
- The growth of the fetus - there is already little space in the baby's stomach and its legs rest against the mother's ribs. If he also pushes, then she gets pain.
First Aid
Before the arrival of the doctor or the arrival of the ambulance, you can do the following:
- As soon as there is pain between the ribs, you need to immediately take a position in which there will be no discomfort.
- Try not to move so the pain doesn't get worse. Placement on a hard surface may help relieve the condition.
- To relieve pain, you can take analgesics - "Analgin", "Ketons" and others. Call an ambulance.
- If the pain is localized on the left side, and there is a history of ischemia, the patient should be laid down, create rest, call an ambulance and give Nitroglycerin before her arrival.
- If pain in the intercostal space is accompanied by discomfort in the stomach, sufficient drinking and temporary refusal of food is indicated.
Treatment
Tietze syndrome is treated with analgesics, anesthetics and warming treatments.
Osteochondrosis, intercostal neuralgia - the use of NSAIDs, thermal procedures. Anti-inflammatory drugs are prescribed in tablets, and for local treatment in the form of ointments, gels, patches. With the subsidence of acute inflammatory processes, massage and therapeutic exercises are necessary.
The basis of the treatment of pleurisy is antibiotic therapy and the removal of inflammation.
If the pain between the ribs appears due to muscle spasms, antispasmodics and muscle relaxants are prescribed.
Other treatments
Physiotherapy (especially electrophoresis, magnetotherapy, etc.), manual therapy, acupuncture will help relieve pain and swelling, relax muscles. After an acute period, you can do exercise therapy, swimming, balneotherapy.
Prevention
Pain between the ribs is often caused by exercise. Therefore, with the upcoming lifting of weights, you need to properly stretch your shoulders and muscles and only then lift weights. The back must remain straight andlegs should be slightly bent at the knees.
Sometimes a sharp pain between the ribs is associated with hypothermia. In this case, you should try to dress warmly and avoid turning on the air conditioners.
During sedentary work, the bones of the shoulders and neck experience additional stress, which means that it is important to monitor your posture. An hourly warm-up will not hurt either.
