Anyone may experience a sharp pain in their side as a random occurrence. In this case there shouldn’t be too much to worry about aside from overexertion but if you are experiencing repeated or prolonged sharp pains alongside other symptoms, this may be a sign of a deeper health issue.
A sharp pain in your ribs may be indicative of anything from acid reflux to broken bones. Sharp pain in your ribs/chest may also be a sign of a heart attack, usually accompanied by other symptoms, that will require emergency medical attention. You may also want to see your doctor if you are in significant pain or are worried that the symptoms you are displaying are a symptom of an undiagnosed medical condition.
It is important to check what may be causing your rib pain so you can manage and treat it.
Sharp pain in the ribs can be caused by a number of things, from problems with the rib cage muscles, cartilage, and bones to more serious medical conditions like heart problems and lung cancer. To determine the cause of sharp pain in your ribs, you should also consider what other symptoms you are having, as this could help your doctor diagnose your condition.
There are also many management and treatment options available to minimise your pain.
Causes of rib pain
If you experience sharp pains in your ribs or chest, you should seek emergency medical attention, as this may be a sign of a heart attack.
The NHS states that the symptoms of a heart attack include:
- Pain in the arms, back, neck and jaw
- Chest pain, tightness and heaviness
- Excessive sweating
- Nausea and vomiting
Do not wait to call the emergency services for medical attention if you suspect you are having a heart attack.
HeartZZ disease may also cause pain in the rib area. This will usually be accompanied by other symptoms such as pain in the chest, breathlessness and pain or swelling in the hands, arms, feet and legs. Heart disease can lead to heart failure or a heart attack if left untreated.
Muscle, Bone, Ligament & Cartilage Problems
Sharp pain in the ribs is commonly caused by problems with the muscles, bones, ligaments and cartilage of and around the rib cage. Some of these problems may be:
- Slipping rib syndrome is sometimes diagnosed when you are experiencing sharp pain in the lower rib cage and occurs when the ligaments holding the bottom ribs become damaged in an injury or accident. Pain may occur or be more pronounced when you’re moving around, coughing or laughing1
- Costochondritis is when the breastbone (bone in the middle of your chest connected to your ribs) becomes inflamed. Sharp pain will usually occur when you’re deep breathing, placing pressure on the breastbone or moving around a lot. It usually affects the left side of the rib cage. Many things can cause costochondritis including an injury or strain from excessive exercise or coughing. Sometimes the underlying cause of costochondritis can be an infection or autoimmune disease (such as fibromyalgia or rheumatoid arthritis) affecting the cartilage joints in the back2
- Broken ribs could also be the cause of sharp pain in your side especially if you’ve just had a motor vehicle or sports injury or other impact accident. The pain may intensify when you take a deep breath or move around a lot. You should seek medical attention if you’ve had an accident and have pain in the rib cage as you need to know whether your rib has been fractured or completely broken. A fractured rib is less serious than a completely broken rib - if the rib bone has been cleanly broken or shattered into several pieces there is risk of complications such as the blood vessels or lungs being punctured by sharp broken bone fragments3
- Intercostal neuralgia is nerve pain caused by damage to the intercostal nerves around the ribs, chest and abdomen. Pain may be a sharp, achey or burning feeling in the front and back of the abdomen. In advanced cases intercostal neuralgia may also cause numbness, tingling or decreased ability to move around4
- Intercostal muscle strain is also a cause of rib pain. The intercostal muscles are the muscles around the rib cage and they can be strained by excessive coughing, strenuous exercise and an accident injury
Pulmonary embolism is a blot clot which travels from the leg and situates in the blood vessels surrounding the lungs. It stops blood from reaching the lungs causing damage to the lung tissue and causing pain in the chest/rib area. Pulmonary embolisms are a serious health issue which requires immediate, often life-saving treatment.2
Bone pain in the rib cage may be a symptom of late stage lung cancer. Bone pain rarely occurs in the early stages of the disease. Symptoms of lung cancer include pain while breathing, long-term cough, wheezing, cough that produces blood or dark red phlegm, excessive tiredness and otherwise unexplained weight loss.5
Other health conditions
Gallstones may cause sharp rib pain if they become entrapped in the bile ducts of the digestive system. Pain may be episodic but not relieved by being sick, toileting or passing wind. Severe cases of gallstones can cause a buildup of bile in the liver, pancreas or small bowel that can pose a medical emergency. You should seek urgent medical advice if you develop a case of jaundice, fever or extreme pain that cannot be relieved or that lasts for longer than 8 hours.
Pain that occurs particularly behind the left rib may be due to a problem with the spleen. The pain may also extend to the left shoulder in certain positions. A ruptured spleen is life-threatening as it can cause internal bleeding and must be dealt with by an emergency medical service team.
Management and treatment for rib pain
If you suspect your pain is due to a heart attack you should contact the emergency services to receive life-saving medical treatment.
Treatment for broken bones or strained muscles and ligaments will usually focus on pain management. You may be able to take over-the-counter or prescribed pain medication depending on your medical history. Other pain management techniques include using a hot or cold compress at the site of pain, resting and doing small amounts of gentle physical exercise.3
Many problems with the rib bones and muscles or ligaments heal on their own if the injury/condition is properly managed.3
If your rib pain is due to another underlying health condition, the treatment you require will be tailored to treat the cause such as specific medication or therapies.
How is pain rib pain diagnosed
The causes of sharp rib pain all have overlapping and similar symptoms so it is important to see your doctor so they can diagnose you with the correct medical condition.
They should first take note of your medical history and any other symptoms you are experiencing. They may then do a physical examination to determine the cause of your rib pain. This usually involves palpating the affected area to check for physical abnormalities with the rib cage.
Your doctor may also then refer you for a scan such as an x-ray to check for broken bones and more serious lung conditions.
When should I see a doctor
You should see your doctor if your pain is prolonged or happens continuously. You should also see your doctor to rule out any of the more serious health conditions associated with sharp pain in the rib cage. You will need emergency medical attention if you think you are having a heart attack.
If your pain is particularly hard to manage or is affecting your daily activities and mental health, seeing your doctor can help you to cope better with the pain.
A sharp pain in your ribs can be alarming. It can also be difficult to determine the cause on your own, as deeper investigations are often needed to rule out the more serious conditions. If you are experiencing unbearable chest/rib pain or pain after an injury to the rib cage, it is important to seek emergency medical attention. Other treatment options such as pain relief medication and management techniques specific to your ailment will also be recommended to you by your doctor.
- Foley CM, Sugimoto D, Mooney DP, Meehan WPI, Stracciolini A. Diagnosis and treatment of slipping rib syndrome. Clinical Journal of Sport Medicine. 2019;29(1):18. doi:10.1097/JSM.0000000000000506
- Schumann JA, Sood T, Parente JJ. Costochondritis. In: StatPearls. Published online 2022. https://europepmc.org/article/NBK/nbk532931#_article-20071_s5_
- Wu WM, Yang Y, Gao ZL, Zhao TC, He WW. Which is better to multiple rib fractures, surgical treatment or conservative treatment? Int J Clin Exp Med. 2015;8(5):7930-7936. Accessed April 18, 2023. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4509295/
- Fazekas D, Doroshenko M, Horn DB. Intercostal neuralgia. In: StatPearls. StatPearls Publishing; 2023. Accessed April 18, 2023. http://www.ncbi.nlm.nih.gov/books/NBK560865/
- Potter J, Higginson IJ. Pain experienced by lung cancer patients: a review of prevalence, causes and pathophysiology. Lung Cancer [Internet]. 2004 Mar 1 [cited 2023 Apr 20];43(3):247–57. Available from: https://www.sciencedirect.com/science/article/pii/S0169500203004586