Rib Pain
Most rib pain comes from the small joints and muscles of the rib cage and mid-back rather than anything sinister, and this kind of mechanical rib pain usually responds well to hands-on treatment.
At Newhill Osteopathy in Horley we see a lot of sharp, catching rib pain, from a rib that has become irritated after a twist or a bout of coughing, to a nagging ache between the shoulder blades that wraps around the side. This page explains the kinds of rib pain we treat, what tends to cause them, and what an appointment actually involves. Please do read the safety note further down first, as chest and rib pain occasionally needs a doctor rather than an osteopath.
What types of rib pain can osteopathy help with?
An irritated or “stuck” rib joint
Each rib joins the spine at a small joint, and when one becomes stiff or irritated it can give a sharp, catching pain, often felt with a deep breath, a cough, or twisting to reach behind you. It feels alarming but usually settles well with gentle treatment.
Costochondritis (pain at the front)
Tenderness where the ribs meet the breastbone at the front of the chest. It can be sore to press on and uncomfortable with deep breathing, and although it can linger, it is not dangerous.
Muscle strain between the ribs
The small muscles between the ribs can be strained by heavy coughing, reaching, lifting or a sudden twist, leaving a sore, tight band along the rib.
Rib pain from a stiff mid-back
When the mid-back does not move well, the strain is often felt around the ribs and side rather than in the spine itself. Freeing up the mid-back tends to ease it.
Why does rib pain happen?
There is rarely one single cause. It is usually a mix of everyday things:
- Twisting or reaching awkwardly – a sudden movement that strains a rib joint that was already a little stiff.
- A bout of coughing – repeated hard coughing works the rib muscles and joints hard.
- Posture and desk set-up – long spells slumped forward stiffen the mid-back and load the ribs.
- Lifting or carrying – particularly something heavy or held out to one side.
- A stiff mid-back – if the thoracic spine does not move freely, the ribs take up the slack.
- An old knock – a previous bump to the rib cage can leave an area that still grumbles.
What happens at your appointment?
- We listen first. Where the pain sits, what brought it on, what makes it better or worse, and whether anything about it needs medical attention rather than osteopathy.
- We examine you. We look at how your mid-back and ribs move and breathe, and check that the pain behaves like a mechanical problem.
- Hands-on treatment. Gentle mobilisation of the rib and mid-back joints, soft tissue work and stretching, always chosen to suit you. You can say no to anything.
- Practical advice. Breathing and posture tips, and a realistic plan to settle it and keep it away.
Simple things you can try at home
- Keep gently moving rather than holding yourself rigid, which tends to stiffen things further.
- Gentle mid-back rotations and slow, easy deep breaths, kept well within comfort.
- A warm wheat bag over the sore area for ten to fifteen minutes to help tight muscles let go.
- If coughing is the culprit, hugging a cushion to the area as you cough can ease the strain.
- Avoid heavy or awkward lifting until the sharp catch has settled.
Please seek medical help, not osteopathy, if rib or chest pain comes with crushing or central chest pain, pain spreading to the jaw or arm, breathlessness, sweating, dizziness or a very fast heartbeat – call 999, as these can be signs of a heart problem. You should also see a doctor promptly if your rib pain followed a significant fall or accident, or comes with a fever, a persistent or productive cough, breathlessness, coughing up blood, or unexplained weight loss. These need medical attention rather than osteopathy.
More reading
- Why your posture matters more than you think – posture and rib or mid-back pain often go hand in hand.
You can also see everything we treat on our conditions page.
Frequently asked questions
My rib pain is sharp when I breathe in or twist. Is that typical of a mechanical problem?
It often is. A sharp, catching pain that comes with a deep breath, a cough or twisting is a very common pattern when a rib joint has become stiff or irritated, and it usually responds well to gentle treatment. That said, chest and rib pain can occasionally have more serious causes, so if the pain is severe, came on with breathlessness, or is accompanied by any of the warning signs in the note above, please get it checked medically first.
Can osteopathy help a “stuck” or “out” rib?
Ribs do not really pop out of place, despite how it can feel, but a rib joint can certainly become stiff and irritated, which gives that catching, locked sensation. Gentle mobilisation of the rib and the neighbouring mid-back joints usually eases it and gets you breathing and turning more comfortably, and we choose techniques to suit you rather than anything forceful.
Can rib pain really come from my mid-back?
Yes, and it catches people out. The ribs and the mid-back work as one unit, so a stiff area in the thoracic spine often shows itself as pain around the side or front of the rib cage rather than in the spine itself. That is why we treat the mid-back and the ribs together rather than focusing only on the spot that hurts.
How do I know my rib or chest pain is not my heart?
This is an important question and worth taking seriously. Mechanical rib pain can usually be reproduced by moving, twisting or pressing on the sore spot, and it tends to be sharp and well localised. Pain that comes from the heart is more often a heavy, crushing or tight feeling in the centre of the chest, may spread to the jaw or arm, and can come with breathlessness, sweating or feeling unwell. If there is any doubt, or any of those warning signs, do not wait to see an osteopath – call 999 or seek urgent medical help.
How long does a rib strain take to settle?
Most mechanical rib problems ease over a few weeks, though they can take a little longer if breathing and coughing keep aggravating the area, since the ribs are in constant use. Gentle treatment and keeping the mid-back moving usually speed things along. We will give you an honest idea of your own timescale once we have examined you.
Book an appointment
If rib pain is getting in the way of breathing easily, sleeping or moving comfortably, we would be glad to help. Call 01293 369 442, email [email protected], or book online.