Pain in the ribs is a characteristic of unpleasant sensations directly in the chest wall, and not inside it. Their source can be ribs (cartilage or their bony part), muscles and fascia adjacent to the ribs, intercostal nerves. These sources will be discussed in the article. The pain in the ribs can be sharp and aching-constant, stitching, dagger, pulling and resembling a hammered stake. They can be constant companions or appear at certain points: during physical exertion, sharp or awkward movements, uncomfortable postures, etc.
Only a specialist can figure out all this variety of symptoms and manifestations. Therefore, it is not necessary to postpone a visit to the doctor if the pain is disturbing, 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 dysfunctional, and it is necessary to find out its nature.
Rib like bone
The rib itself is an arched flat bone that connects the spinal column and sternum, forming the frame of the chest. It is attached to the spine by the condyle - a spherical end. At the sternum, the ribs are connected in pairs, but not all.
In total, there are 12 pairs of ribs, of which the first seven are considered true or real. They are associated with the sternum. The other 5 pairs are referred to as false ribs, because they have no connection with the sternum, but are only bonded to each other. The last 2 pairs of 5 are connected only to the spine - free ribs. For some reason, the attitude to these ribs in some women is rather dismissive. They calmly remove them to create a narrow waist for themselves, but nature does not create anything in vain, and such a solution is not the best solution.
Ribs - the base of the chest
Anomalies of the ribs and sternum, as well as the chest, are many, 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 edges - the absence or excess units. The sternum and chest shape itself may also be abnormal.
Rib injuries
Ribs can be injured during falls, bumps, and pain in such a place is the first symptom. Of the local symptoms can be noted: swelling, swelling, bruising, abrasions.
It is painful to touch the site of injury. In the area of costal fractures, it may prick while trying to inhale.
The pain at the site of the bruise appears upon palpation and is associated with a load, and when it relaxes, it subsides.
If the pleural sheets are damaged, pneumothorax develops. The intensity of the pain depends on the severity of the injury: with a bruise, it is sharp, but not strong, it can occur on either side, quickly goes into aching, and then passes 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 fracture of the rib is already a more serious thing. Pain occurs during inspiration, during movements. They are much more intense, longer, and can become spilled. There are 3 types of rib fractures:
- A crack is only a crack in the rib. It is considered the easiest degree of damage.
- Subperiosteal fracture - the rib is broken, but the periosteum is intact, there are no debris.
- A complete fracture of the rib is dangerous with its fragments, which can damage internal organs.
A patient with a suspected fracture should be taken to the emergency room and an X-ray taken. Gypsum is not applied to the ribs, but only a tight bandage is applied, 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.
Titz syndrome
This phenomenon also causes pain in the ribs. This is costal chondritis - a disease whose etiology has not been elucidated. Pathology is manifested in inflammation of the costal cartilage (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 noted not quite in the ribs themselves. There is pain between the ribs in front of the sternum, so they can be confused with an attack of angina pectoris. Sometimes an unpleasant sensation can occur on the sides of the sternum and radiate to the arm, neck, under the shoulder blade.
Of the additional symptoms, an inflamed rib site can be noted. When you click on the sternum or adjacent cartilage, the pain intensifies. For angina pectoris, this, of course, is uncharacteristic. For diagnosis, an x-ray is prescribed.
Anterior chest wall syndrome
The pain appears after a heart attack, with myositis, shoulder-shoulder periarthritis. It is spilled over the entire surface of the chest wall, especially at the level of the 2nd - 5th rib.
Malignant tumors
More often than others, osteosarcoma of the ribs is diagnosed - at almost any age. Signs of the disease: constant aching, stitching and pulling pains, which often bother at night. Sometimes the course may be asymptomatic, and after minor injuries suddenly appear again.
In the place of pain there may be bumps, swelling, a lump in the place of the tumor. Diagnosis requires a biopsy.
Osteochondrosis of the thoracic spine
It is quite rare, because this section 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 disk and adjacent vertebrae are affected. Compression of the nerve roots occurs, they become inflamed and severe pain occurs. Not only the back can be affected, but the whole arm to the fingertips. In this case, the pains are sharp, shooting, depending on the movements.
Hyperesthesia is noted in the affected areas. In addition, there is a feeling of numbness, burning, "crawling" in the innervation zone of the spine.
More often, pain occurs between the ribs in the front in the center, while the person describes his feelings as a "stake in the chest." Pain always tends to intensify during hypothermia, fading in one position for a long time, with sharp and awkward movements.
If with osteochondrosis there are pains between the ribs on the left side, then the pathology can also resemble ischemia.
Rib osteoporosis
Osteoporosis is a pathology of Ca deficiency, in which there is increased destruction of the bone and a decrease in its ability to recover. Pain in the ribs is a characteristic symptom. More often, the disease occurs in the elderly and for a long time does not give symptoms at all, as long as the bones are strong enough. But then pain occurs between the ribs and in the back, and they are associated with the fact that a lack of Ca leads to many microscopic fractures that irritate the periosteum. She reacts quickly due to the many nerve endings in her. People sleep poorly 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. The rootlets are also 12 pairs, they pass along the lower edge of the corresponding rib, are covered with fascia and pleura. They encircle the chest, contain sensitive receptors and, in some diseases of the spine, can cause pain in the ribs.
Intervertebral disc herniation
Disc herniation in the thoracic spine is relatively rare. The pains are localized not only between the ribs, but also in the back, in the region of the heart.
Costal algias are initially not very intense, but with the progression of pathology 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. She often gives to the neck, arm, accompanied by paresthesia (numbness, tingling), muscle atrophy.
Sometimes the attack resembles angina pectoris, but the difference will help establish the ECG. 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, stitching, lasts differently. Strengthens with any change of posture, movement, coughing and sneezing. Usually 2 of the most painful points are palpated: one of them is near the sternum and gives pain between the ribs in the center, and the second is next to the spine. Most often, the algia is short-term, passes without much treatment.
Muscle pain in the ribs
Such pains are aggravated by inspiration and movements - bending forward or backward, movements in the shoulder joints. Occur in the pathology of the intercostal muscles.
Hypertonicity of the pectoral muscles
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 movements. With too much physical exertion and muscle strain, pain may appear in the intercostal and pectoral muscles - krepatura. The reasons for it in such cases are due to the accumulation of lactic acid in the muscles, the pain passes by itself and does not require treatment. In such cases, you should only review the training schedule.
Fibromyalgia
Fibromyalgia is accompanied by muscle hypertonicity, but the etiology of this behavior of muscle tissue has not been elucidated. With fibromyalgia, the localization of pain between the ribs in the middle and intensifies only with upward movements of the arms or turns of the torso. Morning pain is characteristic. Fibromyalgia in every fourth person can affect different muscle groups.
Another feature: pain between the ribs on the left and right at the same time, i.e., the lesion is bilateral. Also, dizziness and dizziness may occur, and sleep may be lost. Symptoms worsen when the weather changes, that is, weather sensitivity is present.
Pain in the ribs with pleural diseases
Pleura is a connective tissue thin film that envelops the lungs from the outside, and the chest from the inside. Her diseases give pain in the ribs because she is very close to them, and there are a lot of nerve endings in her.
Acute dry pleurisy
Dry pleurisy is an inflammation of the pleura without exudate. The pains in the ribs are usually one-sided, they intensify during coughing, deep inspiration or tension. General health worsens, body temperature is elevated. In the evenings, excessive sweating, shortness of breath are disturbing. Dry cough is characteristic. To reduce pain, a person tries to lie on the affected side, then it subsides.
Pleural Tumors
Pleural tumors - 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 does not particularly bother. Pain can occur between the ribs on the left, on the right, that is, it is localized directly where the tumor itself is located.
Psychogenic pain
Pain in the ribs can occur with depressive states and with neurosis. In this case, unpleasant sensations can occur due to increased tension of the muscles of the chest or to be pseudo-pains.
Rib pain during pregnancy
Pain in the ribs can occur in pregnant women in the later stages. It is associated not with pathology, but with such factors:
- An increase in the size of the pregnant uterus, which grows up and begins to press from the inside to the lower ribs.
- The growth of the fetus - the child already has little space in his stomach and with his legs he rests on the ribs of his mother. If at the same time he is also pushing, then she has pain.
First aid
Before a doctor arrives or an ambulance arrives, you can do the following:
- As soon as pain between the ribs appears, you need to immediately take a position in which there will be no discomfort.
- Try not to move so that the pain does not intensify. Relieve the condition can be placed on a solid surface.
- To relieve pain, you can take analgesics - "Analgin", "Keton" and others. Call an ambulance.
- If the pains are localized on the left side, and there is a history of ischemia, the patient should be laid down, laid down, call an ambulance and give Nitroglycerin before her arrival.
- If pain in the intercostal space is accompanied by discomfort in the stomach, adequate drinking and a temporary refusal of food are indicated.
Treatment
Treatment of Titz syndrome is carried out by analgesics, anesthetics and warming procedures.
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, plasters. When acute inflammatory processes subside, massage and therapeutic exercises are necessary.
The basis for the treatment of pleurisy is antibiotic therapy and the removal of inflammation.
If 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 physical exertion. Therefore, with the upcoming weight lifting, you need to properly stretch your shoulders and muscles and only then lift weights. The back should remain straight, and the legs should be slightly bent at the knees.
Sometimes acute pain between the ribs is associated with hypothermia. In this case, you need to try to dress warmly and avoid the air conditioners turned on.
With sedentary work, the bones of the shoulders and neck experience additional stress, which means that it is important to monitor posture. An hourly warm-up is also welcome.