Why Your Ribs Hurt When You Cough
Feeling a sharp or aching pain in your ribs when you cough can be an unsettling symptom. In many cases, minor rib injuries or strains resolve safely on their own with some rest and care. However, rib pain triggered by coughing can sometimes indicate an underlying lung, muscular, or bone condition requiring medical treatment.
What Your Ribs Actually Are
To understand why coughing can hurt your ribs, it helps to first know what ribs are and how they function. The rib cage refers to the bony structure of ribs surrounding the chest cavity, which also includes the breastbone (sternum) in front, spine behind, and costal cartilage connecting them.
Your 12 pairs of ribs serve important protective and physiological roles:
- Protect vital organs like heart and lungs inside chest cavity
- Assist breathing by allowing chest expansion and contraction
- Anchor upper body muscles involved in moving torso and arms
- Provide attachment points for tendons, nerves and blood vessels
How Can Coughing Strain Your Ribs?
Coughing generates powerful pressure changes and muscular convulsions inside the chest cavity. Both can stress and strain the rib cage, especially with forceful, repetitive coughs:
- Stretches and compresses ribs
- Strains rib joints where they connect behind to spine
- Irritates nerves traveling between ribs
- Inflames tissue around rib cage
Similar rib cage strain can occur with heavy lifting, athletic overexertion, excessive bending or twisting, hard falls directly onto the chest, or intense bouts of sneezing and vomiting.
Serious Causes of Rib Pain When Coughing
While moderate rib soreness from coughing often fades quickly, underlying medical issues sometimes produce more persistent, intense discomfort. See your doctor promptly about rib pain from coughing along with any of the following:
- Shortness of breath - Potential lung infection like pneumonia or pleurisy
- Fever, chills - Possible respiratory infection
- Bloody or yellow phlegm coughed up - May indicate lung abscess, bronchitis or other issue
- Known cancer history - Can spread to rib cage, like lung, breast or blood cancer (leukemia, lymphoma)
- Sudden, severe pain - Possible rib fracture from hard coughing or sneezing fits
- Chest deformation - Unusual rib hump indicates spine curvature problems like scoliosis or kyphosis
Common Causes of Non-Serious Chest and Rib Discomfort When Coughing
Often, rib cage pain triggered by coughing results from minor strains and inflammation treatable with self-care. However, recurring or worsening pain warrants medical evaluation.
Pulled Rib Muscles
Intercostal muscles run between each rib to support breathing. Heavy coughing can strain and overstretch these muscles, resulting in soreness resembling a bruised feeling along your ribcage and sometimes upper abdomen.
It hurts when breathing deeply or twisting your torso. The sore rib muscles also spasm painfully when you cough or sneeze. Resting your ribs and using cold packs can help recovery. Most muscle pulls heal within a few weeks.
Costochondritis
This painful condition inflames cartilage at the sternum (breastbone) points where your upper ribs attach in front. Intense coughing can trigger costochondritis flares producing localized chest tenderness.
Your sternum and ribs may feel exquisitely sensitive to touch and pressure, even from clothing. However, the condition is harmless and often clears up once coughing resolves. Until then, anti-inflammatory medication and heat pads can help symptoms.
Mechanical Stress
Other cases of rib discomfort when coughing stem from simple mechanical overexertion of muscles and connective tissues supporting the chest cavity rather than damage to the ribs themselves.
Examples include strain of ligaments anchoring ribs behind to spinal vertebrae or micro-tears in the diaphragm and abdominal muscles that unconsciously contract to assist forceful coughs.
As with pulled rib cage muscles, management involves rest, protecting ribs from further strain by limiting vigorous activity, and supportive home treatment like heat packs. Symptoms typically resolve within several weeks at most as strained soft tissues heal.
When to See Your Doctor About Rib Pain When Coughing
Occasionally, cough-related rib and chest pain reflects more serious injury or systemic illness requiring medical care. See your doctor promptly if you experience:
- Difficult, painful breathing
- Fever over 101 F
- Color changes like redness or brusing over painful rib area
- Sudden, severe chest pain
- Pain lasting over 3 weeks
- Signs of possible bone fracture - severe localized pain, swelling, bruising, misshapen area, hearing popping sound at time of injury
- Risk factors like osteoporosis or steroid medication that weaken bones and increase fracture risk from hard coughing
Evaluation starts with physical examination of your chest, lungs, ribs and spine. The doctor also reviews your medical history and risk factors. Further testing can include:
- Blood tests to assess for infections
- Chest x-ray to visualize rib cage and lungs
- CT scan for detailed images of bone, lung and tissue structures
- Breathing capacity tests (spirometry) if lung problems suspected
Most cases of rib and chest discomfort from coughing are harmless. However, dont ignore enduring or worsening pain or breathing problems, which can sometimes indicate serious medical issues requiring prompt evaluation and treatment.
When Chest and Rib Discomfort May Signal Arthritis
Inflammation affecting rib cage joints can also cause pain when coughing. This is often due to autoimmune forms of arthritis.
Two types known to affect chest structures are:
- Psoriatic arthritis - Joint disease related to the skin condition psoriasis, often involving inflammation where collarbones and breastbone meet ribs (sternoclavicular joints)
- Rheumatoid arthritis - The most common autoimmune arthritis that can affect small joints between ribs and breastbone (costochondral joints)
See a rheumatologist if your rib pain seems arthritis-related, including:
- Associated rashes, nail changes or eye inflammation
- Chest MRI detecting cartilage and bone damage
- Presence of rheumatoid factor or anti-CCP antibodies in bloodwork
- Family history of other autoimmune diseases
Early, aggressive treatment is key to prevent permanent damage to chest structures over time, along with closely monitoring lung function.
Disclaimer: This article is for informational purposes only and does not constitute medical advice. Always consult with a healthcare professional before starting any new treatment regimen.
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