Why Do My Ribs Hurt When Coughing? A Complete Overview

Why Do My Ribs Hurt When Coughing?

If you've ever had the unpleasant experience of severe rib pain when coughing, you know how debilitating it can be. This intense pain is often caused by bruising or inflammation of the ribs or cartilage due to prolonged coughing. When you understand the anatomy behind this pain, it becomes clear why forceful coughing can lead to rib injuries.

Anatomy of the Ribs

Your ribs are attached to your spine in the back and your sternum (breastbone) in the front by costal cartilage. This cartilage provides flexibility, allowing your ribcage to expand when inhaling and recoil when exhaling. The intercostal muscles between your ribs power inhalation by pulling your ribs up and outward. Your diaphragm and chest wall muscles drive exhalation by pushing your ribs inward and downward. Your ribs move with every breath thanks to this elegant anatomical design.

When you cough forcefully and repeatedly, your ribs sustain significant stress. The costochondral joints where the ribs meet the cartilage can become inflamed or even partially dislocated. The intercostal muscles strain to both expand the ribcage on inhalation and rapidly contract it while coughing. Prolonged, violent coughing essentially leads to rib cage trauma, causing inflammation and pain.

Common Causes of Rib Pain When Coughing

There are several common respiratory conditions that can cause repeated bouts of coughing, leading to rib pain:

• Upper respiratory infections - The common cold, flu, bronchitis, pneumonia, and sinus infections all spark coughing as your body tries to clear infected mucus from your airways.
• COPD - Chronic obstructive pulmonary disease results in inflamed airways and excess mucus production, both of which precipitate coughing.
• Asthma - Asthma attacks trigger severe coughing, wheezing, and difficulty breathing due to airway swelling and mucus buildup.
• Lung cancer - Lung tumors or cancer can block airways and displace tissues, leading to chronic coughs.

Repeated bouts of prolonged, forceful coughing from any respiratory condition can strain the rib joints and muscles, resulting in inflammation and pain.

Other Causes of Rib Pain When Coughing

Sometimes rib pain induced by coughing is unrelated to respiratory illness. Other possible causes include:

• Injury - Any recent trauma to the ribs, like a fracture, bruise, or joint sprain, makes coughing excruciating.
• Osteoporosis - Brittle, weak bones from osteoporosis put you at high risk for rib fractures and injuries when coughing.
• Arthritis - Osteoarthritis affecting the costochondral joints can cause severe pain when coughing.
• Gastric reflux - Acid reflux can cause both coughing and inflammation around the ribcage.

When to See a Doctor

Occasional rib discomfort when coughing fiercely isn't necessarily concerning. However, seek prompt medical care if you experience:

• Very severe or worsening rib pain when coughing
• Pain persisting for a week or more after your cough subsides
• Difficulty breathing or intense pain with inhalation
• Signs of infection like fever, chills, excessive phlegm
• Any history of trauma, osteoporosis, arthritis, or cancer

These red flags could signify fractured ribs, pneumonia, pleurisy, or other complications warranting immediate treatment.

How Are Rib Injuries Diagnosed?

To determine the cause of your rib pain when coughing, your doctor will:

• Ask about your symptoms and medical history
• Listen to your breathing and cough with a stethoscope
• Check for signs of respiratory infection
• Palpate the ribs to pinpoint pain or abnormalities
• Order imaging tests like x-rays, CT scans, or MRI scans of the ribs

These tests help identify any rib fractures, arthritis, osteoporosis, muscle strain, or other injures prompted by coughing. Imaging can also detect lung tumors, infections, or blockages triggering chronic coughs.

How to Treat Painful Ribs from Coughing

To ease rib discomfort from coughing, try:

• OTC pain relievers - Anti-inflammatories like ibuprofen can alleviate pain and swelling.
• Ice packs - Applying cold compresses to the sore ribs reduces inflammation.
• Rest - Avoid any strenuous physical activity to allow ribs to heal.
• Rib binders - Wrapping the chest provides compression and limits painful rib movements.
• Postural changes - Find positions that minimize pain when breathing and coughing.

Your doctor may also prescribe stronger NSAID pain relievers, oral steroids, muscle relaxers, or even painkilling injections for more severe rib injuries.

How to Prevent Painful Rib Injuries When Coughing

You can reduce your odds of incurring rib pain and trauma from coughing by:

• Treating any respiratory illness promptly with antibiotics, inhalers, etc.
• Practicing good cough etiquette by coughing into your sleeve.
• Using cough drops or throat sprays to minimize coughing.
• Avoiding smoke inhalation which aggravates coughing.
• Getting an annual flu shot to prevent respiratory infections.
• Building strong bones with calcium, Vitamin D, and weight-bearing exercise.
• Improving posture and back muscle strength to support the ribcage.
• Using incentive spirometers to deeply inhale and exhale, preventing lung collapse.

Implementing these preventive measures can help you avoid chronic coughs and reduce your risk of rib injuries over time.

When to Seek Emergency Rib Pain Treatment

While most cases of rib discomfort from coughing will resolve with conservative care, certain severe symptoms warrant emergency medical treatment. Seek immediate help if you experience:

• Sudden, stabbing chest pain accompanying coughing
• Breathing difficulties or shortness of breath
• Blood in phlegm coughed up from the lungs
• Feeling like you can't get a full breath
• Fever over 101 F with coughing and rib pain
• Coughing up foul-smelling phlegm

These alarming symptoms could indicate a lung collapse, pneumonia, pleurisy, pulmonary embolism, or other critical condition requiring prompt treatment.

Emergency Department Care for Rib Pain

In the emergency room, you'll be assessed for:

• Vital signs - Fever, heart rate, blood pressure, oxygenation
• Breathing - Rate, effort, lung sounds, use of accessory muscles
• Coughing - Productive or dry? Color of phlegm?
• Rib pain - Location, severity, acute or chronic?

The ER physician may order:

• Bloodwork to check for infection
• Arterial blood gas analysis to evaluate oxygenation
• Chest x-rays to visualize the lungs and ribs
• CT angiogram to check for pulmonary embolism
• EKG to rule out heart attack

Based on results, you may receive:

• Oxygen therapy and breathing treatments
• IV antibiotics for pneumonia or pleurisy
• Hospital admission for further monitoring and testing
• Surgery if a broken rib has collapsed your lung

The ER staff will work quickly to diagnose what's behind your coughing rib pain and initiate appropriate intervention to restore normal breathing and stability.

When to Follow Up After ER Treatment

Be sure to follow up with your primary care doctor within a day or two of emergency room discharge. Bring your discharge papers detailing diagnosis, test results, and treatment. Your PCP can ensure proper healing with:

• Prescription antibiotic or steroid regimens
• Referral to pulmonology or cardiology specialists
• Scheduling of repeat chest imaging in 2-4 weeks
• Advice regarding activity restrictions and home recovery

Don't delay essential follow-up care, as untreated respiratory illness can quickly recur and lead to complications. With prompt ER access and ongoing primary care, you can safely recover from coughing-induced rib injuries.

When Rib Pain Signals Serious Conditions

While passing or mild rib discomfort when coughing is normal, severe or persistent pain can signal more dangerous medical problems. Learn to recognize the following pulmonary and cardiac conditions that may initially only present with coughing-related rib pain:

Pneumonia

Pneumonia, an infection of the lung tissue, causes fever, productive coughs, and stabbing rib pain that worsens with breathing. Pneumonia requires urgent antibiotic treatment to prevent life-threatening respiratory distress.

Pleurisy

Pleurisy results when the pleura membranes lining the lungs become inflamed, filling the pleural space with fluid. The buildup of fluid rubs against the pleura with each breath, causing a sharp, stabbing rib pain when coughing.

Pulmonary Embolism

A pulmonary embolism occurs when a blood clot blocks an artery in the lungs. Symptoms include sudden chest pain, coughing up blood, and shortness of breath. Prompt treatment is vital to avoid permanent lung damage or death.

Collapsed Lung

A puncture wound, broken rib, or blast injury can allow air to leak into the pleural space, causing a lung to collapse. This medical emergency causes severe chest pain aggravated by coughing and requires rapid insertion of a chest tube.

Heart Attack

Crushing, pressure-like chest pain accompanying coughing could signal reduced blood flow to the heart. Other heart attack signs include sweating, nausea, and left arm or jaw pain. Quickly call 911 if you suspect cardiac related rib discomfort.

Don't ignore unexplained rib pain worsened by coughing. Seek prompt medical evaluation to determine if a serious pulmonary or cardiac issue requires emergency treatment. Proper diagnosis leads to lifesaving care.

When to See a Specialist for Rib Pain

For rib pain specifically induced or aggravated by coughing, you may need to see specialists beyond your primary care physician. Depending on exam and test findings, you may be referred to:

Pulmonologist

A pulmonologist specializes in lung disorders and can accurately diagnose and treat pneumonia, COPD, asthma, pleurisy and other respiratory diseases behind chronic coughs and rib pain.

Rheumatologist

For inflammatory causes of rib pain like costochondritis or arthritis, seeing a rheumatologist ensures correct diagnosis of the autoimmune disorder and proper treatment to reduce inflammation.

Cardiologist

If heart disease is the suspected culprit triggering coughing and chest discomfort, prompt cardiac assessment by a cardiologist is key. Heart tests like a stress test, echocardiogram and cardiac CT scan can pinpoint the issue.

Physical Therapist

Physical therapists can provide rib mobilization techniques, posture correction, and strength training to stabilize the core and ribcage area. This improves rib biomechanics and alleviates pain.

Don't neglect troubling rib symptoms flaring up with coughs. Getting the right specialist onboard ensures an accurate diagnosis guides your treatment and recovery plan.

When Home Remedies Ease Rib Discomfort from Coughing

Mild to moderate rib pain induced by coughing often responds well to home treatment between doctor's visits. Conservative self-care measures to reduce discomfort include:

Heat Therapy

Applying a heating pad or taking a warm bath helps relax muscles and boost circulation to accelerate healing of bruised, strained rib tissues.

Massage

Gentle massage releases tension in the intercostal muscles between ribs. Use arnica oil to reduce inflammation and bruising.

Stretching

Light stretches for the ribcage area improve range of motion and flexibility of rib joints, relieving tightness.

Posture Support

Wearing rib belts or kinesiology taping improves posture alignment and takes pressure off sore rib joints when coughing.

Humidifiers

Using cool mist humidifiers can hydrate and soothe aggravated airways, reducing coughs that spark rib pain.

Throat Lozenges

Cough drops with anesthetic and soothing ingredients like menthol and eucalyptus help control coughs and associated rib discomfort.

When rib pain from coughing is mild, these conservative home remedies can offer relief between doctors appointments. But seek immediate care if pain worsens or persists beyond a week.

When to Change Habits to Prevent Rib Injuries

Repeated bouts of severe coughing can certainly take a toll on your rib health over time. To reduce your risk of painful rib injuries when coughing, make the following lifestyle changes:

Quit Smoking

Smoking severely aggravates coughing and makes ribs more vulnerable to fracture in older adults due to osteoporosis. Quit now to protect your ribs and lungs.

Improve Posture

Correcting hunched posture takes pressure off rib joints, keeps your chest open for deep breaths, and prevents painful muscle spasms.

Lose Weight

Excess weight strains rib joint and belly movement can worsen reflux, a cause of chronic coughs. Shedding extra pounds by improving your diet and exercising relieves this pressure.

Avoid Pollution

Breathing in pollutants, allergens, and chemicals promotes respiratory irritation and coughing. Wearing an N95 face mask outdoors can help.

Get a Flu Shot

Getting an annual influenza vaccine significantly reduces your risk of respiratory infections like flu and pneumonia which spark painful coughing spells.

Learn Cough Etiquette

Always cough into your sleeve rather than your hands. Wash hands frequently to avoid transmitting viruses and bacteria that cause productive coughs.

By making cough prevention part of your daily health routine, you can avoid chronic coughs that take a toll on your rib health over the long run.

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.