Causes of Rib Cage Pain
There are many possible causes of rib cage pain or pain that seems to come from the area around your ribs. These can range from conditions that are primarily a nuisance to those that are life-threatening.
We will look at common and uncommon causes musculoskeletal causes of this pain, as well as causes that may be felt in the rib cage but instead originates in organs within or outside of the rib cage. When the cause of rib pain is uncertain, a careful history and physical exam can help guide you and your healthcare provider to choose any labs or imaging studies that are needed.
Rib Cage Anatomy and Structure
When looking at potential causes and how rib cage pain is evaluated, it's helpful to think about the structures in and around the rib cage.
There are 12 ribs on each side of the chest. The upper seven ribs are attached directly to the breastbone (sternum) via cartilage. These are known as the "true ribs." The remaining five ribs are referred to as the "false ribs."
Of these, ribs eight through 10 are also attached to the sternum, but indirectly (they attach to the cartilage of the rib above which ultimately attaches to the sternum). Ribs 11 and 12 are not attached to the sternum either directly or indirectly and are called the floating ribs.
There can be variations to this pattern, with some people having an extra set of rubs and some have fewer ribs (primarily the floating ribs).
In addition to the bones that make up the ribs, sternum, and spine, as well as the attaching cartilage, there are many other structures associated with the rib cage that could potentially cause pain. This includes the intercostal muscles (the muscles between the ribs) and the diaphragm (the large muscle at the base of the chest cavity), ligaments, nerves, blood vessels, and lymph nodes.
Organs Within the Rib Cage
The rib cage functions to protect several organs while allowing movement so that the lungs can expand with each breath.
Organs protected by the rib cage include the:
- Great vessels (the thoracic aorta and part of the superior and inferior vena cava)
- Lungs and pleura (lining of the lungs)
- Upper digestive tract (esophagus and stomach)
- Liver (on the right side at the bottom of the rib cage)
- Spleen (on the left side at the bottom of the rib cage)
The area between the lungs, called the mediastinum, also contains many blood vessels, nerves, lymph nodes, and other structures.
Organs Outside of the Rib Cage
Organs not within the rib cage but that can sometimes cause pain that feels like it comes from the rib cage include the gallbladder, pancreas, and kidneys. The skin overlying the rib cage may also be affected by conditions (such as shingles) which cause rib cage pain.
There are a number of variations that may be found in the rib cage that can, in turn, lead to or affect symptoms in this region.
- Extra ribs: An extra rib lies above the first rib in 0.5% to 1% of the population and is called a cervical rib or neck rib.
- Missing ribs, most often one of the floating ribs
- Bifurcated (bifid) ribs, a condition present from birth in which the rib splits into two parts by the sternum
- Pigeon chest (pectus carinatum), a deformity in which the ribs and sternum stick out from the body
- Sunken chest (pectus excavatum), in which abnormal growth of the ribs results in the chest having a sunken appearance
There are many potential causes of pain that feels like it arises from the rib cage, including injuries, inflammation, infection, cancer, and referred pain from organs such as the heart, lungs, spleen, and liver.
In an outpatient clinic setting (such as a family practice clinic), musculoskeletal conditions are the most common cause of rib cage pain. In the emergency room, however, serious conditions that mimic rib cage pain (such as a pulmonary embolism) are more common.
We will look at some of the common and uncommon musculoskeletal causes or rib cage pain, as well as causes that may arise from organs within or outside of the rib cage.
Common Musculoskeletal Causes
Some of the more common musculoskeletal causes of rib cage pain include:
Muscle strains may occur with an injury or even coughing or bending. Rib fractures are relatively common and can sometimes cause intense pain. Ribs can also be bruised (bone bruise) without a fracture.
The sternum is infrequently fractured, but chest trauma can result in a number of abnormalities ranging from single fractures to flail chest. With osteoporosis, rib fractures can sometimes occur with very little trauma.
Costochondritis is an inflammatory condition that involves the cartilage that connects the ribs to the sternum. The condition is common, and can sometimes mimic a heart attack with the type of pain that occurs.
Fibromyalgia is a relatively common cause of rib cage pain and can be challenging to both diagnose and treat (it's primarily a diagnosis of exclusion). Along with pain and morning stiffness, people with the disorder often experience mental fog, fatigue, and other annoying symptoms.
Common rheumatoid conditions that can cause rib cage pain include rheumatoid arthritis and psoriatic arthritis.
Intercostal neuralgia is a condition in which nerve pain (neuropathic pain) arises from an injury, shingles, nerve impingement, and more. It can be challenging both to diagnose and treat.
Slipping Rib Syndrome
Slipping rib syndrome (also called lower rib pain syndrome, rib tip syndrome, or 12th rib syndrome) is thought to be under-diagnosed and can cause significant pain in the lower ribs (the floating ribs). In the condition, it's thought that overly mobile floating ribs slip under the ribs above and pinch the intercostal nerves, nerves that supply the muscles that run between the ribs.
Other relatively common causes can include pain related to conditions involving the thoracic spine (which not uncommonly causes chest pain in the front of the rib cage), Sternalis syndrome, and painful xiphoid syndrome (the xiphoid is the pointy bony growth at the bottom of the sternum).
Less Common Musculoskeletal Causes
Less common, but significant musculoskeletal causes of rib cage pain can include:
Rib Stress Fractures
Rib stress fracturesare an overuse injury commonly seen with activities such as rowing or backpacking. They can be challenging to diagnose, so it is important to let your healthcare provider know what type of exercises and sports you participate in.
Tietze syndrome is similar to costochondritis but less common. Unlike costochondritis, there is swelling that accompanies the inflammation of the cartilage connecting the ribs to the sternum.
A number of cancers can lead to rib cage pain. Both lung cancer and breast cancer commonly spread (metastasize) to bones, including those of the rib cage. This can occur with a number of different cancers as well.
Pain may be due to the presence of the tumor in bone (bone metastases) or due to fractures that result in weakened bones (pathologic fractures). In some cases, rib cage pain may be the first symptom of the cancer.
These tumors may also grow directly in to the rib cage and cause pain. Multiple myeloma is a blood-related cancer that may occur in the bone marrow of the rib cage and other bones and can also cause rib cage pain.
A sickle cell crisis (bone infarct or essentially a death of bone) is an uncommon cause of rib cage pain. Rheumatoid causes such as lupus are less commonly associated with rib cage pain.
Some other potential but infrequent causes include infections in joints in the rib cage (septic arthritis), polychondritis, and sternoclavicular hyperostosis.
It can sometimes be very difficult to know whether pain that is felt in the rib cage is related to rib cage itself, or underlying structures. Some potential causes of rib cage pain include the following.
Shingles is a condition in which the chickenpox virus (which remains in the body after the initial infection) reactivates. Symptoms include fever, chills, and rash distributed on one side of the body, but pain (which can be severe) often occurs before these other symptoms and can be challenging to diagnosis.
Heart disease not uncommonly causes pain that is felt as rib cage pain, and women especially, tend to have atypical symptoms such as these. The possibility of a heart attack should always be considered in a person who has any form of chest-related pain. Pericarditis, an inflammation of the membrane that lines the heart is also a potential cause.
Enlargement of the large artery (aorta) in the chest may cause rib cage pain. Risk factors include the condition Marfan's syndrome as well as cardiovascular disease.
Lung conditions such as pneumonia or lung cancer may cause rib cage pain. Lung cancer, in particular, may irritate nerves that lead to pain that feels like it originates in the rib cage. Pulmonary emboli, or blood clots in the legs (deep venous thromboses) that break off and travel to the lungs are a serious cause of rib cage pain.
Inflammation of the pleura (pleurisy) or the build-up of fluid between the two layers of pleura can cause rib cage pain. This may cause pain with a deep breath and in some positions more than others.
Enlargement of the Spleen
Spleen enlargement, such as with some blood-related conditions or cancers, may cause rib cage pain. The spleen may also become enlarged (and sometimes rupture with mild trauma) with the infectious mononucleosis.
Inflammation or scarring of the liver, such as with hepatitis or cirrhosis may cause rib cage pain.
Digestive System Conditions
Gastroesophageal reflux disease (GERD) often causes heartburn, but can also cause other types of pain. Peptic ulcer disease or gastritis are other potential causes.
Referred Pain From Outside of the Rib Cage
Organs outside of the rib cage may also cause pain that feels like it arises in the rib cage. Some of the organs and medical conditions to consider include:
- Gallbladder: Gallstones or cholecystitis (infection of the gallbladder)
- Pancreas: Pancreatitis or pancreatic tumors
- Kidneys and ureters: Kidney stones may sometimes cause referred pain that's felt in the rib cage (and is often severe).
Rib Cage Pain in Pregnancy
Rib cage pain, especially upper rib cage pain, is also relatively common in pregnancy. Most of the time it's thought that the pain is due to the positioning of the baby or related to the round ligament.
Much less commonly, and after the 20th week of gestation, pain on the right side felt under the lower ribs is sometimes a sign of preeclampsia or HELLP syndrome, a medical emergency.
When to See a Healthcare Provider
If you are experiencing rib cage pain that does not have an obvious explanation, it's important to make an appointment to see your healthcare provider.
Symptoms that should alert you to call 911 and not wait include:
- Chest pressure or tightening
- Pain in the rib cage that radiates into your arm, back, or jaw
- Heart palpitations
- Shortness of breath, especially of sudden onset
- Pain that is severe
- Sudden onset of sweating
- New onset confusion or change in consciousness
- Coughing up blood, even if only a very small amount
- Difficulty swallowing
- Numbness or tingling in your arms or legs
In order to determine the cause or causes of rib cage pain, your healthcare provider will take a careful history and may do a number of different tests based on your answers.
A careful history is essential in making a diagnosis when the cause of rib cage pain in unknown. The questions noted above may help narrow down potential causes and further guide your work-up. These will include questions to not only understand the characteristics of your pain, but a review of past medical conditions, risk factors, and family history.
To narrow down potential causes, your healthcare provider may ask a number of questions. Some of these include:
- What is the quality of your pain? Is the pain sharp or dull?
- How long have you had the pain? Did it start gradually or abruptly?
- Have you ever experienced pain like this in the past?
- Where is the location of your pain? Is it localized or diffuse? Does it affect both sides of your chest or is it isolated to the left side or right side?
- Is there anything that makes your pain better or worse? For example, pain with a deep breath (pleuritic chest pain) may suggest pleurisy or other lung conditions. Movement may worsen musculoskeletal pain.
- Is the pain present at rest or only with movement?
- Is the pain worse during the day or at night? Pain that is worse at night may suggest serious causes such as an infection, fracture, or cancer.
- Is the pain worse in one particular position (PE)?
- Can your pain be reproduced by pressing on any area of your chest?
- If you also have neck or shoulder pain, does it radiation to your arms? Do you have any weakness, tingling, or numbness of your fingers?
- What medical conditions do you have and have you had? For example, a history of early stage breast cancer in the past might raise concern over a bony recurrence in the rib cage.
- What illnesses have your family members experienced (family history)?
- Do you or have you ever smoked?
- What other symptoms have you experienced (associated symptoms)? Symptoms such as palpitations, shortness of breath, a cough, a rash, jaundice (a yellowish discoloration of the skin), nausea, vomiting, itchy skin, etc. should be shared with your healthcare provider.
On physical examination, your healthcare provider will likely begin with an examination of your chest (unless you have symptoms suggesting an emergency condition is present). Palpation (touching) your chest will be done to look for any localized areas of tenderness, such as over a fracture or inflammation.
With costochondritis, pain is most commonly noted with palpation to the left of the sternum in a very localized region. Swelling may be related can occur if Tietze syndrome is present or with an injury such as a fracture.
With fractures, tenderness is usually very localized. With sternalis syndrome, pain is often felt over the front of the rib cage, and palpation can cause the pain to radiate to both sides of the chest. With intercostal neuralgia, pain may be felt over the whole chest or along one rib, but can not usually be reproduced with palpation.
Range of motion tests, such as having you lean forward (flexion), stand up straight (extension), and turn to the right and left are done to see if any of these movements can reproduce the pain.
An examination of your skin will be done to look for any evidence of shingles rash, and an examination of your extremities might show signs of a rheumatoid condition such as any swelling or deformity of joints. In addition to examining your chest, your healthcare provider will likely listen to your heart and lungs and palpate your abdomen for any tenderness.
A pleural friction rub is a breath sound that may be heard with inflammation of the lining of the lungs (the pleura). Other breath sounds might suggest an underlying pneumonia or other lung conditions.
In women, a breast exam may be done to look for any masses (that could spread to the ribs).
Labs and Tests
A number of laboratory tests may be considered depending on your history and physical exam. This may include markers for rheumatoid conditions and more. Blood chemistry including a liver panel, as well as a complete blood count may give important clues.
Imaging tests are often needed if trauma has occurred, or if there are any signs to suggest an underlying cancer or lung disease. A regular X-ray may be helpful if something is seen, but cannot rule out either a fracture or lung cancer.
Rib detail exercises are better for visualizing the ribs, but can still easily miss rib fractures. In order to diagnose many rib fractures or stress fractures, an MRI may be needed. A bone scan is another good option both for detecting fractures and looking for potential bone metastases.
A chest computed tomography scan (CT scan) is often done if there is concern over lung cancer or pleural effusion. With cancer, a positron emission tomography (PET) scan can be good both for looking at bony abnormalities and other soft tissue spread, such as tumors in the mediastinum.
Since abdominal conditions (such as gallbladder or pancreatic conditions) may cause rib cage pain, an ultrasound or CT scan of the abdomen may be done.
Procedures may be needed to diagnosis some conditions that can cause referred pain to the rib cage.
An electrocardiogram (ECG) may be done to look for any evidence of heart damage (such as a heart attack) and to detect abnormal heart rhythms. An echocardiogram (ultrasound of the heart) can give further information about the heart and also detect a pericardial effusion (fluid between the membranes lining the heart) if present.
If a person has had a choking episode or has risk factors for lung cancer, a bronchoscopy may be done. In this procedure, a tube is inserted through the mouth (after sedation) and threaded down into the large airways. A camera at the end of the scope allows a healthcare provider to directly visualize the area inside the bronchi.
Endoscopy may be done to visualize the esophagus or stomach for conditions involving these organs.
The treatment of rib cage pain will depend on the underlying cause. Sometimes this simply requires reassurance and advice to avoid activities and movements that aggravate the pain.
Rib fractures are difficult to treat, and many healthcare providers are leaning against only conservative treatments such as wrapping the rib cage due to the potential for complications.
For musculoskeletal causes of rib cage pain, a number of options may be considered ranging from pain control, to stretching, to physical therapy, to local injections of numbing medication.
A Word From Verywell
Rib cage pain can signal a number of different musculoskeletal conditions as well as non-musculoskeletal conditions within or outside of the chest. Some of these conditions can be challenging to diagnose. Taking a careful history is often the best single "test" in finding an answer so the underlying cause can be treated.
It can be frustrating to be asked a thousand questions (that are sometimes repeated more than once), but in the case of rib cage pain, is worth the time it takes to make sure your healthcare provider has all of the clues possible to diagnose, and subsequently treat, your pain.
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Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
Fliegel BE, Menezes RG. Anatomy, thorax, cervical rib. StatPearls. Updated January 10, 2020.
Winzenberg T, Jones G, Callisaya M. Musculoskeletal chest wall pain. Australian Family Physician. 2015;44(8):540-544.
Wilkerson RG, Ogunbodede AC. Hypertensive Disorders of Pregnancy. Emerg Med Clin North Am. 2019;37(2):301-316. doi:10.1016/j.emc.2019.01.008
American Society of Regional Anesthesia and Pain Medicine. The slipping rib syndrome: An often-overlooked diagnosis. February 2019.
McMahon LE. Slipping rib syndrome: A review of evaluation, diagnosis and treatment. Seminars in Pediatric Surgery. 2018. 27(3):183-188. doi:10.1053/j.sempedsurg.2018.05.009
At night she suffered through searing pain, but by morning it mysteriously vanished
On nights that the pain became unbearable, Marion Millhouse Barker would get out of bed, head for the guest room, shut the door and scream as loud as she could.
"It helped," said Barker, recalling the strategies she devised to cope with the stabbing sensation on the right side of her rib cage that left her doubled over. "I have a high pain tolerance," she said, but this pain proved to be more excruciating than unmedicated childbirth or acute appendicitis.
On other nights, Barker headed for the shower. She aimed the pulsating spray of water, as hot as she could stand it, at the locus of her pain. Like the screaming, it brought temporary relief.
For nearly two years, Barker, now 65, lived with the attacks, which were initially intermittent. At the time, her family was coping with a series of medical crises that took precedence.
But tolerating the pain became an impossibility when the episodes increased from once a month to nearly every night; oddly, it never struck in the daytime.
"If the pain hadn't gone away during the day, I would have gone back to the doctor much sooner," she said. "It's too bad I waited so long."
Her problem began in the fall of 2012, a year after Barker sold the suburban Maryland medical communications firm she co-founded and decided to retire.
Barker had been doing a lot of kayaking to stay in shape. When her rib cage began to hurt, she suspected she had pulled a muscle and tried to take it easy.
In January 2013, when the pain hadn't gone away, she consulted her internist. The doctor ordered a chest X-ray, an ultrasound of Barker's gallbladder and a liver test. All were normal.
"Unfortunately," Barker said, the doctor "didn't order the test that would have allowed the problem to be correctly diagnosed."
The internist told Barker she suspected that the pain was the result of costochondritis, an inflammation of the cartilage in her rib cage, probably related to kayaking. The doctor advised that she take a prescription-strength nonsteroidal painkiller to reduce inflammation.
It didn't help. A few months later, Barker switched primary-care practices and consulted a family medicine specialist. The new doctor agreed with the earlier diagnosis and prescribed an anti-inflammatory cream. That, too, proved useless.
For the next year or so, Barker coped with the pain on her own. She and her family were contending with more pressing problems. Barker's widowed father, who was in his 90s and lived alone in Richmond, Virginia, fell and broke his hip, which required surgery. And one of Barker's stepdaughters was shuttling from her Pennsylvania home to a Boston hospital for treatment of the recurrent that would prove fatal at age 40.
Barker, whose husband is a retired physician-researcher at the National Institutes of Health, decided to try various over-the-counter remedies, hoping she might hit on one that would vanquish her strange pain. She didn't go back to the doctor.
"I thought I had a diagnosis," she said, noting that the two physicians she had consulted ruled out something serious. She said she figured that a return visit would be "fruitless."
"I thought, 'If I go back to the doctor, what are they going to do?' "
But Barker grew increasingly worried about the attacks, which left her wrung out and exhausted. They usually began around 7 p.m., then subsided after a few hours, sometimes recurring around 5 a.m. for a few hours before disappearing.
Her days were pain-free. Barker used some of the time to nap and compensate for her disrupted sleep.
"It was sporadic enough that I learned to live with it," she said. Barker was puzzled that during a 10-day family vacation in July 2014, "I didn't have one attack."
But a month later the episodes were back, and occurring nearly every night. Neither the screaming, nor the shower remedy nor the cocktail of over-the-counter painkillers worked.
Once while driving back from a visit to her father in Richmond, she briefly fell asleep on Interstate 95 in the middle of the day. The incident freaked her out. "I'm so glad I didn't have an accident," she said.
Over Labor Day, when her brother, a San Francisco cardiologist was visiting, Barker asked his advice. He told her that the pain in her side might be emanating not from her rib cage but from her back, possibly her upper spine. Its sharp quality was suggestive of nerve pain, not inflammation, he said. And the pain relievers she had been taking for months don't work for nerve pain.
His advice: Get an MRI scan.
A few weeks later, Barker returned to her primary-care doctor. She recounted her continuing symptoms and relayed her brother's observations. The doctor ordered two tests: an MRI and a CT scan of her spine.
The tests revealed the cause of Barker's pain: A large tumor, roughly the size and shape of a small cocktail frank, was lodged inside her spinal canal. It was pressing on the T6 vertebra, located below the shoulder blade.
To help determine whether the tumor was benign or malignant, Barker underwent an MRI of her brain.
"I wasn't scared," she recalled. "I didn't feel it was in my brain. I didn't have any headaches, changes in vision or balance problems," which can be signs of a brain tumor.
Her brain scan was clear.
Barker's family physician referred her to a pair of neurosurgeons, Shih-Chun "David" Lin and Quoc-Anh Thai, who performed spinal surgery together at Suburban Hospital in Bethesda. (Thai recently left for a job in Arkansas.)
"Usually you don't want two cooks in the kitchen," said Lin, Washington-area division chief of Johns Hopkins neurosurgery. But in the case of spine surgery, he continued, an additional pair of hands and eyes can be invaluable.
"You're working in a sensitive area with very little space" and the potential for catastrophe, said Lin, who is also an assistant professor of neurosurgery at Hopkins's medical school. Having two surgeons positioned on either side of a patient helps expedite surgery and minimizes the chance of complications.
The neurosurgeons told Barker they suspected that the growth was a schwannoma, a rare, slow-growing tumor that is usually benign. But, Lin emphasized, the surgeons told Barker that until they operated, they wouldn't know for sure what it was.
Schwannomas arise from nerve cells called Schwann cells, which are part of the peripheral nervous system. In most cases they occur by chance for unknown reasons and can develop anywhere in the body. Some never cause problems, but in other cases radiating pain of the kind Barker experienced can occur, as can hearing loss if the tumor is located in the head or neck.
"This kind of tumor is not that common overall," said Lin. Surgeons must weigh the risks and benefits of removing the tumor, which can be tricky.
Barker was both surprised and relieved by the news. More than two decades earlier, her mother had undergone surgery to remove a schwannoma on her neck. Lin said he did not believe that Barker's tumor had a genetic cause because it was a single mass. (Hereditary schwannomas usually occur in multiples.)
Lin said there is no known reason that Barker's pain occurred only at night, not in the daytime. "Sometimes it's the opposite," he said.
Barker said that the surgeons recommended operating "sooner rather than later" because of the severity of her pain and because they worried that if left too long, it could affect her legs, causing paralysis.
Then, Barker said, "I made a stupid decision."
Her family was coming for Thanksgiving, and Barker worried she would be immobile after surgery. When the surgeons told her it wasn't an emergency, she scheduled her operation for early December.
But in the intervening weeks, Barker's pain intensified and her ability to walk began to be affected.
She also grew increasingly nervous about something the surgeons had told her: Sometimes, even after the tumor is removed, the pain doesn't go away.
"I just couldn't believe that," she said. "I remember saying to my husband that I can't keep doing this if it doesn't get better."
Luckily for Barker, it did. Her operation, which was supposed to take several hours, lasted only 90 minutes because the tumor was relatively easy to remove. "It was encapsulated," Lin said, "not stuck to the spinal cord."
"It literally popped out," said Barker, who months later watched a video of her operation that the surgeons made as a tool to teach medical students. "It was elegant, really."
Although the rib pain vanished quickly, recovery from the operation took more than a year. Barker also needed three months of physical therapy to regain her ability to walk normally. She has fully recovered.
Her advice to others facing prolonged unexplained pain - particularly if it is severe - is simple: Don't do what I did.
"Now that I can stand back," she said, "I can see it was an issue that was relatively easily fixed. I think waiting so long [to return to a doctor] was a big mistake."
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"Why do my ribs hurt on my left side when I get up in the morning?"
It sounds like this pain in your ribs has been going on for quite a while. Therefore, it wouldn't be a bad idea to go see your primary care doctor. They can perform a quick examination and make sure there is nothing serious going.
Find Primary care doctors near you
on. The most likely cause of your pain is simple strain of the muscles between the ribs, which are known as the intercostal muscles. This commonly occurs as the result of vigorous physical exercise or heavy lifting but it can also occurs just from "sleeping funny." Another cause might be costochondritis, which is an inflammation of the cartilage joints connecting the ribs to the breastbone. This often occurs after a common viral infection, such as the cold or flu. Both muscle strain and costrochondritis can linger for quite a while, up to a few months. However, most of the time they do gradually get better, and your doctor, if they confirm the diagnosis, will likely want to prescribe you some anti inflammatory medications, like ibuprofen or naproxen, to help reduce the pain and tenderness and speed healing. Contact your doctor's office and make an appointment at your earliest convenience! I hope you are feeling better soon.
Pain in your upper back after sleeping?
Many people wake up with pain in their upper back. But what is the exact reason for this? What can be the cause? And more importantly: what can be done about it? Often, a good bed with the right mattress will offer a solution.
What is the structure of the back?
To know why you have back pain, it is useful to know the exact structure of your back. The back consists of seven cervical vertebrae (neck), 12 thoracic vertebrae (breast), 5 lumbar vertebrae (loin), 5 sacral vertebrae (the sacrum) and a coccyx. A vertebra has a vertebral body to which a vertebral arch is connected. Protrusions are attached to this arch, with weights. The vertebrae are stacked on top of each other. Between two vertebrae sits an intervertebral disc. The vertebral arches jointly constitute a long hollow containing the spinal cord: the spine.
Back pain due to the trapezius muscle
An important cause of pain in the upper back may be the trapezius muscle. This is a large muscle that protects part of the back. The trapezius starts high at the cervical vertebrae and the head and runs up to the middle back, where it attaches to the thoracic vertebrae. This muscle has various connection points and ensures amongst others that you can move your shoulder up, down or backwards.
Interesting detail: the trapezius is also called ‘monk’s cowl muscle’. This name indicates the shape of the muscle in respect of the rest of the torso: it resembles a cowl of a monk’s habit that has not been pulled up.
The trapezius muscle has many trigger points and therefore also many stress points. The muscle often tenses up due to stress and this may result in pain in the upper back, the neck and head. In order to avoid building up too much tension, the neck must lie in line with the spine during sleep. A good pillow plays an important role in this respect.
Make sure you have good support
In order to go through life without back pain, the back must be able to sufficiently relax and recover, both day and night. If you do sedentary work, a good office chair is a real necessity. But what is most important, is a good bed offering the right support to all of the back, no matter how you sleep (on your back, stomach or side). Even an adjusted mattress can be a good solution for most of the upper back problems.
Pain in the upper back due to a hernia
A hernia in the upper back is quite rare, but certainly not impossible. If you have a hernia, you must consult a medical specialist. A good bed may alleviate the pain somewhat but cannot remove the problem.
Other causes of pain in the upper back
The ribs are suspended from the dorsal vertebrae and form a type of corset. Pain and pressure on the rib cage may therefore cause pain in the (upper) back. Certain diseases may also cause pain in the upper back. For instance, this type of backache may be an indication of heart problems. Airway infections and lung diseases may also cause discomfort in the upper back. If in doubt, consult a doctor!
Waking when rib up pain
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