KW Chiropractor discusses Rib Pain vs Chest Pain


If you’ve ever suffered from rib pain, you know just how irritating it can be. Rib pain is most commonly located under or just to the inside of the shoulder blade, and is typically sharp persistent pain that is aggravated with breathing and reaching forward with the arms. Rib pain can be brought on from constant static postures, like sitting at a desk. Additionally, constantly reaching forward to use the mouse or the phone can irritate the muscles that surround the ribs and lead to pain. Another common cause of rib pain is shingles, so be sure to keep your eye out for a rash or lesions that wrap around the rib cage.

It is a common misconception that when there is rib pain, the rib is ‘out’. When a rib is painful it is one of two joints that the rib forms with the spine (costovertebral or costotransverse joints) that is irritated. This irritation is due to tight surrounding musculature, in particular a muscle called levator costarum. When this muscle becomes tight, typically for the reasons mentioned above, it becomes more palpable; it can even feel like a bump that might lead one to believe that the rib is ‘out’. Rest assured, this is a tight muscle, the rib is right where it belongs, it’s just inflamed and irritated from being pulled on by the tight muscle!

Pain originating from a rib can surprisingly mimic chest pain similar to that experienced with angina or a heart attack. Rib pain can occasionally be felt in the chest where the rib connects to the sternum as in costochondritis and Tietze’s syndrome. Costochondritis is a condition in which the joint that connects the rib to the sternum is inflamed for any number of reasons ranging from trauma and arthritis to infection. Tietze’s syndrome is the name given to this rib irritation when it occurs at more than one rib. Rib pain can also mimic the arm pain that we’re all familiar with as a warning sign for heart attack. The nerve that supplies this pain down the arm originates from our upper back, specifically from T2, the 2nd thoracic vertebrae, and is called the intercostobrachial nerve. This nerve can be irritated with rib dysfunction and produce arm pain.

Rib pain can be easily treated with chiropractic care! Your chiropractor will release the tight musculature surrounding your rib, and ensure the joints are moving well. They will also help you to identify what brought on the pain so it can be avoided in the future.

If you are experiencing any of the signs and symptoms of a heart attack, do not dismiss them as rib pain! Be sure to seek appropriate assistance immediately!

Dr. Julia Callaghan, BSc (Hons), DC, ART,

CSCS, Contemporary Medical Acupuncture

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