When you think about your ribs, you tend to concentrate on the ones at the front of your chest. But, of course, they’re connected to your spine, too, at the back. Which is why many problems that develop in your ribs affect your back as well. Unfortunately, the precise cause can be difficult to diagnose because the pain they cause can be linked to a variety of factors.


The symptoms of rib problems are pain, either localised over part of the chest, and pain on breathing deeply, coughing, sneezing, and laughing. Several things can be responsible, including strains, sprains, and fractures. Other conditions can also cause similar types of pain.

What Causes Pain in the Rib Cage?

Costovertebral Joint

Rib problems that cause back pain fall into two main groups:

Costovertebral Joint Strains

Each rib is attached to the spine, and the joint is termed the costovertebral joint. It is supported by cartilage and ligaments. Causes of costovertebral joint strain include:

  • Muscle imbalances
    Tight chest muscles and weak back muscles.
  • Working overhead
    As in painting ceilings, hanging curtains, or lifting objects up and down from high shelves.
  • Poor posture
    While working at a computer or in a car.
  • Conditions
    Bronchitis, asthma, or other problems that cause you to cough and sneeze a lot.
  • A poor sleeping position
    Possibly caused by an unsupportive mattress or by falling asleep in an armchair

Ligament Sprains

Ligaments bind and surround the costovertebral joints at the spine and also where the ribs attach to the sternum (breastbone) at the front – the costochondral joints. The ligaments and cartilage surrounding these joints can be sprained – pulled or torn suddenly, especially in areas that are carrying the most load and strain – which tires the surrounding muscles.

Possible causes include:

  • Chest trauma
    This may be caused by a car accident or a fall. Such accidents are also often associated with rib fractures.
  • Excessive movements
    Including bending, lifting, arching, or twisting.
  • Sports
    Especially if you’re not in good shape. Contact sports such as football and ice hockey carry a particular task.
  • Falls
    These may result from an accident in the home or at work, or from participation in sports such as skiing, gymnastics, or horseback riding.
  • Carrying heavy loads
    For prolonged periods.

Figuring out What’s Wrong with the Ribs

First, the doctor will want to rule out a prolapsed or bulging disc in your neck or mid-back because the pain that these cause can be similar to that of a rib problem. Then your doctor will touch and manipulate the joints and ligaments involved before diagnosing the problem.

If a rib fracture is suspected, X-rays may be needed to confirm the diagnosis; if multiple rib problems are suspected, a CT or MRI scan may also be necessary.

Fixing Pain in the Rib Cage

In the case of both costovertebral joint strains and ligament sprains, the first port of call is oral medications. Next comes the an anti-inflammatory injection. Physiotherapy may be recommended to complement the treatment which aims to reduce inflammation, increase joint mobility, and relax any possible muscle spasm.

Rib Cage Specialist

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore


Book Appointment Online for Rib Cage Pain Treatment


Call me at +65 64712674 for an appointment.

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