Pain Under Ribs On Both Sides [ 11 Possible Causes]

Experiencing pain under the ribs on both sides may feel debilitating and raise health concerns about the dysfunction/damage of the vital organs inside the rib cage.

Muscles connect each rib bone with its peripheral bones, which help form and move the chest wall. Dysfunction of any of these components might result in rib pain on both sides. Other potential causes may include muscular strain, inflammation, or injury to the rib cage.

Fortunately, most incidences of rib pain are benign and easily treatable. However, some cases require evaluation and intervention by a doctor. It is essential to recognize the symptoms and seek medical attention when necessary.

This article will discuss in depth the potential causes of rib pain on both sides. It will also explore the accompanying signs of rib pain, treatment options, and diagnostic procedures.

Symptoms Of Rib Pain

Rib pain on both sides may present with multiple symptoms that could help determine the underlying cause of the pain:

• Discomfort or tenderness in the area around the ribs.
• Difficulty breathing
• Chest tightness or a feeling of pressure in the chest
• Cough
• Fatigue
• Fever
• Weight loss
• Bruise
• Difficulty sleeping

Causes Of Rib Pain On Both Sides

Understanding the causative factors behind rib pain (on both sides) is essential for determining the appropriate treatment and management strategies. Here are some common causes of rib pain on both sides:

Causes of Rib Pain on Both Sides	Description
Pulmonary Embolism	Blood clots in the lung arteries, causing sharp chest pain and difficulty breathing.
Acute Costochondritis	Inflammation of the cartilage interlinking the ribs to the breastbone, resulting in chest pain.
Pneumonia	Infection of the lungs that leads to chest pain, coughing, and difficulty breathing.
Hypertensive Crisis	Severe high blood pressure that may induce chest pain and other symptoms.
Panic Disorder	Anxiety disorder could manifest as physical symptoms, including chest pain.
Tuberculosis	Bacterial infection primarily affecting the lungs, causing persistent cough and chest pain.

1. Hypertensive Crisis

   A hypertensive crisis (or malignant hypertension) may lead to serious health issues when the blood pressure rises above 180/120. Factors like excessive stress, poor diet, sleep apnea, or illicit drug use might induce a hypertensive crisis.

   If unchecked, malignant hypertension could damage the blood vessels, induce organ damage, and increase the risk of stroke and heart attack.

   Signs of a hypertensive crisis may include chest pain (that may radiate to both ribs and the back), blurred vision, and severe headaches. Other signs such as nausea, vomiting, blacking out, or shortness of breath might also be experienced.

   It is vital to get immediate medical attention if experiencing these symptoms, as high blood pressure at such levels may cause irreversible damage to vascular health and increase the risk of stroke.

2. Bacterial Pneumonia

   Bacterial pneumonia (a severe lung infection) is caused by bacterial strains, particularly Streptococcus pneumoniae. It may induce severe symptoms, including rib pain, fever, and chills. Other signs could be experienced, like painful and difficult breathing and a cough that brings up mucus. Elderly patients may experience low body temperature and confusion, which could be concerning.

3. Traumatic

   Trauma to the chest wall or rib cage cavity may cause internal injuries, potentially inducing rib pain. These injuries include:

   • Bone fracture: Chest wall trauma, like a car accident, a severe fall, or a direct blow to the area, may lead to fractures of the ribs. It could damage the sternum (breastbone) or clavicle (collarbone). Fractures in these areas may induce pain that feels like it is coming from the ribs. Rib fractures, in particular, worsen with breathing and coughing.
   • Lung bruise: Trauma to the chest wall may injure the underlying lung, resulting in pain that mimics rib pain. The phenomenon is known as a pulmonary contusion, where the lung tissue becomes bruised.
   • Muscle strain: The intercostal muscles connect the ribs and could be strained or pulled when overexerted. It could occur during heavy lifting or intense coughing. Strained intercostal muscles may cause rib pain on both sides.
   • Chest wall trauma: Repetitive trauma to the chest wall or a direct blow may lead to injuries like strains, bruises, or contusions. These injuries may cause rib pain.

4. Inflammatory

   Inflammatory causes of rib pain on both sides may include conditions like rib joint inflammation (costochondritis), pulmonary embolism, and lung or airway infections.

   In costochondritis, the rib cartilage connecting the rib bones to the sternum becomes irritated or inflamed. Such inflammation could cause pain in the ribs on both sides.

   Infections of the lung or airway, such as pneumonia, might also lead to rib pain. Pneumonia, known as pleura, may irritate the tissue lining surrounding the lungs. The irritation or inflammation (pleuritis) might mimic rib pain on both sides.

5. Pulmonary Embolism

   Pulmonary embolism refers to a blood clot formation in the lung(s), which may irritate the delicate lung lining and result in rib pain. The inflammation of the lining, known as pleuritis, could manifest as pain in the ribs on both sides.

   The common signs of pulmonary embolism include chest pain (radiating to ribs on both sides), difficulty breathing, coughing (sometimes with blood), and anxiety. Other accompanying signs could consist of lightheadedness and irregular heartbeat.

6. Panic Disorder

   Rapid and unexplained feelings of anxiety and overwhelming fear characterize panic disorder, a mental health condition. Physical signs like sweating, a pounding heart, and shortness of breath may accompany it.

   A panic attack may induce hyperventilation, causing rapid breathing and the chest muscles to expand near the rib cage. These effects may cause rib pain on both sides.

7. Normal Occurrence Of Chest Pain

   If the pain is brief and subsides right away, it is most likely from an injury like a broken rib or a pulled muscle in the chest.

   Sharp pain in the chest that improves with exercise may indicate acid reflux or a similar condition. It could be eased with antacids.

   Acute pain near the chest area that feels worse on breathing is probably from a lung inflammation like asthma or pneumonia.

   An actual heart attack involves intense, radiating chest pain that may last for several minutes. It worsens with activity and is accompanied by dizziness, pain (in the arms, back, or jaw), and shortness of breath. In such cases, seek immediate medical attention by going to the emergency room.

8. Systemic

   Some diseases may affect multiple body parts, including the ribs. These systemic illnesses may induce rib pain on both sides. Examples include lupus, rheumatoid arthritis, and fibromyalgia. Proper diagnosis and treatment might manage the underlying condition and alleviate rib pain.

   Non-physical factors like stress or anxiety could also lead to rib pain. These emotions could manifest as physical chest pain, including rib pain on both sides. Managing stress and anxiety through techniques like relaxation exercises, therapy, and lifestyle changes may help subside it.

9. Acute Costochondritis

   Acute costochondritis, or chest wall syndrome, is characterized by inflammation of the flexible cartilage that connects each rib to the breastbone. It may induce significant discomfort and pain in the chest area, particularly near the breastbone.

10. Tuberculosis

    Tuberculosis (TB) is a lung infection induced by the Mycobacterium tuberculosis bacteria that might also affect other organs in the body. It could primarily spread through the air when an infected person coughs, exhales, or speaks.

    Signs of tuberculosis may include a severe cough that brings up sputum or blood. Chest pain (near the rib area), weakness, weight loss, fever, and night sweats are other accompanying symptoms.

11. Atypical Chest Pain

    Atypical chest pain refers to situations where the chest pain is unlikely to be associated with heart or lung disease. Other potential causes like sore chest wall muscles or psychological factors like stress and anxiety could explain atypical chest pain.

Diagnosis Procedures

Upon visiting a doctor for rib pain, a comprehensive diagnostic evaluation typically includes a physical examination to assess the area for tenderness and abnormalities.

The doctor may suggest imaging tests like CT scans, chest X-rays, and ultrasounds to provide a detailed view of the organs and tissues involved.

Here are the common tests that may be performed to diagnose rib pain on both sides:

• X-rays
• CT scans
• Ultrasounds
• Blood tests

Treatments For Rib Pain

1. Home Treatments

   Certain home treatments could relieve and address rib pain while awaiting a medical evaluation. These may include:

   • Rest: Resting is essential for enabling the body to heal. If the rib pain is related to injury or straining of the rib muscles, taking a break from activities aggravating the pain may help speed up the healing process.
   • Exercise and stretching: Gradual exercise and stretching maneuvers might improve rib pain caused by injury to the muscles between the ribs. Partaking in low-impact exercises, like swimming or walking, could help strengthen the muscles and promote healing.
   • Over-the-counter pain medication: Nonsteroidal anti-inflammatory drugs (NSAIDs) like naproxen, ibuprofen, and aspirin may help reduce rib pain and inflammation. Acetaminophen may also provide relief from pain and fever.
   • Application of heat or cold: Applying a heating pad or a cold pack near the rib area might soothe rib pain. Heat could relax the muscles and increase blood circulation; cold therapy may reduce inflammation and numb the area.

2. Medications/Interventions

   Medical interventions and medications are crucial in managing rib pain and tackling the underlying causes. If an infection is the cause, antibiotics may help eradicate the bacteria.

   In rib pain induced by acid reflux or gastrointestinal disorders, proton pump inhibitors (PPIs) may reduce stomach acid and relieve discomfort.

   However, it is essential to note that a doctor should always guide medical interventions. They will assess the individual's situation and determine the most appropriate course of treatment.

When To See A Doctor?

If you are experiencing persistent or worsening rib pain, seeking medical attention from a doctor is essential. You must seek medical help if you encounter any of these symptoms:

• If your rib pain continues for an extended period
• If your rib pain is worsening instead of improving
• Rib pain that worsens at night or wakes you up while sleeping
• Rib pain associated with increased fatigue, unexplained weight loss, and decreased appetite
• Fevers and chills

Frequently Asked Questions

1. Can Rib Pain on Both Sides Be a Symptom of a Heart Attack?
   Rib pain on both sides might be a symptom of a heart attack, although it is not the most common presentation. Other signs of heart attack, like chest tightness, pain radiating to the arm, and shortness of breath, should also be considered.
2. Can Pregnancy Cause Rib Pain on Both Sides?
   Pregnancy might cause rib pain on both sides due to the growing uterus, inducing pressure on the ribs and stretching of ligaments. In such cases, it is essential to consult a doctor for proper evaluation and management.
3. How Long Does Rib Pain Typically Last?
   Rib pain duration might vary depending on the underlying cause. Acute conditions may resolve in a few days to weeks, while chronic conditions may persist for months or longer.

Conclusion

Pain under the ribs on both sides may or may not be a cause for concern, depending on the underlying cause. Acute conditions like inflammation, muscle strains, etc., may cause rib pain. More severe causes of rib pain, like heart attack or lung infections, warrant medical attention.

Lifestyle measures like using warm/cold compresses, consuming OTC painkillers, taking a hot bath, or using compression therapy on the affected area may help minimize rib pain on both sides.