Those occurring in the area of the chest Rib pain can be due to a variety of causes. A distinction must also be made between short-term pain and longer-lasting, chronic rib pain.
Infogram on the pain regions, the course and development of pain as well as the degree of intensity in pain perception. Click image to enlarge.
The rib pain is called chronic if it lasts more than six months or if the patient complains of regularly recurring pain. About a third of patients with rib pain suffer from a chronic illness. In contrast to acute rib pain, chronic complaints often do not have a special warning function with regard to another disease, but rather represent an independent disease.
According to the source of the rib pain, a distinction is made between two subgroups: The pain that comes directly from the rib area can be triggered, for example, by bruises or broken ribs. The pain can originate from all twelve pairs of ribs and thoracic vertebrae as well as from the sternum. The second group includes rib pain, which is caused by disease of organs located in the chest or tissue that is near the ribs.
Rib fractures or bruises are mostly caused by violent bumps or falls. An inflammatory change is also possible.
In the so-called Tietze syndrome, the rib or sternum cartilages are noticeably swollen and trigger the pain in the ribs. There is also the possibility of ossification of the rib joints, which can not only lead to rib pain but also to shortness of breath. The rather rare Thoretic Outlet Syndrome (TOS) describes rib pain that is often caused by a congenital, unilateral or bilateral anomaly of the cervical rib. This anomaly can e.g. B. cause rib pain when moving the arms.
The rib pain can also be due to osteoarthritis (joint wear), a rheumatic disease (a chronic inflammatory disease due to a malfunction of the immune system) or to scoliosis. Scoliosis is when the spine is bent sideways and vertebrae are twisted at the same time.
At the beginning of any treatment for rib pain, a thorough root cause analysis must first be carried out, which includes an in-depth examination of the body and a precise determination of the duration and type of pain.
Most acute rib pain will go away by itself after a few days without further action. However, if the pain persists for more than a week, the doctor will conduct a closer examination. A broken rib can often be diagnosed by a simple palpation examination. An X-ray or ultrasound examination, a computer or magnetic resonance tomography and, in individual cases, a so-called bone scintigraphy, with which the metabolism of a bone can be examined, also come into consideration.
The course of the rib pain depends largely on the individual disease. For example, bruises lead to very severe, but not very long-lasting rib pain. However, broken ribs can lead to secondary pain if internal organs such as the spleen or lungs are injured by a rib.
The body tissue that swells up from fractures or bruises can cause persistent and intense pain. Those affected see themselves severely restricted in their performance and mobility. If the condition persists, a detailed examination must quickly determine the exact cause. Superficial injuries are not always the reason for intense complaints. A breakthrough or an injury to the organs themselves can trigger lasting complications.
The function of the liver, spleen, lungs and the upper part of the stomach is then impaired. Depending on the location, patients develop fears of dangerous but non-existent diseases. Last but not least, the increased heartbeat and shallow breathing to avoid pain fuel the fear of a heart attack. As the foci of inflammation progresses, water deposits accumulate in the tissue between the lungs and the pleura.
At the same time, the swollen tissue exerts additional pressure on the surrounding organs and sustainably increases the level of suffering. If the symptoms are not due to a mechanical influence from outside, fever, loss of appetite and nausea are common symptoms. In addition to the risk of a neurosis manifesting, the patient's sleep quality sometimes suffers in the long term.
Even small movements in bed can intensify pain. As a consequence, unnatural postures are adopted to protect yourself. In the long term, these put a strain on the health of the back and lead to further distortions or blockages in the musculoskeletal system. Unless properly treated, bacterial infections can spread to the entire body and threaten the patient's life.
The diagnosis made on the basis of rib pain then determines the therapy in the further course. If there is no possibility of eliminating the cause of the pain, treatment will be limited to pain therapy.
For this purpose, pain-relieving medication can be used or, in individual cases, local anesthesia of the painful rib area can be carried out, which as a side effect can also bring about better blood circulation and thus anti-inflammatory effects.
Rib pain that is solely due to a bruise is usually only treated with pain medication. In contrast to the procedure for other bone fractures, a rib fracture requires fixation e.g. B. not required by a plaster cast.
All other causes of rib pain are combated by treating the underlying disease in question. For some diseases (such as scoliosis), physiotherapeutic treatment can be considered. With TOS, too, treatment is usually conservative with targeted physiotherapy. Only in the case of unsuccessful physiotherapy efforts may a rather complicated operation be performed in which ligaments and / or neck ribs are removed.
Tietze syndrome is treated with pain reliever medication if there is severe pain in the ribs. In the case of osteoarthritis, in addition to pure pain therapy and physiotherapeutic measures, e.g. For example, a simple measure such as cooling the affected chest area, but possibly also the administration of cortisone preparations against the pain in the ribs.
The possibility of preventive measures for rib pain depends on the nature of the underlying illness. For dangerous jobs or sports there is z. B. the possibility of wearing protective clothing that prevents shock or fall injuries. If rib pain is due to a specific disease, at least the worsening of the pain can be counteracted by treating this disease. An early examination of long-lasting rib pain enables a prompt diagnosis, on the basis of which possible complications can be avoided.