Make saving on Rx even easier

Get the Free SingleCare app

(23,450)
Open app
Close Menu
Hello
Explore

What causes rib pain from coughing? Related conditions and treatments

Medically reviewed by Leslie Greenberg, MD
Board-Certified Family Physician
Updated Apr. 24, 2024  •  Published Jan. 10, 2024
Fact Checked
What causes rib pain from coughing? Related conditions and treatments
In this article:

Overview: What does rib pain from coughing feel like?

Rib pain is a common problem when people have one violent cough, or a few coughing jags, or cough persistently. Most of the time, the pain is caused by a pulled muscle that attaches to the rib. It’s just like any other kind of muscle strain when a muscle is used too much or too harshly. That’s the most common cause, but it could be a rib bruise, cartilage swelling, or even a stress fracture … or worse. 

What does rib pain feel like? Usually, it’s a dull ache, but even a pulled rib muscle can cause severe, sharp pain. The pain worsens with a deep breath, coughing, or sneezing. If it’s an injury, it will be pinpoint tenderness that is painful when pushed on. There may be overlying skin bruising or discoloration. However, sometimes chest wall pain can be caused by the lungs or the sack that surrounds the lungs. You think your ribs hurt, but it’s the tissues right below the ribs that hurt. In those cases, there will probably be other symptoms indicating something’s wrong with the lungs or other tissues.

RELATED: What causes coughing? Related conditions and treatments

Key takeaways:

  • Rib pain from coughing is a common symptom that may be caused by persistent or violent coughing. In some cases, rib pain may be due to a problem with the lungs or the tissues around the lungs.

  • Typically, rib pain from coughing does not require immediate medical attention unless you have difficulty breathing.

  • Rib pain from coughing generally requires medical advice but should be treated if the pain is unbearable or prevents you from taking deep breaths. It typically resolves without treatment within a few days or weeks.

  • Treatment of rib pain from coughing may include pain relievers, cough suppressants, and taking a break from physically demanding activities.

  • Rib pain from coughing can be managed with ice, cold compresses, heating pads,, and over-the-counter pain medications and cough suppressants.

  • Use coupons for rib pain from coughing treatments, like Vicks Dayquil Cough (dextromethorphan), Motrin (ibuprofen), and Advil (acetaminophen), to save up to 80%.

What causes rib pain from coughing?

The most common causes of rib pain from coughing are musculoskeletal injuries from coughing too much. These include:

  • Intercostal muscle strain

  • Cartilage inflammation or damage (costochondritis)

  • Bruising

  • Rib fracture

Intercostal muscle injury

The most common injury caused by coughing is muscle strain. The intercostal muscles are the muscles between the ribs. They connect the ribs to one another and help control the expansion and contraction of the chest wall. Persistent or violent coughing works these muscles a bit too hard. It’s like running a marathon without training or exercising too hard and pulling a muscle somewhere. Like any other pulled muscle, rib muscle strain heals on its own.

Costochondritis

Costochondritis is injury or inflammation of the cartilage that joins the ribs to the breastbone (sternum). Because of the location, most people describe the pain as “chest pain” rather than rib pain. As with intercostal muscle strain, the pain will worsen when breathing in or coughing. Costochondritis is a temporary condition that heals on its own.

Rib bruise

Bruised ribs are usually caused by trauma: falls, accidents, or getting hit in the ribs. They can be caused by chronic or forceful coughing. The pain is usually mild but worsens with taking deep breaths, coughing, or sneezing. Bruising takes a week or two and will heal on its own.

Rib fracture

Coughing only rarely causes broken ribs. There are only a few reported incidents, usually involving older people with thin bones called osteoporosis. Most rib fractures heal on their own over a few weeks. Some rib fractures can damage other organs and require more medical intervention. Consider a fractured rib causing a hole in the lung (pneumothorax) or puncturing other organs. 

Other conditions

Sometimes, what feels like rib cage pain is instead a problem in the tissues under the ribs, like the lungs or the membranes that surround the lungs, called the pleura. This condition may be the same one causing the cough. These include:

  • Pneumonia

  • Pleurisy (inflammation of the membrane surrounding the lungs)

  • Lung cancer if it pushes or spreads out to the surrounding tissues

  • Blood clots in the lungs

These conditions typically will have other symptoms, many of which are more concerning than rib pain. One distinguishing feature of the rib pain caused by these conditions is that it’s not always tender or painful to the touch, like a rib cage injury. 

Should I be worried about rib pain from coughing?

If the pain is minor and breathing is normal, call a healthcare provider for medical advice just to make sure there isn’t a more serious problem. 

If the pain is relentless, it’s difficult to take deep breaths, or you have other symptoms like shortness of breath or chest pressure, see a healthcare provider. People with osteoporosis should also see a healthcare provider if they experience rib cage pain due to coughing. 

See a doctor if the pain feels like chest pain. If there are other symptoms like shoulder pain, back pain between the shoulder blades, arm pain, lightheadedness, or shortness of breath, along with chest pain, get emergency medical attention. These are signs of a possible heart attack and require emergent treatment.

The most concerning symptom is not the rib pain but the chronic or severe cough that causes it. If a cough persists for longer than three weeks or you experience violent coughing jags, see a healthcare professional. If you’re already seeing a healthcare professional about the cough, tell the clinician about the rib pain, too.

RELATED: What causes coughing? Related conditions and treatments

How is the cause of rib pain from coughing diagnosed?

Healthcare professionals diagnose the cause of rib pain from coughing by trying to find the underlying cause of the coughing and the underlying cause of the rib pain. Most people will start with a primary care provider and may be referred to a specialist. The clinician will start with a medical history, a review of symptoms, and a physical examination. Because rib cage pain could be due to a lung problem, the clinician will assess lung function to be sure. 

If there’s suspicion that a lung problem is present, the clinician may need further tests such as:

  • A chest X-ray

  • A CT scan

  • Bronchoscopy

If there’s chest pain, the clinician may order a chest X-ray to assess the ribs and rule out lung issues. Other tests that may help evaluate the heart are an electrocardiogram (EKG) to assess heart electrical rhythm and an echocardiogram to evaluate heart valves and overall heart function.

If the most likely problem is an injury, diagnosis is usually made based on the history, symptoms, and physical exam. The clinician will palpate the rib cage and concentrate on the area that hurts. That’s usually enough for a diagnosis. If a rib is broken, the clinician may obtain a chest X-ray or CT scan to make sure the lungs or other vital organs are not damaged.

Is rib pain from coughing contagious? 

Rib pain is not contagious, but whatever is causing the cough may be contagious. It may be an upper respiratory infection like a cold or flu or a lung infection like bronchitis or pneumonia. If a cough is due to other problems, such as asthma or chronic obstructive pulmonary disease (COPD), these illnesses cannot be spread.

How long does rib pain from coughing last?

If rib pain is due to muscle strain or bruised ribs, it could take a few weeks to get better. Rib fractures typically take about six to eight weeks to heal. If it’s a stress fracture, the pain may resolve in as little as three weeks.

How to stop rib pain from coughing

For any musculoskeletal injury, the primary treatment involves pain relief and rest. For muscle strain, costochondritis, bruising, and rib fractures, over-the-counter painkillers and home remedies like ice packs should be sufficient to control pain. For bad rib fractures or severe pain that interferes with breathing, a clinician may use nerve blocks or prescribe an opioid. 

The clinician may advise abstaining from activities that cause pain, such as sports, exercise, or any other exertion to give the injury a chance to heal. “Relative rest” is a term used for patients to do what does not cause them pain. 

For a rib fracture or other painful rib cage injury, the clinician may send you home with an incentive spirometer to help you maintain lung volume and decrease the chance of resulting pneumonia from taking chronic shallow breaths. If not, the clinician will advise you to take several deep breaths every hour. 

Healthcare providers discourage the use of rib taping, rib binding, or rib braces. Though they help control the pain, they prevent people from breathing deeply and may even interfere with normal breathing. People using these devices are at an increased risk of developing pneumonia and other problems.

If coughing is still a problem, it will not only cause pain but could worsen the injury. Instead of over-the-counter cough suppressants, the clinician may switch you to prescription cough suppressants to reduce the coughing. The cause of a chronic cough needs to be investigated, as this can result from uncontrolled asthma, COPD, or lung cancer.

RELATED: Antitussives: uses, common brands, and safety info

Living with rib pain from coughing 

Rib cage pain due to any musculoskeletal injury from coughing will take some time to get better, but it will get better. Unless there’s severe pain, a few tips can help manage the pain:

  • Take a break from strenuous activities

  • Use ice packs or heating pads over the affected area

  • Use a small pillow or other cushion as a brace when breathing deeply, coughing, or sneezing to help reduce the discomfort

  • Move around—sitting around or lying about increases the risk of pneumonia and fluid build-up in the lungs

  • Take 10 deep breaths per hour

  • Control the cough with over-the-counter cough suppressants, throat lozenges, steam, hot showers, humidifiers, using an air purifier, and drinking plenty of fluids

RELATED: The best cough medicine for fast results

Most importantly, talk to a healthcare professional

Though the cause of rib pain is usually benign and temporary, healthcare professionals worry that rib cage pain may have a more ominous underlying cause. If the pain is mild and goes away in a couple of days, there’s no worry. If the pain is bad, persistent, or gets worse, call a healthcare professional. A clinician knows the right questions to ask to rule out more serious problems.

What’s next? Additional resources for people with rib pain from coughing

Test and diagnostics

Treatments

Scientific studies and clinical trials

Medically reviewed by Leslie Greenberg, MD
Board-Certified Family Physician

Leslie Greenberg, MD, is a board-certified practicing family physician with more than 25 years of doctoring experience. She was a psychology major at Northwestern University near Chicago, then graduated with an MD from the University of Nevada School of Medicine. She completed her family medicine residency at St. Joseph Hospital in Wichita, Kansas. She has trained more than 350 family medicine resident-physicians, been in private practice, and delivered babies for 22 years.

...