Rib joint pain is pain from the small joints where the ribs meet the spine at the back, often called a rib sprain or costovertebral dysfunction. It typically causes sharp, one-sided pain beside the spine that can wrap around the chest and catch with breathing or twisting. It is usually musculoskeletal and settles with time, but it can mimic heart or lung pain, so worrying symptoms need checking first.
Also known as costovertebral joint dysfunction, rib sprain, 'rib out', costotransverse joint pain
Symptoms
- Sharp or catching pain just to one side of the spine in the upper or mid back
- Pain that can wrap around the side of the chest along the line of a rib
- Pain on deep breaths, coughing, sneezing, twisting or reaching
- A localised tender spot over the rib joint
- Difficulty getting comfortable lying down or rolling over in bed
Causes and risk factors
- Awkward twisting, reaching or lifting
- Sudden forceful coughing or sneezing
- Contact sports, falls or a knock to the back or chest
- Repetitive upper body sports such as rowing, swimming or racket sports
- Long periods in one position, such as desk work or driving
What the evidence says helps
- The rib joints at the back have their own nerve supply, which helps explain why they can be a genuine source of upper back and chest wall pain.2
- Rib joint problems can be mistaken for heart or lung pain. Careful examination can help identify a musculoskeletal cause once serious causes have been ruled out, and may reduce unnecessary tests.3
- In people with chest pain of musculoskeletal origin, a short course of hands-on care including spinal and rib manipulation, soft tissue work and advice led to better short-term improvement than self-management alone, though the difference had disappeared by one year.45
- Overall, high-quality evidence for upper back and chest wall pain treatments is sparse. Hands-on care appears to give small, short-term benefits, so it is best combined with movement and a gradual return to activity.6
Things you can try at home
- Keep gently moving: slow rotations and side bends within comfort help prevent stiffening
- Try slow, relaxed breathing into the sides of the ribcage a few times a day
- Use heat on the sore area to ease muscle guarding
- Support the area with a pillow if coughing or sneezing is painful
- Ease back into sport, lifting and twisting tasks gradually over a week or two
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- Call 999 for chest or upper back pain with breathlessness, sweating, feeling sick, or pain spreading to the arm, jaw or neck
- Call 999 for sudden breathlessness or sharp chest pain after a fall or blow to the ribs, or if you cough up blood
- Go to A&E if you think you may have broken a rib after a significant injury, especially if breathing is difficult
- Call NHS 111 or see a GP urgently if rib pain comes with fever, cough or feeling generally unwell
- See a GP urgently if you have a band of pain followed by a rash (possible shingles), or unexplained weight loss or night sweats
- See a GP urgently for rib pain after minimal force if you have osteoporosis or take long-term steroids
How Apollo can help
Our osteopaths assess the ribs, thoracic spine, breathing and shoulder movement, and screen for signs that need medical review. Care may include gentle hands-on techniques where appropriate, breathing and mobility exercises, and a plan to return to sport or work. We will refer you on if your symptoms suggest a non-musculoskeletal cause.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
Can a rib really 'pop out'?
Ribs do not usually come out of place. The term is often used to describe a sprained or irritated rib joint, which can feel sharp and catch with breathing. True dislocations need major force and are rare.
Why does my rib hurt when I breathe in?
The ribs move with every breath, so an irritated rib joint or strained muscle between the ribs often hurts on deep breaths or coughing. Painful breathing can also have lung causes, so seek urgent help if you are breathless, feverish or coughing up blood.
How long does a rib sprain take to heal?
Many rib joint sprains improve over a few days to a few weeks. Keeping gently active usually helps. Pain that lasts longer, or followed a significant fall, should be checked.
References
- Mott T, Jones G, Roman K (2021). Costochondritis: rapid evidence review. American Family Physician. View source
- Erwin WM, et al. (2000). Innervation of the human costovertebral joint: implications for clinical back pain syndromes. Journal of Manipulative and Physiological Therapeutics. View source
- Arroyo JF, et al. (1992). Costovertebral joint dysfunction: another misdiagnosed cause of atypical chest pain. Postgraduate Medical Journal. View source
- Stochkendahl MJ, et al. (2011). Chiropractic treatment vs self-management in patients with acute chest pain: a randomized controlled trial of patients without acute coronary syndrome. Journal of Manipulative and Physiological Therapeutics. View source
- Stochkendahl MJ, et al. (2012). A randomized clinical trial of chiropractic treatment and self-management in patients with acute musculoskeletal chest pain: 1-year follow-up. Journal of Manipulative and Physiological Therapeutics. View source
- Southerst D, et al. (2015). The effectiveness of noninvasive interventions for musculoskeletal thoracic spine and chest wall pain: a systematic review by the OPTIMa collaboration. Journal of Manipulative and Physiological Therapeutics. View source
This page is general information, not a diagnosis or a substitute for medical advice. If you are worried about your symptoms, speak to your GP or a registered healthcare professional. Content prepared from the sources above, November 2026.
