Slipping rib syndrome happens when the cartilage at the front of one of the lower ribs becomes too mobile and slips under the rib above, irritating the nerve between them. It causes sharp, stabbing pain at the lower edge of the ribcage, sometimes with a clicking or popping feeling, followed by a dull ache. It is often overlooked, and people can go a long time without a diagnosis, although it can usually be identified by examination alone.
Also known as painful rib syndrome, rib tip syndrome, clicking rib, floating rib syndrome
Anatomy: where the problem is
Front view of the rib cage. Highlighted in the diagram: lower rib cartilages.
Symptoms
- Sharp, stabbing pain at the lower edge of the ribcage, usually on one side
- A clicking, popping or slipping sensation
- A dull ache that lingers after the sharp pain
- Pain brought on by bending, twisting, reaching, coughing or certain sitting positions
- Pain that can be felt in the upper tummy or the back
- A tender spot on the rib margin
Causes and risk factors
- Looseness of the cartilage that links the 8th, 9th and 10th ribs at the front
- A blow to the ribs or a twisting injury
- Sports with repeated trunk movement, such as swimming and running
- Joint hypermobility
- Often no clear trigger
What the evidence says helps
- It is a clinical diagnosis. A clinician can usually reproduce the pain by pressing on the rib margin or gently hooking the fingers under the ribs. Dynamic ultrasound can help in doubtful cases.1
- Recognising the condition is valuable in itself. In a series of 76 people, the diagnosis was safe and needed no further investigation, yet many had already been through extensive tests.2
- Initial care is conservative: reassurance, avoiding the movements that provoke it, and pain relief. A nerve block or local injection can be used for diagnosis and relief.1
- For persistent, troublesome symptoms, surgery to remove or stabilise the slipping cartilage gives good pain relief.1
Things you can try at home
- Avoid the specific movements and positions that bring on the pain while it settles
- Sit with support and avoid slumping for long spells if that provokes it
- Use heat or ice for short-term relief
- Ask a pharmacist about pain relief
- Keep a note of what triggers the pain, to help a clinician recognise the pattern
When to get urgent help
Contact your GP urgently, call NHS 111, or call 999 in an emergency if you have:
- Chest pain that spreads to the arm, neck, jaw or back, or comes with breathlessness, sweating, nausea or light-headedness: call 999
- Sudden sharp chest pain with breathlessness or coughing up blood: call 999
- Chest or upper back pain with a fever, a cough or feeling very unwell: get same-day medical help
- Constant pain that is worse at night, with unexplained weight loss or a history of cancer: see your GP
- Severe pain in the upper tummy with vomiting, a fever or yellowing of the skin: get same-day medical help
How Apollo can help
Pain in the lower ribs or upper tummy has many possible causes, so we take a careful history and refer you to your GP if anything suggests a problem with the heart, lungs or abdominal organs. If the pattern fits a slipping rib, we explain what is happening, which many people find a relief after a long search for answers. Care includes advice on positions and activity, gentle treatment for the surrounding muscles and upper back, and exercises for trunk control. If symptoms persist, we write to your GP about an injection or a surgical opinion.
No GP referral needed. Clinics in Sheringham, Coltishall and Norwich.
Related reading
Frequently asked questions
What does slipping rib syndrome feel like?
People describe a sharp stab at the lower edge of the ribs, sometimes with a click or a feeling that something has moved, followed by an ache that can last hours. Certain movements, such as bending or twisting, set it off.
How is slipping rib syndrome diagnosed?
It is diagnosed by examination. Pressing along the edge of the ribs or gently hooking under them reproduces the familiar pain. Scans are usually normal, although a moving ultrasound scan can sometimes show the rib slipping.
Does slipping rib syndrome need surgery?
Often not. Many people manage with an explanation, changes to activity and pain relief. Surgery is an option for symptoms that stay severe, and reports show good results for pain.
References
- McMahon LE (2018). Slipping Rib Syndrome: A review of evaluation, diagnosis and treatment. Seminars in Pediatric Surgery 27:183-188. View source
- Scott EM, Scott BB (1993). Painful rib syndrome--a review of 76 cases. Gut 34:1006-1008. 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.
