When you experience rib pain from coughing there could be several different causes. That type of pain can be an indication of a serious problem, or it could be something cured as easily as just resting a strained muscle. The important thing is that you learn more about what can cause it, when you should see a doctor, and what to expect as far as treatment. What you shouldn’t do is that just assume it will go away on its own.

What Causes Rib Pain When Coughing?

1. Forceful Coughing or Muscle Strain

The simplest reason you may have rib pain is just the strength of the cough itself. It is easy to forget that the ribs are where a complex series of muscles are located that help with all things involving breath. That includes respiration and coughing. The intercostal muscles are the muscles located along the ribs and it is easy to strain them with a harsh cough, plus your diaphragm muscle is involved.

The muscle involvement doesn’t end there, the ones in your neck and back also work to allow your chest to lift up and open to enlarge the thoracic cavity. It is the negative pressure that this movement creates that draws air into the lungs that is then forced out with the cough. The key word is pressure, and there is a lot of it. All of this is also controlled by the vocal and throat muscles; they act as a valve to let the intense pressure of air in and out. All of that can quickly fatigue muscle and cause strain, which you then experience as rib pain. 

2. Costochondritis (Inflamed Cartilage)

Cartilage is what connects bones together. When the cartilage that connects the ribs to other bones becomes inflamed through overuse or injury, it is called constochondritis. Pain and tenderness in the area is common but upon coughing the pain is much more extreme.

The pain you will feel as a symptom of this condition is typically located on the left side of your breast bone. It can be a dull and constant pain, but upon deep breathing, coughing or sneezing can cause pain in several ribs at once.

3. Injury or Overuse

Injuring your ribs can happen very easily. You can break or bruise the rib bone, you can also strain, stretch or tear the muscles and tendons that surround the ribs too. Sometimes, overuse of the muscle can also cause harm to the bone - and that is just double trouble. 

One of the classic signs of a rib injury is that you feel like you can only breathe in small gasps. As part of your recovery you have to make yourself take deep breaths. This is the only way to prevent lung and chest infections from developing as you need to clear the mucus from your chest. Another thing to expect is some swelling, bruising and overall tenderness in the area.

4. Joint Conditions

Osteoarthritis, osteoporosis and other degenerative joint diseases can all lead to rib pain, especially when coughing. The cartilage that joins the ribs to other bones is also a large part of the flexibility and movement of the rib area. When this becomes inflamed, or begins to degenerate, the pain is often intense. There can also be points at which the rib area feels stiff and it can make coughing painful.

5. Pleurisy

Another common cause is pleurisy. This is caused by an inflammation of the pleura (a membrane that covers the lungs and has two layers) and there may also be a buildup of fluid between the membranes.

It is experienced by sharp pain when breathing, usually on one side, and severe pain when coughing, moving, bending or sneezing. The pain very often radiates up into the shoulder as well. Breathing shallowly can relieve the pain. Other important symptoms of pleurisy include shallow breathing and a very dry cough. The body is trying to clear the lungs when it is not the lungs but the fluid in the membrane causes the issue.

6. Other Lung Infections and Disorders

If you have rib pain from coughing that could be a sign of a lung infection or disorder. The most common is pneumonia. The thick mucus that builds up in the lungs requires coughing to be expelled, but it is so thick that the stress of coughing strains the ribs and causes pain.

Asthma, bronchitis and COPD can also be contributing factors to rib pain.

When to Worry

Some rib pain while coughing is no cause for concern, but when it is occurring with certain other symptoms there is cause for alarm. If you notice any of the following symptoms along with your coughing and rib pain, seek medical help as soon as possible.

• An increase in the shortness or shallowness of breaths you are taking
• Rib or chest pain that is getting more frequent or more severe
• Pain in chest
• Abdominal pain or pain in your shoulder
• Sputum that contains blood
• A cough that produces yellow or green mucous
• Fever

All of the above are warning signs that you may be in immediate danger. These signs, in any combination - and not all of them have to be present - may mean you have a serious chest infection or that you may have broken a rib. A broken rib can be life-threatening as it can cause a lung to collapse or puncture a major organ. Get help immediately if you have rib pain when you cough and have any of these symptoms.

How to Deal with Rib Pain from Coughing

• Once the cause of your rib pain is identified, there will be a course of treatment prescribed. Depending on whether or not it is infection based, you may need medication. Your doctor may also prescribe you medication to thin mucus so you do not have to cough so deeply.
• Rest and icing the area may also be called for. While you are recovering it is important that you follow your doctor’s instructions. If you have damage to your ribs and still are coughing, they may recommend that you press a pillow to your ribs when coughing to lessen the movement of the injured bone.
• Complete bedrest is typical in the case of broken ribs as they cannot be put in a cast and must move to allow you to breathe. Your doctor may also prescribe a cough reliever and/or pain medication. The type of treatment you receive will depend on the diagnosis of the cause of your pain.

What Others Have Experienced

“When I was pregnant with my first child I started to have rib pain every time I coughed and it felt like I couldn’t take a full breath without pain. Everyone around me told me not to worry and that it was just pleurisy. I didn’t want to risk anything so I went to the ER. They were concerned about a clot on my lung so I had X-rays and other tests done to make sure that everything was OK. It was OK, but I am glad I went. What they told me about what could cause rib pain from coughing was nothing to be taken lightly. It could have been a life threatening condition for me and the baby.”

“I made the mistake of deciding that my rib pain was just a muscle pain and all I needed was some aspirin. By the time I decided it was time to go see the doctor the pain was so bad I could barely walk or breathe. Turns out I didn’t have a muscle sprain, I had three broken ribs and pleurisy. The doctor was mad. If I had gone in earlier I would not have wound up in such bad condition. Now I am on bed rest, no lifting and no driving for 3 weeks. If I had waited any longer he said I would have developed an infection in my lungs. I didn’t know it could be that serious, but now I do. ”