Though trauma to the ribs is often the contributing factor for a sharp pain in the ribs, rib cage pain could also be a sign of certain medical conditions. This write-up provides information on these conditions.

The thoracic cage, also known as the rib cage, is a bony structure that protects the vital organs located in the chest cavity. It comprises twelve pairs of ribs, along with a flat and elongated T-shaped bone at the front called the sternum. Besides these bones, the other components of the rib cage include the costal cartilage, which is the cartilaginous structure that connects the sternum and the ends of the ribs. The intercostal spaces lying between the ribs, also comprise muscles, nerves, and blood vessels. Out of the 12 pairs of ribs, the first seven pairs that are referred to as the true ribs attach to the sternum. The next three pairs are referred to as false ribs. These attach to the costal cartilages of the ribs just above them, but are not connected to the sternum. The last two pairs are called floating ribs. These don't attach to the sternum and are only connected to the spine at the back. While this bony framework is quite strong, it is not immune to injury. A severe blow to the chest or trauma to the ribs due to motor vehicle accidents can cause damage to the ribs. This can cause a sharp pain in the ribs.

Contributing Factors

Out of the twelve pairs of ribs, the middle ribs are more likely to be affected by rib fractures. They can develop cracks or fracture, if the force with which these are struck is considerable. Here are some of the common conditions that could be responsible for causing rib cage pain.

Traumatic Injury
A strong blow to the chest is most likely to cause damage to the bones, cartilage, or muscles present in the chest. Ribs can also get fractured in the event of motor vehicle accidents, wherein the chest slams against the steering wheel with great force. Under these circumstances, one is most likely to experience chest pain, painful breathing, and painful movements. If one experiences these symptoms after an injury, one must consult a doctor immediately. An X-ray examination can help in determining the extent of damage. A displaced rib fracture is more serious as it could lead to internal bleeding. If a part of the fractured rib punctures the lungs or other organs, a life-threatening situation may arise.

Costochondritis
Costochondritis is a medical condition that is characterized by the inflammation of the costal cartilage. While a severe rib injury may cause inflammation of the costal cartilage present at the junction of ribs and sternum, strain could also be caused due to physical activities that involve forceful or jerky arm movements. Sudden and forceful swinging of arms in contact sports, rowing, tennis, or golf could put strain on the cartilage, thereby causing pain. It is believed that upper respiratory infections could also cause the inflammation of the cartilage. Its symptoms include painful breathing and tenderness of the rib joints. The pain usually worsens with exercise and may also radiate to the abdominal region or the back. Inflammation of the nerves or muscles present in the intercostal space could also cause rib pain.

Tietze Syndrome
This is a rare condition that is characterized by the inflammation of one or more costal cartilages. However, it is not the same as costochondritis. A person is diagnosed with this syndrome, when inflammation is accompanied by swelling of the costal cartilages. It is characterized by localized swelling of the costosternal, sternoclavicular or costochondral joints. More often than not, the inflammation affects the area of the second and third ribs. Though its exact cause is not known, it is believed that the inflammation and swelling might be associated with trauma, physical strain, severe and violent coughing, or upper respiratory tract infections.

Joint Disorders
Individuals affected by medical conditions that are characterized by the weakening of bones are at a greater risk of rib injuries. Such medical conditions include osteoarthritis, osteoporosis or rheumatoid arthritis. While the bone density is adversely affected by osteoporosis, osteoarthritis is associated with the wearing down of cartilage that cushions the joints. Rheumatoid arthritis is an autoimmune disorder wherein the antibodies start targeting the joints and cause inflammation. If the joints get weakened due to any of these diseases, even small injuries can make one susceptible to fractures or cracked ribs, thereby causing a sharp pain in the ribs.

Osteochondritis Dissecans
Repetitive stress can also cause a condition called osteochondritis dissecans. This is a condition wherein a small piece of cartilage and a thin layer of the bone beneath it, detach from the end of the bone. It is believed to be caused due to a reduced blood supply to the end of the bone. If the fragment gets lodged in the space surrounding the joint, it may restrict the range of the motion of the joint. If this condition affects any of the ribs, it is likely to cause pain in the ribs.

Referred Pain
The term 'referred pain' refers to the pain that is felt is a place other than the site of painful stimulus. At times, one might experience rib cage pain, even though it might actually be arising from the organs located in the chest cavity. For instance, inflammation of the lining of the lungs or a lung infection may be causing pain in the chest region. Upper respiratory infections or acid reflux disease could also cause chest pain.

Pain in and around the ribs could be attributed to injuries or the aforementioned medical conditions. A physical examination, chest X-ray, and other imaging procedures can help in ascertaining the extent of damage caused by an injury or other medical conditions. If the pain is caused due to a medical condition, treating the underlying cause will help in alleviating pain. The use of painkillers, anti-inflammatory drugs, or nerve block injections might be recommended for easing the pain or discomfort. In severe cases of displaced rib fracture or multiple fractures, surgery would be required. During the recovery period, one must take ample rest and avoid any physical activity that might put strain on the ribs.

Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.