8 Causes Of Pain Under The Ribs When Breathing

Pain under your ribs when breathing can be quite frightening for patients — and because it happens for a number of different reasons, you may be very anxious to find out the possible cause. Some of the more innocent underlying causes of rib pain while breathing include things like muscle cramping during times of strenuous activity, while other causes can be more menacing in nature.

Costochondritis as a cause of rib pain while breathing

The first sickness to consider as a possible cause of your discomfort is a textbook description of what doctors look into first when they hear a patient presenting with tenderness in their rib cage while breathing.

Costochondritis is a condition that causes inflammation of the costochondral junction in the rib cage that can be aggravated when a patient breathes [1].

Studies show that low levels of Vitamin D could predispose patients to this condition [2]. There is no real understanding of what causes this inflammation in the first place. Some theories suggest that the inflammation is secondary to potential bouts of viral infections or repetitive minor trauma to the chest wall [3]. This condition will often resolve as quickly as it appeared, but anti-inflammation medication is usually used to accelerate healing [4]. 

Pneumonia can lead to pain under your ribs while you breathe

Pain under your ribs from breathing can also be caused by systemic illnesses like pneumonia infections. When fluid collects in the lungs during an infection, more effort is required to breathe, and muscle stress occurs. Pain when breathing can indicate muscle fatigue and patients should begin antibiotics immediately if they are not already taking them to avoid potential long-term complications of pneumonia infections. [5]

Muscle Cramping as a Cause of Rib Pain While Breathing

Similar to the first two conditions, muscle cramping can manifest as pain under your ribs. When your electrolyte levels are unbalanced during times of exercise or extreme exertion, muscles can easily begin to cramp. This is a common injury in active patients who fail to warm-up properly and disregard pre-workout stretching. Muscle cramping will often occur in the first 10 minutes of the exercise so it is important to ensure you are in the proper physiological state of mind before any type of exercise routine. [6] 

Rib Pain While Breathing: Could it be a Pulmonary Embolism?

A more menacing medical condition that could present with pain under your ribs when breathing would be a pulmonary embolism. Pulmonary embolisms occur after patients have some type of clot from in their veins due to prolonged immobility.

Elderly patients and those who are bed-ridden as they recover from operations are very susceptible to this type of coagulopathy and a pulmonary embolism is something physicians are quite concerned with after any surgical procedure. The clot will usually start in the legs and when it becomes dislodged, this clot will travel through the bloodstream to your lungs, where it can block blood flow.

Patients affected by a pulmonary embolism will present with sharp chest pain and severe shortness of breath and urgent medical attention is necessary to try to save the patient's life. Making sure patients move their joints as much as possible and taking blood-thinning medications are two techniques that we doctors use often to try to make the risk for clotting less likely. [7]

A Myocardial Infarction (Heart Attack): An Infamous Cause Of Pain under the Ribs while Breathing

An equally sinister cause of pain under your ribs when breathing could be an ischemic event like a myocardial infarction, better known as a heart attack. When there is insufficient blood traveling through your body, even simple actions like breathing could lead to severe chest pain.

Patients with a history of kidney problems and diabetes are most prone to heart attacks but obesity, poor cholesterol levels, and smoking are also potential aggravating factors. Call an ambulance immediately if you start to feel dull chest pain that travels to your arms or jaw so urgent medical attention can begin, and call emergency services if you see anyone else experiencing the possible symptoms of a heart attack as well. [8]

Lupus: A Chronic Condition that can cause Rib Pain while Breathing

Another systemic disease that could have presentations of chest pain would be systemic lupus erythematosus (SLE). Lupus is a very common autoimmune disease that is most common in female patients. Not only may lupus patients develop skin rashes when exposed to sunlight, they also have a high risk for kidney and heart problems because of the autoimmune attack. Should you have a number of bizarre symptoms that physicians are struggling to tell you what is causing them, ask about the possibility of SLE affecting you. [9]

Mechanical Injuries as a Cause of Painful Ribs while You Breathe

Another potential cause of pain under your ribs when breathing can come from a more obvious source, and that is any type of mechanical injury that you may have suffered. Blunt force trauma from car accidents or contact sports can be two ways you can easily break ribs, and physical fights would be another source. Patients should go to the clinic immediately to have a chest X-ray looking for signs of possible fractures after these types of injuries. [10]

Rib Pain when Breathing: Could it be Cancer? 

Cancer is the last possibility worth mentioning when someone presents with pain under your ribs when breathing. Patients who have lung cancer are most likely to present with this type of pain. Weight loss and difficulty breathing could also suggest this type of pathology. Patients need to get a CT-scan of their chests immediately if they have a long pack-year history of smoking to make sure this pain is not linked to tumor growth in their lungs. [11]