Rib Pain from Coughing: Causes and Treatments

You probably don’t give your ribs much thought as you go through your day, but if they are causing you pain they can be hard to ignore. If you’ve ever had a bout of coughing accompanied by pain in your ribs, you know how distracting rib pain can be. Some conditions, like colds, flu, or asthma, can cause you to cough frequently, and when this triggers rib pain, it can disrupt your daily life. If your ribs often hurt when you cough, you probably want to know why this is happening, and how you can ease the pain.

Can Severe Coughing Cause Rib Pain?

It is very common to feel pain in your ribs during coughing. Pain can be felt on the right side under the ribs and also on the left side under the ribs. Where you feel the pain most acutely depends on the source of the pain. Sometimes your ribs hurt when you cough because the muscles in your rib cage are strained. We’ll discuss this more below. (Do your ribs hurt from coughing? Want to talk to a doctor about it? Click here to chat with a clinician in minutes.)

Other possible causes of rib pain include:

• Cold, flu, and other respiratory infections
• Physical injury, included repeated trauma from coughing
• Diseases such as pulmonary embolism, pleurisy, and heart disease

Can You Pull a Muscle in Your Ribs from Coughing?

If you feel a sharp pain, or hear a cracking or popping sound when you cough, this can be a sign that you have pulled or strained one of the muscles in your rib cage, called intercostal muscles. Your intercostal muscles lie between your ribs and attach them to one another. They also stabilize your upper body and help you breathe. If your ribs hurt when you cough, it could be because the coughing is causing your intercostal muscles to work too hard. The more you cough, the more the intercostal muscles have to work, and the repeated movement can cause these muscles to stretch, pull, or partially tear.

If you think you’ve pulled a muscle when coughing, talk to a doctor. Your doctor will be able to identify which muscles have been strained, and make sure your symptoms are not caused by something else.

Any of the following symptoms could indicate that you have strained one of your intercostal muscles.

Pain that gradually worsens after repetitive movements, such as swimming, lifting, or other physical exercises

• Stiffness and tension in your back muscles
• Muscle rigidity when you bend or twist your upper body
• Sharp pain in your upper back or in the general area of your ribs
• Severe pain that comes on suddenly, particularly if caused by a blow to your chest or back
• Severe pain when you cough, sneeze or breathe deeply
• Spasms of the intercostal muscles in your ribs. Muscle spasms can range in intensity from mild twitches to severe pain. You may be able to visibly see your muscles twitching.
• Tenderness in the area between your ribs

How Do I Stop My Ribs from Hurting When I Cough?

If your ribs hurt from coughing and you’re in a good deal of pain, there is no need to suffer in silence. Here are some things you can try that might alleviate the pain:

• Painkillers: Regular over-the-counter pain medications, like acetaminophen or ibuprofen, can provide relief from rib pain.
• Compression: For fast relief from sudden, unpredictable coughing, firmly press a small pillow or cushion against your chest in the area that hurts the most. This relieves pressure on the muscles and can ease the pain.
• Cough with care: When you feel a coughing fit coming on, sit in a chair and lean forward slightly. Press your arm against your belly and cough sharply a couple of times into a tissue. Relax for a moment and then do it again. If the coughing hurts, press a pillow against your belly while you do it.
• Heat: Apply a heating pad over the sore area to ease pain and soothe your strained rib muscles.
• Cold: Applying a cold compress, or even a bag of frozen peas, to the sore area can give a lot of relief.
• Creams/gels: If your ribs are very sore from repeated coughing, applying a cream or gel formulated to treat muscle pain to your chest might help. You can find several such products at your local pharmacy, including creams that contain arnica—a herbal substance that can be effective at reducing pain.
• Treat your cough: If your cough is caused by a cold, flu, or upper respiratory infection, try to treat the cough directly by having regular warm drinks, sucking on cough drops, or adding a teaspoon of honey into your tea. Cough medicines, decongestants, and steam-inhalation can also help improve your cough.

(Do your ribs hurt from coughing? Want to talk to a doctor about it? Click here to chat with a clinician in minutes.)

What Helps a Pulled Muscle from Coughing?

Intercostal muscle strain can be extremely painful, especially if you are coughing on a regular basis. As every cough can worsen the pain, you will want to try and get some relief. The following methods might help:

• Apply an ice pack to your chest
• Use heat therapy, such as a warm bath, heating pads, or adhesive heat wraps
• Limit physical activity for a few days to allow time for your muscles to recover
• Take over-the-counter pain medications
• Splint the area by holding a pillow against the injured muscle

Your doctor may order the following treatments to further ease your symptoms:

• Muscle relaxants
• Physical therapy (PT)
• Lidocaine or corticosteroids injections

If symptoms persist for a long time and nothing you have tired is giving you relief, or if you are also having difficulty breathing, seek medical attention as soon as possible to get a proper diagnosis.

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