Pain in the rib cage can range from mild tenderness to severe cramps or a burning sensation. Sometimes rib pain stems from a problem in the spine, even if the pain is felt more toward the chest or abdomen.
Here are some potential causes of rib pain that may stem from the mid-spine, also called the thoracic spine.
Fractured or displaced rib
A traumatic injury, such as from a collision, is a common cause of rib fracture and/or displacement where it connects with the thoracic spine. If the rib becomes displaced, it may lead to painful muscle cramps between the ribs, such as in the back or in front. It may also compress the intercostal nerve and send pain, tingling, and/or numbness along the rib and into the chest and less commonly to the abdomen.
Sometimes rib displacement occurs without any type of significant impact or collision. For example, slipping rib syndrome is a condition where the rib becomes hypermobile, such as from a weakened connection at the front of the rib with the cartilage or sternum, and/or at the back of the rib with the vertebra. Many cases of slipping rib syndrome have involved traumatic injury but some have not.
Thoracic herniated disc
While rare, a thoracic herniated disc may lead to inflammatory proteins leaking from the disc and inflaming a thoracic spinal nerve, sending pain along the nerve path. Pain, tingling, and/or numbness may radiate anywhere from the location of the herniation in the upper back along the rib toward the chest or abdomen. Pain may come and go, and may worsen with certain types of activities, such as vigorous exercise or bending in a specific direction.
A thoracic herniated disc can be caused by an injury, or it could be part of the degenerative disc disease process. In many cases, degenerative disc disease and osteoarthritis occur together.
Thoracic osteoarthritis occurs when protective cartilage starts to break down within the facet joints in the thoracic spine. Osteoarthritic joints become inflamed and bones start to grind together, which can cause bone spurs to grow. Osteoarthritis in the thoracic spine may trigger muscle cramps in the intercostal muscles (between the ribs) and/or contribute to nerve inflammation that causes pain or tingling to travel along a rib and into the chest or abdomen.
Osteoarthritic inflammation and bony overgrowth are less common in the thoracic spine compared to the cervical spine and lumbar spine. It is also possible to have osteoarthritis develop in the costovertebral and/or costotransverse joints which connect the ribs to the thoracic spine.
Read more about Osteoarthritis of the Spine
When to see a doctor
When unexplained pain in the rib cage area is severe enough to limit activities or does not alleviate with rest, seek medical attention. In addition, any type of radiating pain, tingling, numbness, or weakness needs an immediate medical evaluation. Treatment is typically more effective the sooner it is started. It is important to get an accurate medical diagnosis rather than trying to ignore the pain.