Pain in the costal arch – How dangerous is that?
Pain in the costal arch, which can mainly be caused by a severe cough, indicates a disorder of the locomotor system of the affected area. If a specific organ is the cause of pain in the costal arch, the pain is usually not modulated by movement or coughing and is present constantly. The cause of pain in the costal arch, which can only be felt when coughing, is in most cases due to trauma.
Thus, especially contusions or fractures of the ribs can trigger these symptoms. But muscular causes can also be the reason for the complaints. The reason for this is that coughing causes involuntary pressure in the lungs and puts strain on the costal arch.
If there are rib injuries, they are particularly painful when moving, as is the case when coughing. If muscles are pulled, nerve irritation can also cause pain when coughing. Especially after an accident, the symptoms of the costal arch when coughing should be examined by a doctor in order to diagnose larger injuries and, if necessary, to be able to treat them properly.
Breathlessness is not a rare symptom of pain in the costal arch. Breathlessness can have the same cause or be caused by the pain itself. Particularly when the musculoskeletal system or the lungs are involved, strong, respiration-dependent pain can sometimes occur.
In addition to injuries to the ribs, nerves or muscles in the chest area, these can also be inflammatory lung diseases, which cause pain when the lung moves in the lung membrane. Rarer causes may be organs in the chest and upper abdomen. Heart attacks and pulmonary embolisms are two common acutely life-threatening diseases that are associated with shortness of breath and lead to chest pain.
The pain cannot be triggered by targeted pressure on the costal arch and is felt in an indefinably diffuse manner in the thorax. A rare clinical picture is the diaphragmatic hernia. Under certain circumstances, the stomach can enter the chest through the diaphragm.
A stabbing pain in the area of the costal arch is not unusual. If the stomach displaces the lungs, breathing difficulties may also occur. Some diseases of the chest area are associated with respiratory pain.
With each breath, the muscles between the ribs tense up, lifting the rib cage and the outer pleura and causing the lung to expand. Any muscular, nervous or skeletal damage to the ribcage can cause stabbing pain during this movement. In the case of inflammation of the lung, the respiration-related displacement of the pleura can also cause friction and unpleasant pain in the costal arch.
The respiration-related pain is therefore an important indication in the examination of chest pain. A cold can be accompanied by inflammation of the airways and coughing. In severe cases, pneumonia can occur, which leads to chest pain.
Not infrequently, a severe cough can lead to a sore respiratory muscle. This affects the diaphragm and rib muscles. With every breath taken, this sore muscle leads to slight pain.
Pain in the costal arch of the ribs during influenza is rather rare. Usually this pain is associated with a severe cough and the resulting muscle ache in the chest area. It is also possible that the infection leads to a generalized, sensitized pain sensation.
Normally this manifests itself as pain in the limbs, although it may radiate into the region of the costal arch. Fever is a common sign of an existing infection. Together with coughing, sore throat, aching limbs, chills and fatigue, it can indicate respiratory disease.
Pain in the costal arch is caused by involvement of the pleura in the inflammation. The pain can also occur as a result of aching chest muscles when coughing too much. If nausea occurs as a further symptom in addition to the pain in the costal arch, this can have several causes.
For example, pain in the right costal arch, together with nausea and sometimes vomiting and constipation, are typical of an inflammation of the gall bladder. Diseases of the intestine or stomach can also be the cause of pain in the costal arch if there is also nausea. In this case a reflux or diseases of the large intestine are particularly to be considered.Another cause of pain in the costal arch and simultaneous nausea is a special form of pre-eclampsia during pregnancy.
This is the so-called HELLP syndrome, a serious disease of pregnant women, which, in addition to high blood pressure, leads to liver dysfunction, which can be perceived as pain in the right costal arch. In addition to the pain, nausea, vomiting and diarrhoea are typical symptoms of HELLP syndrome. Since this is a dangerous complication during pregnancy, the attending physician should be consulted as soon as possible when these symptoms are perceived, who can carry out a diagnosis and, if necessary, initiate an appropriate therapy.
Pain in the breast area, which occurs immediately after eating, can be caused by various organs. A burning sensation in the stomach is caused by the acid build-up. This is a common problem for many adults.
More rarely, biliary colic can be behind it. A blockage of the bile ducts causes a backlog of bile and severe pain. Since the fluid is mainly secreted during eating, this pain occurs with a slight time lag with food intake.
In rare cases, there may also be a hole in the diaphragm behind it. As a result, the stomach can lie in the chest area and press on organs there. With the ingestion of food, the stomach increases and the pressure on the surrounding organs increases, so that the pain becomes worse.
The stomach can cause pain in the chest area and the costal arch in the context of various diseases. Very common is a burning pain caused by acid reflux (heartburn). In the initial stage, the reflux manifests itself as heartburn and is felt burning behind the breastbone.
In some cases it can be mistaken for a pain in the costal arch. A stomach ulcer can also cause similar pain. Stinging pain often occurs when swallowing large bites of unchewed food.
When entering the stomach, it leads to a stabbing pain in the chest area. The diaphragm is a very large muscle that makes up the largest part of the respiratory muscles. It separates the chest area from the upper abdomen.
If this muscle is damaged, holes and crevices can develop, which may force abdominal organs into the chest. These diaphragmatic defects can be congenital or acquired. Parts of the stomach and intestines can enter the thorax and cause pain, shortness of breath and other complications due to pressure on the organs lying there.
In the region of the costal arch, there are many muscle groups that are involved in breathing and many activities and which move the ribs. Due to a variety of causes, the muscles in the rib cage can tense and cramp. This can occur for no reason, in the context of sporting activities or during monotonous activities or tense sitting.
The tensed muscle cramps and shortens, so that many movements can trigger a stabbing pain in this muscle. This can also affect the respiration-dependent muscle movement. Tensions often release themselves, through massage or movement.
Light pain medication can make the tension more bearable until then. Causes for the pain in the costal arch can also come from the back, in addition to the possibilities described above. The reason for this is that the ribs are adjacent to the spinal column with small joints, which can easily project a problem of the back into the ribs.
For example, pain in the costal arch can occur when the costovertebral joint (Articulatio costovertebralis) is dislocated, thus irritating the nerves that run directly along the affected structure. In these cases, inhalation, bending or walking alone can lead to pain in the costal arch. In some cases, there may even be shortness of breath when the joints of the costal arch are affected.
An orthopedist, osteopath or physiotherapist can diagnose the problem and improve the symptoms by straightening the joints. Muscles that come from the back are partially attached to the ribs and can explain the existing symptoms of a muscular problem. Particularly if sports or training sessions have only recently begun, muscle strains can occur which can explain the pain at the costal arch.
The connection of the ribs to the spine can also cause the pain in the costal arch to radiate into the back.If the pain can be modulated mainly by movement, a detailed physical examination by the orthopedist can provide information about the individual problem. Pain radiating into the back can also be an indication of a serious cause, which is why the symptoms should always be clarified. Therefore, diseases of the internal organs, such as the pancreas, are also included.
Injuries in the back can also trigger the symptoms of pain in the costal arch. Especially when the spine is affected, pain in the costal arch can also occur in addition to local complaints. Similarly, malformations of the spine can also lead to pain in the costal arch.
For example, scoliosis caused by the displaced spine can cause considerable discomfort, which sometimes occurs in the costal arch. The fact that the ribs are connected to the spinal column means that, in addition to the spinal column, the costal arch is also displaced on both sides in the case of existing scoliosis, thus leading to massive pain in many cases. Pain that is mainly triggered or intensified by sitting often indicates a muscular problem.
It is not uncommon for pain in the costal arch to occur in professionals in the office or after particularly long periods of sitting. The cause is a cramping and tensing of the musculature. Back pain can also be additionally associated with it.
Ergonomic office chairs and muscle building of the back help in the long term against pain while sitting. Some forms of chest pain can become worse when lying down. Those affected complain of stabbing pain that keeps them awake at night and that is aggravated mainly by pressure, breathing and lying horizontally.
Especially lying on your side leads to increased pressure on the chest and ribs and can increase muscular or skeletal pain. Only an increased lying on the back or soft padding in bed can make the night more bearable. If you have severe sleeping problems caused by the pain, painkillers can be taken before going to bed.
Respiration-related pain can also worsen at night under certain circumstances. Since the position on the back causes the structures in the abdomen and chest to shift, the already existing pain can also become more noticeable when lying down. Many pregnant women experience pain in the costal arch during pregnancy.
These occur mainly in the second half of the pregnancy. In most cases, these pains are harmless. They manifest themselves as sudden, stabbing pains and usually disappear again by themselves after a short time.
The reason for this is usually the growing baby. The abdominal muscles are put under great strain and are stretched further and further. Since these originate at the costal arch, a pull is created here, which can lead to pain in this area.
This pain can even radiate to both sides of the spine. The growing uterus stretches increasingly upwards to below the costal arch and presses here on the organs that are located there. The pain of the costal arch during pregnancy usually occurs on the right side, since this is where the liver and gall bladder are located, which can cause the pain due to the increasing pressure.
Extended body parts of the baby can also cause pain here. To relieve the pain, it can help to lie on the opposite side and sleep. Special pregnancy pillows can also provide relief.
Usually the pain disappears by itself from the 38th week of pregnancy onwards, as the baby’s head then enters the pelvis and the weight is redistributed. If the pain lasts for a long time, or if it gets worse, a gynaecologist should be consulted. In very rare cases, this can be the so-called HELLP syndrome.
This is a serious complication during pregnancy which is accompanied by an enlarged liver and increased liver values. It requires urgent medical treatment. It can also lead to pain in the costal arch during sports.
These can be caused by external force, such as a fall. In most cases, this is a contusion of the ribs, which is harmless and heals by itself. A broken rib can also be the cause of the pain.
A contusion of the ribs and a broken rib are often not directly distinguishable.Often the pain is even more pronounced in the case of a contusion than in the case of a fracture. An X-ray examination can be used to determine the underlying cause. In the case of a contusion, a period of rest of about 2 weeks is to be expected, whereas this period is about 6 to 8 weeks in the case of a rib fracture.
In addition, an irritation or inflammation of the pleura (pleuritis) can also cause pain in the area of the costal arch. This can be caused by an incorrect breathing technique and the resulting incorrect strain on the respiratory muscles. In this case, the breathing should be paused until the inflammation subsides and then the breathing technique should be changed during the sport.
Pain in the region of the costal arch occurs more often after sport, especially if exercises have been done for the abdominal, back or chest muscles. The pain is then the result of sore muscles in the muscle groups that start at the costal arch. In severe cases, strength training with heavy weights and incorrect loading can also cause displacement of a rib and torn muscle fibers in the rib muscles.
In such a situation a doctor should be consulted. Many different muscle groups start in the area of the rib cage or have their origin there. In addition to the muscles between the individual ribs, there are also chest muscles that are connected to the shoulder and arm.
Back muscles, which are used to move the spine, also sometimes start at the ribs. Incorrect strain or overloading of individual muscles can lead to muscle soreness, i.e. small tears in the muscle fibres. Within several hours after the incorrect load or sporting activity, the pain occurs depending on the load.
In unpleasant cases, a slight pain can be felt with every breath. In the context of pneumonia or bronchitis, a persistent cough can lead to muscle aches in the rib muscles.
- Thoracic pain
- Pinched nerve at the rib
- Pain in the ribs
- Right costal arch pain
- Left costal arch pain
- Periostitis of the ribs
