Definition
The pain at the costal arch caused by coughing is a symptom that can have many different triggers. The fact that the pain preferably occurs through coughing makes musculoskeletal causes such as strains, bruises or even small rib fractures probable, since these cause forced pain through movement and tension when coughing. Nevertheless, other causes should not be ignored. Pain in the costal arch, which manifests itself when coughing, can also be an indication of injuries or diseases of internal organs in the chest or abdominal area. An exact diagnosis is therefore very important in order to find the trigger of the pain and to initiate an appropriate therapy.
Causes
The causes of pain in the costal arch due to coughing are very diverse. They can be harmless causes, but they can also be triggered by serious underlying diseases. Obvious causes can be musculoskeletal injuries or diseases.
When coughing, the muscles of the trunk tense up, so that strains or sprains can manifest themselves with severe pain in the ribcage area. In addition to the soft tissue, bony structures, in this case the ribs, can also be injured. Smaller rib fractures would also occur more frequently under mechanical stress such as coughing.
If a fracture is the cause of the pain, it is essential to ensure that the lungs are not damaged. Small bone splinters can puncture or perforate the lung, which is associated with the risk of bleeding or collapse of the lung (pneumothorax). If coughing is the primary problem of the affected person, the pain can also manifest itself secondarily in the form of muscle ache due to the heavy strain on the trunk muscles when coughing.
A characteristic feature here would be that the pain occurs symmetrically, i.e. on both sides of the costal arch. A chronic form of pain at the costal arch due to coughing can also be caused by extreme incorrect strain and poor posture, which is associated with tension and blockages. Typical of pain at the costal arch due to musculoskeletal causes is, in addition to the occurrence of coughing, respiratory dependence.
Furthermore, pain at the costal arch due to coughing can be caused by inflammation of the pleura (Latin pleuritis). In this case, the affected person classically suffers from breath-dependent thoracic pain, i.e. also from pain in the region of the costal arch, in combination with dry coughing and sometimes feverish conditions. Likewise, diseases of the lungs such as pneumonia or pulmonary embolism can be the trigger for the pain, which increases when coughing.
Ultimately, however, internal organs of the abdominal cavity can also trigger pain in the costal arch by coughing. These include the liver, bile and colon on the right side and the spleen on the left side. These organs may be enlarged or inflamed, resulting in pain due to pressure or tension. In general, it is important that regardless of the ultimate cause, if the pain at the costal arch is prolonged by coughing, a doctor should be consulted to clarify the symptoms.
