The pain in the back
On the back side, the ribs are directly connected to the spine and are fixed by ligaments and muscles. At this point, many muscles and tendons of the spine attach to the individual ribs to ensure the stability of the back. When these muscles are tense, overstrained or injured, the pain also manifests itself under the posterior ribs.
Rapid rotations of the upper body, monotonous movements or heavy weight loads can damage the muscles. The pain can be provoked by deep breathing and coughing. The spine can also be the cause.
The thoracic spine is a possible site for herniated discs and pain. A herniated disc in the thoracic spine occurs significantly less frequently than in the deep back. Under certain circumstances, nerve cords can be affected, which in turn can cause pain under the ribs and radiate from the spine.
In the case of dull pain of the ribs in the back, a kidney problem must also be considered. The renal pelvis is sensitive to pain, which is why pain occurs in the context of injuries and inflammation. The pain can be provoked by dull patting on the back. In most cases, inflammation of the kidney is accompanied by a strong feeling of illness and general symptoms.
The pain of breathing
Breathing is largely performed through the diaphragm. However, some muscles of the thorax support this process, which is why they are called “respiratory assist muscles”. These include some muscle groups that start at the ribs and, when contracted, lift the ribs and expand the chest for breathing.
Between the individual ribs run transverse small muscle strands that help with deep inhalation and forced exhalation. Tension, sore muscles or tears in these muscles cause sharp pain under the ribs with each breath. Irritation and damage to the intercostal nerves (nerves under the ribs) also aggravate the pain or are triggered by deep breathing.
Unconsciously, patients breathe shallower, and if the pain is particularly severe, breathing difficulties may occur. In the case of rib fractures, the pain is also increased by deep breathing, which causes the rib cage to move and thus the fracture sites to shift. In cases of shortness of breath or unbearable pain, strong painkillers, for example morphine, must sometimes be given to ensure breathing and make it bearable.
Some organic diseases also cause breathing difficulties. However, the pain under the ribs is not necessarily respiratory. In the case of inflammation of the lungs or heart attacks, but also in heart failure, there is pain in the chest with shortness of breath. One of the immediate measures to be taken in the event of an acute heart attack is to support yourself with your hands behind you while sitting. This supports the respiratory muscles of the chest and makes breathing easier.
