Lower Back Rib Pain Explained: What Is Causing This Pain?

Grasping the intricacies of lower back rib pain can be quite a puzzle, as it's often hard to nail down the exact cause. In this article, we'll delve into the common culprits behind this kind of pain, which range from muscle injuries to underlying health conditions, and we'll go over the right ways to address it. You'll learn when you can manage the pain on your own and when you should definitely consult a doctor.

What causes lower back rib pain?

There are multiple reasons you might be feeling pain in your lower back ribs. It could be from straining muscles during heavy lifting or intense exercise, an injury to the ribs, or even a problem with your kidneys. Each case comes with its own symptoms and requires a different approach to diagnosis and treatment, which should be customized to your specific situation.

Muscle strains & overuse

Overexertion in physical activities or accidental injuries can lead to straining your intercostal muscles1.These muscles, which lie between the ribs can be overstretched or torn. This results in a sharp pain that becomes more intense with activities like taking deep breaths or twisting the torso.

When these strains occur near the shoulder blades, they can significantly disrupt your daily life. Simple actions, such as bending to tie your shoes or reaching upwards, can become painful reminders of the injury. During the healing process, it's crucial to rest and move carefully to avoid worsening the condition.

Rib injuries

Rib injuries, such as a rib fracture, usually occurs from a direct impact to the chest area. This might happen during a fall, a vehicle collision, or a sports-related accident. A fractured rib can severely limit your ability to breathe deeply and move without experiencing sharp pain. It's also common to feel anxious about causing further harm through movement. Recovery can involve rest and pain management, and sometimes surgery if the injury is severe.

Another condition to be aware of is slipping rib syndrome, which can cause a sharp, stabbing pain under your ribs. While many rib fractures heal on their own with sufficient rest, some of the more serious or multiple fractures might need surgical intervention to ensure proper healing.

Kidney-related concerns

Sometimes, the discomfort you feel under the lower ribs isn't actually related to the bones or muscles, but rather comes from internal issues. Conditions like kidney stones or kidney infections are known for causing a constant, dull pain that spreads to the back and the back of the ribs2. This can make you feel quite uncomfortable right under the ribcage, even though it's not a problem with the the back or the ribs themselves.

Remember how kidney stones are described? They cause an intense cramping pain that starts in the back and can wrap around to your belly. If you have a kidney infection, you might also have a fever, chills, and it could hurt when you go to the bathroom. These symptoms tell us that your body is fighting off something inside. When the pain is this strong, it's usually a sign that you need to get medical help right away.

Disc herniation

Herniated discs are a common cause of the severe pain you might be feeling in your lower back and ribs. Imagine the discs in your spine as small cushions that sit between your bones, helping to absorb shock and allow your spine to move smoothly. When a disc herniates, its inner material pushes through a tear in its outer layer, which can irritate nearby nerves3.

This condition can affect your body in many ways. The leaked material from the disc can irritate the nerves that go from your spinal cord to other parts of your body, leading to pain that may spread from your lower back to your ribs or even down your legs. The pain's intensity can range from a mild ache to a sharp, burning feeling, or it may feel like a sudden jolt, similar to an electric shock. Certain movements, such as bending, lifting, or twisting, can make this pain worse.


Fibromyalgia is a chronic condition characterized by widespread pain and tenderness throughout the body. The exact cause of this syndrome is not fully understood, but it is believed to involve a combination of genetic, environmental, and psychological factors that affect how the brain processes pain signals, a phenomenon known as central sensitization. This results in an increased sensitivity to pain.

People with fibromyalgia experience a broad range of pain, including in the lower back ribs. The pain can be deep, aching, or sharp, and its intensity may vary. Factors such as weather changes, stress, and physical activity can affect the level of pain. Daily activities can be greatly impacted by fibromyalgia, as the pain can become more intense with prolonged sitting or during physical exertion.


Costochondritis is an inflammation of the cartilage that connects the ribs to the breastbone and often presents as pain in the lower back ribs4. This condition can cause a persistent and sharp ache, sometimes mistaken for heart problems due to its intensity and location.

The pain from costochondritis typically occurs on the left side near the sternum, affects several ribs, and can worsen with actions like deep breathing or applying pressure to the affected area. The exact causes of costochondritis can be difficult to pinpoint but may be linked to incidents such as physical injury, repetitive motion, or unusually heavy physical activity.

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What does lower back rib pain feel like?

Individuals may encounter various forms of lower back rib pain, which include:

  • Sharp, stabbing sensations: Such pain is often felt near the rib cage and intensifies with actions like deep breathing, coughing, or stretching the chest.
  • Dull aching pain: A widespread, dull ache may originate from muscle issues in the lower back or near the ribs.
  • Breathing challenges: Difficulty in taking deep breaths can be a significant symptom, possibly indicating a serious condition. Swelling and pain due to rib damage can restrict deep breathing and cause chest pain.
  • Tingling feelings: This type of pain could be due to nerve issues like shingles, which also causes a rash in the affected back or chest area.
  • Spreading sharp pain: Common with kidney stones, this pain starts in the lower back and side and may extend to the groin or lower abdomen.

When is lower back rib pain considered chronic?

Chronic lower back rib pain is defined as persistent pain for more than 3 months. The transition from acute to chronic pain is not obvious, and it's not always clear why some people recover quickly while others progress to chronic pain states. Persistent inflammation, nerve damage, and psychological factors like stress can all play roles in the perpetuation of pain.

How can you diagnose lower back rib pain?

To accurately pinpoint the source of lower back rib pain, your doctor will probably perform a thorough examination, and will:

  • examine your back and rib areas
  • evaluate how well you can move
  • identify any areas that are tender to touch
  • look for injury or trauma indicators
  • test your muscle strength and nerve functionality.

Specific techniques, such as imaging tests like X-rays and MRI scans offer a deeper look into potential structural issues, such as fractures or herniated discs. Blood tests might also be performed to search for infection indicators, check for inflammation, or rule out blood clots that could be causing the rib pain.

How to treat lower back rib pain

A comprehensive range of therapeutic approaches is available for addressing lower back rib pain, varying from simple home remedies to intricate surgeries. The specific treatment, or mix of treatments, that is right for you can be influenced by your personal situation, preferences, and the underlying cause of your discomfort in the lower back ribs, and may encompass:

  • home-based care measures
  • structured physical therapy programs
  • prescription medication
  • precision-guided injection treatments
  • complementary treatments from an acupuncturist, chiropractor, osteopath, or massage therapist
  • surgical interventions when necessary.


When that familiar discomfort encircles your ribs, it's natural to reach for over-the-counter pain relievers such as ibuprofen or naproxen to ease any inflammation and pain. Applying heat and cold alternately can also comfort the inflamed areas. And don't underestimate the power of rest; giving your body a break is essential for recovery, especially if your pain stems from an overzealous workout or a relentless cough. However, being completely sedentary can do more harm than good, so try taking short, gentle walks once or twice a day to stay active while still giving your body a chance to recover.

These simple home treatments are key for managing mild rib pain and empower you to take an active role in your healing journey.

Professional therapies

When home-based remedies fall short, professional therapies step in to fill the gap in managing rib pain. Customized physical therapy plans are designed to support and strengthen the muscles around the ribs, enhance flexibility, and alleviate pain through targeted exercises and manual therapy. For more complex medical conditions, an array of advanced treatments may be employed, including antibiotics for infections or lifestyle adjustments to alleviate joint pressure.

In cases where back rib pain stems from serious conditions like lung cancer, the treatment plan may escalate to include rigorous options such as surgical intervention or chemotherapy, aimed at confronting the root cause.


Maintaining an active lifestyle is key to mitigating chronic inflammation and improving your overall balance and coordination, which help prevent injuries and maintain healthy joints. Regular exercise is not only beneficial for your ribs but also for promoting a dynamic, pain-free existence. To aid in alleviating discomfort, integrating the following activities into your daily regimen is recommended:

  • Practice yoga and tai chi: These practices enhance your flexibility, expand your range of motion, and encourage the secretion of synovial fluid, which is critical for the smooth operation and lubrication of your joints.
  • Participate in strength training: Strengthening the muscles surrounding your joints offers extra support and fortifies stability.
  • Perform aerobic exercises: Activities that increase your heart rate help improve circulation, essential for tissue repair and upkeep.

Do I need to "fix" my posture?

Despite all the things we're told about posture, it's actually a common myth that "poor posture" can cause back pain.

A bigger issue than how you move your body is if you move your body. Moving regularly and changing your posture throughout the day can help to loosen tight muscles and build your confidence in your body's ability to move. This in turn can help you to avoid bracing your body against pain, which can put unnecessary pressure and tension on your body. Plus, a tall posture can boost your sense of self-assurance, which can be good for overall wellbeing!

When to seek help

If your pain is new, persists over a prolonged period, fails to respond to self-treatment, or progressively worsens, it’s crucial to take it seriously and speak with your doctor. If you experience severe pain that impedes your routine tasks or is accompanied by additional symptoms such as fever, vomiting, or respiratory difficulties, seek immediate medical attention.