Read below about rib pain that gets worse when breathing, coughing, sneezing, or laughing, including causes, treatment options and remedies. Or get a personalized analysis of your rib pain that gets worse when breathing, coughing, sneezing, or laughing from our A.I. health assistant. At Buoy, we build tools that help you know what’s wrong right now and how to get the right care.

Rib Pain That Gets Worse When Breathing, Coughing, Sneezing, or Laughing Symptom Checker

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Rib Pain That Gets Worse When Breathing, Coughing, Sneezing, or Laughing Symptoms

The 24 ribs of the rib cage and the muscles of the chest wall enclose and protect various organs of the upper body, including the lungs and the heart.

Although damage to the ribs can produce pain, rib pain most often originates from organs in the chest such as the lungs or heart. When the components of the chest or lungs become injured or inflamed, the pain may be felt most in the rib/chest wall [2]. This is known as referred pain, or pain felt not at the site of origin [4].

Characteristics

Some types of referred pain from the lungs or heart can manifest in the rib area and worsen with actions such as breathing, coughing, sneezing or laughing. The pain may feel sharp, stabbing or burning and may also be associated with symptoms including:

The pain can be sudden and intense thus a serious cause for concern. It is important to get medical attention immediately as this type of pain can signal serious underlying conditions that require prompt assessment and treatment.

Rib Pain That Gets Worse When Breathing, Coughing, Sneezing, or Laughing Causes

Since the ribs enclose so many organs, rib pain that gets worse when breathing, coughing, sneezing or laughing can have a variety of causes. These causes can be most easily grouped into the following categories.

Pulmonary

The lungs are in closest proximity to the ribs/chest wall and are often the most common cause of rib pain associated with exhalation or inhalation. The medical term for such pain is pleurisy or pleuritic chest pain. Pleuritic pain relates to large tissues, called pleura, that separate the lungs from the chest wall [1]. One layer of pleura wraps around the lungs and the other layer of pleura lines the chest wall. Under normal conditions, the layers slide or glide against each other smoothly during inhalation or exhalation. However, certain conditions can cause inflammation or irritation of the pleura causing friction. As a result, the two pleural layers rub against each other like sandpaper, causing pain during any activities or movements that cause expansion of the lungs such as coughing, sneezing, laughing and basic breathing. Many types of conditions can cause such irritation, including:

  • Inflammation: Inflammatory pathogens such as viruses, bacteria, and fungi can infect the pleura and cause pleuritic pain in addition to symptoms such as a cough, fever, and congestion. A primary infection of the lung itself such as in pneumonia can also spread to the pleura and cause pleuritic pain [5].
  • Obstruction: Chronic or acute obstruction to the vessels of the lungs, especially in the form of a blood clot (embolism) can result in sudden shortness of breath and pain worsened with inhalation or exhalation.

Musculoskeletal

The muscles, bones, skin and soft tissues of the chest wall can also become inflamed or injured, resulting in rib pain that worsens with specific activities.

  • Overuse: Physical activity that is strenuous and puts stress on the muscles of the chest, such as pushups or weightlifting, can result in soreness that can worsen with taking deep breaths or laughing or sneezing.
  • Inflammation: Inflammation to the cartilage that attaches the ribs to the sternum can result in a condition called costochondritis [7]. Costochondritis results in pain and tenderness around the ribs that can be exacerbated with taking deep breaths or coughing.
  • Traumatic: Direct injury to the chest wall can result in damage such as a fractured rib or torn muscles that may present as rib pain that worsens with inhalation or exhalation.

Cardiac

Similarly to the lungs, damage or inflammation to the heart can also result in distinctive pleuritic pain that comes on suddenly and is felt primarily over the front of the chest. A sac called the pericardium surrounds the heart; see an image of the pericardium here. Inflammation of the pericardium is known as pericarditis and similar etiologies such as infection, trauma, systemic inflammatory conditions, etc. can cause it [8].

9 Possible Conditions

The list below shows results from the use of our quiz by Buoy users who experienced rib pain that gets worse when breathing, coughing, sneezing, or laughing. This list does not constitute medical advice and may not accurately represent what you have.

  1. 1.Acute Costochondritis (Chest Wall Syndrome)

    Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone. Pain caused by costochondritis may mimic that of a heart attack or other heart conditions.

    Costochondritis is generally self-limiting but may take several weeks to go away.

    Rarity:
    Uncommon
    Top Symptoms:
    rib pain, chest pain that is worse when breathing, chest pain, rib pain when moving, pain when pressing on the chest
    Urgency:
    Phone call or in-person visit
  2. 2.Normal Occurence of Chest Pain

    Many people experience chest pain and it's not always indicative of a serious issue.

    1 day

    Rarity:
    Common
    Top Symptoms:
    chest pain, rib pain
    Symptoms that always occur with normal occurence of chest pain:
    chest pain
    Symptoms that never occur with normal occurence of chest pain:
    being severely ill, shortness of breath, fainting, severe chest pain, crushing chest pain, excessive sweating, nausea or vomiting, fast heart rate in adults, slow heart rate
    Urgency:
    Phone call or in-person visit
  3. 3.Atypical Chest Pain

    Atypical chest pain describes the situation when someone's chest pain is unlikely to be related to heart or lung disease. There are many other possible causes that could explain chest pain, like sore chest wall muscles or psychological factors like stress and anxiety.

    Recovery time depends on the underlying cause.

    Rarity:
    Common
    Top Symptoms:
    chest pain, shortness of breath
    Symptoms that always occur with atypical chest pain:
    chest pain
    Symptoms that never occur with atypical chest pain:
    fever
    Urgency:
    Primary care doctor
  4. 4.Bronchitis

    Bronchitis is an inflammation of the bronchial tubes, the airways that carry air to your lungs. It causes a cough that often brings up mucus, as well as shortness of breath, wheezing, and chest tightness. It is typically caused by a virus.

    Symptoms resolve within 1-2 weeks.

    Rarity:
    Common
    Top Symptoms:
    cough, productive cough, sore throat, wheezing, coughing up green or yellow phlegm
    Symptoms that always occur with bronchitis:
    cough
    Symptoms that never occur with bronchitis:
    nausea or vomiting
    Urgency:
    Self-treatment

    Rib Pain That Gets Worse When Breathing, Coughing, Sneezing, or Laughing Symptom Checker

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  5. 5.Viral Pneumonia

    Viral pneumonia is inflammation (irritation and swelling) of the lungs due to infection with a virus. Community-acquired pneumonia is the most common type, which is usually acquired in public areas such as at work, school, or grocery store.

    Symptoms begin to improve within a few days.

    Rarity:
    Uncommon
    Top Symptoms:
    fatigue, headache, cough, shortness of breath, loss of appetite
    Urgency:
    Primary care doctor
  6. 6.Pleurisy

    Pleurisy is inflammation of the lining of the lungs and chest (the pleura) that leads to chest pain when taking a breath or cough.

    Indefinite

    Rarity:
    Uncommon
    Top Symptoms:
    shortness of breath, muscle aches, fever, cough with dry or watery sputum, rib pain that gets worse when breathing, coughing, sneezing, or laughing
    Urgency:
    Primary care doctor
  7. 7.Bacterial Pneumonia

    Bacterial pneumonia is the infection of the lungs with bacteria (as opposed to a fungus or a virus).

    1-3 weeks

    Rarity:
    Common
    Top Symptoms:
    fatigue, cough, headache, loss of appetite, shortness of breath
    Symptoms that always occur with bacterial pneumonia:
    cough
    Urgency:
    In-person visit
  8. 8.Rib Bruise or Fracture

    Broken or bruised ribs are usually caused by a fall or a blow to the chest, although occasionally this can happen due to severe coughing. With a broken rib, the pain is worse when bending and twisting the body.

    Improves on its own within 3 to 6 weeks.

    Rarity:
    Uncommon
    Top Symptoms:
    rib pain that gets worse when breathing, coughing, sneezing, or laughing, rib pain from an injury, sports injury, rib pain on one side, injury from a common fall
    Symptoms that always occur with rib bruise or fracture:
    rib pain from an injury
    Urgency:
    Primary care doctor
  9. 9.Chronic Costochondritis (Chest Wall Syndrome)

    Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone. Pain caused by costochondritis may mimic that of a heart attack or other heart conditions.

    Costochondritis is generally self-limiting but may take several weeks to go away.

    Rarity:
    Uncommon
    Top Symptoms:
    rib pain, chest pain, chest pain that is worse when breathing, rib pain when moving, pain when pressing on the chest
    Urgency:
    Phone call or in-person visit

Rib Pain That Gets Worse When Breathing, Coughing, Sneezing, or Laughing Treatments, Relief and Prevention

Treatment of pleuritic pain is very dependent on the cause, making it of utmost importance to get prompt medical attention.

The goals of treatment for many causes of pleurisy are to alleviate pain and resolve inflammation. Depending on the specific cause, your healthcare provider may prescribe the following medications:

  • Pain medication: Medications such as aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) are often used to combat both the pain and inflammation associated with many of these conditions. Another anti-inflammatory medication colchicine, more often used to treat gout, can also be used to treat pericarditis [8].
  • Antibiotics: If the pleuritic pain is associated with bacterial infection, your healthcare provider will prescribe antibiotics targeted to the specific pathogen.

There are many causes of lung or heart inflammation such as pulmonary embolism (PE) or myocardial infarction (heart attack) that require emergency intervention such as medications to dissolve clots (thrombolytics) or thin the blood (anticoagulant).

FAQs About Rib Pain That Gets Worse When Breathing, Coughing, Sneezing, or Laughing

Here are some frequently asked questions about rib pain that gets worse when breathing, coughing, sneezing, or laughing.

Is pain that worsens when I laugh, sneeze, cough or breathe life-threatening?

Never ignore such symptoms because pleuritic pain can be a symptom of seriously life-threatening conditions such as a pulmonary embolism. Get emergency treatment immediately especially if you experience additional symptoms such as shortness of breath, calf or thigh pain/ swelling or have a history of blood clots in the leg.

If my pleuritic pain is due to a musculoskeletal etiology, is there anything I can do at home to help my symptoms?

You can try doing stretching exercises that target the chest and its muscles like yoga or Tai Chi. Putting a heating pad or ice pack on the painful area periodically may also help relax and ease your pain.

How is costochondritis treated?

Often, costochondritis is self-limiting, meaning it goes away without treatment; however, over-the-counter medications such as Tylenol or ibuprofen can provide pain relief [7].

How long will my symptoms of pleuritic chest pain last?

The duration of symptoms depends on the specific cause [2]. For example, irritation of the pleura by a viral infection is self-limited and not treated with antibiotics. Most often, once the viral infection resolves, the inflammation and pleuritic pain will also resolve. Make sure to talk with your physician about your specific symptoms and possible duration.

Why does my rib pain worsen when I take a deep breath?

When the lining of the lungs (the pleura) becomes inflamed, this causes a condition called pleuritis — sharp chest pain that worsens during breathing [1]. The pleura is divided into two thin layers. One layer wraps around the lungs and the other layer lines the inner chest wall. Breathing causes the lungs to expand and the inflamed pleura rub against each other, causing pain during inhalation and exhalation.

Questions Your Doctor May Ask About Rib Pain That Gets Worse When Breathing, Coughing, Sneezing, or Laughing

  • Q.Do you have a cough?
  • Q.Any fever today or during the last week?
  • Q.How would you explain why your chest hurts?
  • Q.Did you have any cold-like symptoms in the past week or two?

If you've answered yes to one or more of these questions, try our rib pain that gets worse when breathing, coughing, sneezing, or laughing symptom checker to find out more.

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Rib Pain That Gets Worse When Breathing, Coughing, Sneezing, or Laughing Symptom Checker Statistics

  • People who have experienced rib pain that gets worse when breathing, coughing, sneezing, or laughing have also experienced:

    • 12% Chest Pain That Gets Worse When Breathing or Coughing
    • 8% Rib Pain on One Side
    • 8% Rib Pain
  • People who have experienced rib pain that gets worse when breathing, coughing, sneezing, or laughing had symptoms persist for:

    • 48% Less Than a Day
    • 23% Less Than a Week
    • 14% Over a Month
  • People who have experienced rib pain that gets worse when breathing, coughing, sneezing, or laughing were most often matched with:

    • 50% Atypical Chest Pain
    • 25% Acute Costochondritis (Chest Wall Syndrome)
    • 25% Normal Occurence of Chest Pain
  • Source: Aggregated and anonymized results from visits to the Buoy AI health assistant (check it out by clicking on “Take Quiz”).

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References

  1. Reamy BV, Williams PM, Odom MR. Pleuritic Chest Pain: Sorting Through the Differential Diagnosis. American Family Physician. 2017;96(5):306-312. AAFP Link
  2. Aroesty JM, Kannam JP. Patient Education: Chest Pain (Beyond the Basics). UpToDate. Updated August 27, 2018. UpToDate Link
  3. Wise CM. Major Causes of Musculoskeletal Chest Pain in Adults. UpToDate. Updated November 22, 2017. UpToDate Link
  4. Murray GM, eds. Referred Pain. Journal of Applied Oral Science. 2009;17(6):i. NCBI Link
  5. Scivoletti-Polan NA, Valentino DJ, Rosenberg SB, Cowan SW, Soiferman EI. A 65-Year-Old Man with Shortness of Breath, Pleuritic Chest Pain, and Recurrent Pneumonia. The Journal of American Osteopathic Association. 2010;110:733-736. JAOA Link
  6. Moua T, Wood K. COPD and PE: A Clinical Dilemma. International Journal of Chronic Obstructive Pulmonary Disease. 2008;3(2):277-284. NCBI Link
  7. Costochondritis: What You Need To Know. American Family Physician. 2009 Sep 15;75(10):1. AAFP Link
  8. Imazio M. Patient Education: Pericarditis (Beyond the Basics). UpToDate. Updated December 1, 2017. UpToDate Link