Rib Pain From Coughing: Why It Happens and How to Ease It

A bad cold can leave you with more than a sore throat. After a week of hard coughing, many people end up with sore ribs from coughing: a sharp or aching pain along the ribcage. It can catch you when you breathe in, twist, laugh or cough again.

Most rib pain from coughing comes from strained muscles or irritated rib joints, and it usually settles as the cough does. Sometimes, though, it points to something that needs a doctor. Here’s how to tell the difference, what helps at home, and when chiropractic care can help.

Why coughing makes your ribs hurt

A single cough pushes air out of your lungs at high speed. To do that, the muscles between and around your ribs contract hard and fast. Do that hundreds of times a day for a week, and the ribcage takes a beating.

1. Strained rib muscles

This is the most common cause. The small muscles between your ribs (the intercostals) can become strained, just like a pulled hamstring. It’s often called a pulled rib muscle from coughing. The pain is usually on one side, feels sore or tight, and gets worse when you cough, sneeze or take a deep breath.

2. Irritated rib joints

Each rib connects to your spine at the back and, for most ribs, to cartilage near your breastbone at the front. Repeated coughing can irritate these joints. At the back, it can feel like a sharp catch beside your spine, and many people describe it as a rib “out of place.” At the front, irritation of the rib cartilage (costochondritis) causes tenderness beside the breastbone. Our rib guide covers the “out of place” feeling in more detail.

3. A cracked rib

Less often, forceful coughing can crack a rib. This is more likely with weakened bones (osteoporosis), long-term steroid use, or a severe cough that has lasted weeks. The pain is usually sharp, sits on one small spot, and may have started with a pop or crack. A suspected fracture needs a medical exam, sometimes with imaging. X-rays can miss small cracks, so pinpoint pain that doesn’t ease still needs follow-up.

4. Something in the chest, not the ribs

Pain can also come from the lungs or the lining around them, as with pneumonia or pleurisy. This pain is often sharp when you breathe in and may come with fever or shortness of breath. It needs a doctor, not a chiropractor.

What helps at home

For a strained muscle or irritated rib joint, these steps usually help while the cough runs its course:

• Brace when you cough. Hug a pillow firmly against the sore side before each cough. It supports the ribs and takes the edge off the pain.
• Keep breathing deeply. It’s tempting to take shallow breaths, but a few slow, deep breaths every hour help keep your lungs clear. If deep breaths are too painful to take, see a doctor.
• Cold first, then heat. For the first two days, try a wrapped ice pack for 15 to 20 minutes at a time. After that, gentle heat can help tight muscles relax.
• Calm the cough. Ask your doctor or pharmacist about the cough itself. Every cough you avoid gives your ribs a chance to heal.
• Go easy on lifting and twisting. For a week or two, avoid heavy lifting and try sleeping propped up on pillows.
• Ask your pharmacist which over-the-counter pain reliever is right for you, especially if you take other medications.

When to see a doctor first

Some rib and chest pain is not a muscle or joint problem. Call 911 if you have:

• Chest pain or pressure, especially if it spreads to your arm, jaw, neck or back
• Sudden sharp chest pain with shortness of breath, especially with a swollen or painful calf
• Pain that makes it hard to breathe
• Coughing up blood
• Pain under your left ribs with pain at the tip of your left shoulder, or under your right ribs with pain at the tip of your right shoulder

See a doctor today if you have:

• Fever, chills, or a cough that is getting worse instead of better
• Burning pain or a rash in a band around one side of your chest (a sign of shingles)

See your doctor soon if:

• Your cough has lasted more than three weeks
• You felt a pop or crack, or one small spot on a rib is very tender
• You have osteoporosis, take long-term steroids, or have a history of cancer
• The pain started after a fall or other injury
• The pain is constant, worse at night, or doesn’t change when you move
• You have numbness, tingling or weakness in your arms, legs or chest wall, or new bladder or bowel changes
• You have lost weight without trying

How chiropractic care can help

Once a fracture, infection or heart and lung problem has been ruled out, rib pain from coughing is usually a muscle and joint problem. That’s where chiropractic care fits. At True Form, every first visit starts with a full history and exam, so we know what we’re treating before we treat it. Depending on what we find, care may include:

• Gentle adjustments or mobilization of stiff rib joints and the mid-back, to ease stiffness and improve movement
• Active Release Techniques to release strained muscles between and around the ribs
• Functional taping with light, flexible tape (never tight strapping) to support the area while the cough settles
• Breathing and posture exercises to keep the ribcage moving as you recover

If anything in your exam suggests a fracture or a problem outside chiropractic care, we’ll refer you to your doctor. We also adjust or avoid hands-on techniques for patients with osteoporosis, those taking blood thinners, and during pregnancy.

Frequently asked questions

How long does rib pain from coughing last?

Rib pain after coughing from a strained muscle usually improves within one to three weeks once the cough eases. A cracked rib typically takes about six weeks to heal. If your pain isn’t getting better after two weeks, get it checked.

Can coughing make a rib feel “out of place”?

Yes. Repeated coughing can irritate the joint where a rib meets the spine, which can cause a sharp catch that many people describe as a rib out of place. Our rib guide explains what’s happening and what helps.

Is it a pulled muscle or a cracked rib?

A pulled muscle usually feels like broad soreness that worsens with movement. A cracked rib tends to cause sharp pain in one small spot, sometimes after a pop or crack. Only an exam can tell for sure, sometimes with imaging. X-rays can miss small cracks, so ongoing pinpoint pain still needs follow-up.

Should I use heat or ice?

Try ice for the first two days, then switch to gentle heat to relax tight muscles.

Get relief in Denver

If a lingering cough has left your ribs sore, we can help you take a deep breath, move and sleep with less pain. True Form Chiropractic is at 4155 E Jewell Ave, Suite 610, Denver, CO 80222. Call (720) 449-6723 or request an appointment online.

This article is for general information and isn’t a substitute for medical advice. If you’re unsure what’s causing your pain, talk with a healthcare provider.