Rib pain from coughing: causes and how to get relief?

rib pain from coughing
Medically reviewed by Dr. Marsha Dunkely


The episode of severe cough during bouts of chronic bronchitis or a potent cold can be debilitating and concerning when accompanied by intense rib pain. That sharp, localized discomfort might trigger concerns of a fractured rib, but more often, it strains the rib cage. To understand the cause behind rib pain from coughing, it is crucial to understand various causes, ranging from pulmonary issues to musculoskeletal strains. This blog explores the potential triggers for rib pain and treatment options. Whether the culprit is a respiratory ailment, musculoskeletal strain, or another factor, gaining insights into the root causes helps individuals to navigate discomfort effectively.

What does rib pain from coughing feel like?

While rib injuries can result in pain, the primary source of rib pain often stems from chest organs such as the lungs or heart. The pain is frequently localized to the rib or chest wall when the chest or lung area is injured or inflamed. This phenomenon is referred to as referred pain, where the pain is felt not at the origin site.

Pain in the rib area from lung or heart issues can occur and exacerbate during activities like breathing, coughing, sneezing, or laughing. The pain may present as sharp, stabbing, or burning, accompanied by additional symptoms such as

  • Fever
  • Shortness of breath
  • Upper respiratory infection symptoms like cough, congestion, and a runny nose

Given the sudden and intense pain, it raises serious concerns and warrants immediate medical attention. See a doctor for a proper diagnosis, as this type of pain may indicate severe underlying conditions that require timely treatment.

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Why do my ribs hurt so bad from coughing?

Ribs protect many important organs in the body, which makes it necessary to have your ribs healthy. Rib pain exacerbated by breathing, coughing, sneezing, or laughing can stem from various causes, grouped into three categories:

  1. Pulmonary Causes

Pulmonary embolism can cause blockages, such as blood clots, in lung vessels and can intensify the pain by inhalation or exhalation. Other pulmonary causes include COPD, asthma, and lung cancer. 

  1. Musculoskeletal Causes

Excessive physical activity like weightlifting can strain chest muscles, resulting in soreness exacerbated by deep breaths or coughing. Also, direct chest wall injury, like a fractured rib or torn muscles, can lead to pain worsened by breathing.

  1. Inflammation and Infection
  • Pericarditis: Inflammation of the pericardium, the sac surrounding the heart, can cause sudden pleuritic pain primarily felt over the front of the chest.
  • Chronic costochondritis: Inflammation of rib cartilage, mimicking heart attack symptoms, requiring immediate evaluation.
  • Viral pneumonia: An infection of lung tissue causing symptoms like cough, fever, and chest pain, necessitating immediate medical attention.
  • Bronchitis and bacterial Pneumonia: Inflammation or infection of the bronchial tubes or lungs can lead to chest pain, with bacterial pneumonia requiring urgent medical care.
  • Pleurisy: Inflammation or infection of the pleura, the tissues surrounding the lungs, can cause friction and pain during activities that expand the lungs.

  1. Other Causes

Brief, shock-like pain subsiding quickly may be due to injuries like a broken rib or pulled chest muscle. Sharp pain improving with exercise may indicate acid reflux, while lung inflammation may cause small, sharp pain intensified by breathing.

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How to treat severe rib pain from coughing?

Treatment of severe rib pain, especially when associated with pleuritic pain, is highly dependent on the underlying cause, which emphasizes the importance of seeking immediate medical attention. Depending on the specific diagnosis, healthcare providers may recommend the following treatment options:

Pain medication

  • Medications like aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly prescribed to address both pain and inflammation related to various conditions.
  • Colchicine, typically used for gout, may also treat conditions like pericarditis.


If pleuritic pain is linked to a bacterial infection, healthcare providers will prescribe antibiotics to combat the infection of the causing pathogen.


If you experience symptoms of pulmonary embolism or myocardial infarction, you must go to the emergency room (ER) immediately. Medications such as thrombolytics to dissolve clots or anticoagulants to thin the blood may be administered immediately.

Timely intervention is crucial, especially for conditions requiring emergency measures, ensuring appropriate and effective management of severe rib pain.

How long does it take for rib muscles to heal from coughing?

The healing duration for rib muscles strained due to coughing depends on the severity of the injury. Typically, mild intercostal muscle strains, common with coughing, may resolve within a few days. Moderate strains might take approximately 3–7 weeks to heal, while severe strains involving a complete tear of the muscles may require an even more extended healing period. 

In general, most intercostal muscle sprains and rib injuries, including those induced by persistent coughing, should exhibit noticeable improvement within six weeks. However, individual healing times can vary, and it’s essential to prioritize rest and follow healthcare provider recommendations for a full and effective recovery.

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When should I be concerned about rib pain?

If the rib pain worsens or persists without improvement, it is advisable to contact a healthcare provider for a proper diagnosis. Severe rib pain warrants immediate attention, especially if accompanied by additional symptoms like shortness of breath. In such cases, contact your doctor for emergency diagnosis and treatment.

FAQs about coughing

What damage can you do by coughing too hard?

Persistent and forceful coughing can lead to lung irritation, triggering a cycle of continued coughing. Additionally, it can result in exhaustion, sleep disturbances, dizziness, headaches, urinary incontinence, vomiting, and the potential for broken ribs.

How do you know if rib pain is muscular?

Muscular rib pain, such as intercostal muscle strain, manifests with symptoms like chest or rib area pain, breathlessness, restricted upper torso movement, and spasms in the intercostal muscles. The pain, whether sharp or dull, intensifies during breathing, movement, coughing, or sneezing.

What is the best position to sleep in with rib pain?

Optimal sleeping positions for rib pain include lying on your back with a pillow between your knees, promoting proper spinal alignment, and easing pressure on injured muscles. Additionally, you can sleep on your side with a pillow between your knees to maintain spine position and reduce the strain on intercostal muscles. 

Your Doctors Online uses high-quality and trustworthy sources to ensure content accuracy and reliability. We rely on peer-reviewed studies, academic research institutions and medical associations to provide up-to-date and evidence-based information to the users.

  • Hanak, Viktor, Thomas E. Hartman, and Jay H. Ryu. “Cough-induced rib fractures.” In Mayo clinic proceedings, vol. 80, no. 7, pp. 879-882. Elsevier, 2005.
  • Sano, Atsushi, Ken Tashiro, and Tsutomu Fukuda. “Cough-induced rib fractures.” Asian Cardiovascular and Thoracic Annals 23, no. 8 (2015): 958-960.
  • De Maeseneer, Michel, Johan De Mey, Carl Debaere, Marc Meysman, and Michel Osteaux. “Rib fractures induced by coughing: an unusual cause of acute chest pain.” The American journal of emergency medicine 18, no. 2 (2000): 194-197.

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