Upper back and rib pain
Costovertebral joint pain
Costovertebral joint pain refers to discomfort that arises from the joints where the ribs meet the vertebrae of the spine. These joints are known as costovertebral joints, and they play a key role in allowing your rib cage to expand and contract with breathing. When these joints become irritated or inflamed, it can cause pain in the upper back or chest area.
Common symptoms:
Upper Back Pain: The pain is often felt in the upper back, near the spine, between the shoulder blades, or along the sides of the rib cage. It may be sharp, aching, or a dull, constant discomfort.
Pain with Breathing: Like other chest or rib-related pain, costovertebral joint pain can worsen with deep breaths, sneezing, or coughing, as the ribs move and the muscles stretch.
Tenderness: The area around the costovertebral joints (where the ribs meet the spine) may feel tender to the touch.
Pain on Movement: Twisting the torso, bending forward, or any motion that involves the upper back and ribcage might increase the pain.
Referred Pain: Sometimes the pain can radiate, meaning it can be felt in other areas such as the chest, upper abdomen, or even the shoulder blade region. It might be mistaken for heart pain or other issues, though it is not related to the heart.
Intercostal muscle strain
An intercostal muscle strain occurs when one of the muscles between your ribs (the intercostal muscles) is stretched or torn, usually due to sudden movements, heavy lifting, or overuse. These muscles are responsible for helping you breathe by expanding and contracting your rib cage. When they get strained, it can be quite painful, particularly when breathing, coughing, or moving your torso.
Sharp or Stabbing Pain: Usually on one side of your chest or upper ribs, which is often worse when you breathe in deeply, cough, or twist your torso.
Tenderness: The area between the ribs will be tender to touch, and the pain can worsen with physical activity or when you press on the affected muscles.
Pain with Breathing or Coughing: Deep breaths, sneezing, or coughing might trigger or intensify the pain. The muscles are involved in expanding and contracting the chest during these actions, so it’s not uncommon for the strain to be aggravated by these movements.
Muscle Spasms: In some cases, you might experience spasms or tightness in the affected muscle.
Limited Range of Motion: Moving or twisting your upper body might feel restricted or uncomfortable due to the pain.
Tietze syndrome
Tietze Syndrome is a rare, benign condition that involves inflammation of the cartilage in the rib cage, most commonly where the upper ribs attach to the breastbone (sternum). It's similar to costochondritis in terms of symptoms, but the key difference is that Tietze Syndrome often causes swelling at the site of inflammation, whereas costochondritis generally does not.
Potential symptoms:
Chest Pain: Like costochondritis, the main symptom is pain in the chest, which is typically sharp or aching. This pain is usually localized to the area where the rib cartilage meets the breastbone or sternum.
Swelling: One of the hallmark symptoms of Tietze Syndrome is visible swelling at the site where the cartilage meets the sternum. This swelling is often noticeable and can make the area tender to touch.
Tenderness: Pressing on the inflamed area of cartilage will usually cause pain.
Pain with Breathing or Coughing: Similar to other chest-related conditions, Tietze Syndrome can cause discomfort when taking deep breaths, coughing, or sneezing due to the involvement of the ribcage muscles.
Limited Mobility: Pain may restrict your ability to move freely or perform certain activities without discomfort, especially those involving your upper body or arms.
Costochondritis
Costochondritis is an inflammation of the cartilage where your ribs attach to your breastbone (sternum). It's often described as a sharp or aching pain in the chest, which can be mistaken for heart-related issues, though it's not actually related to the heart. The pain is typically on the left side of the chest, but it can affect either side.
If you’re experiencing chest pain, it’s always wise to consult a doctor to rule out other more serious causes, such as heart problems.
Potential symptoms:
Chest Pain: The main symptom is a sharp or aching pain in the chest, often on the left side.
Pain on Movement or Pressure: The pain may worsen with certain movements, like twisting your torso, or with activities that involve lifting your arms or coughing.
Pain in the Rib Cage: Some people experience discomfort along the side of the ribs, especially if the inflammation extends to the cartilage in that region.
Worsening Pain with Activity: The pain might be aggravated by physical activity, heavy lifting, or even deep breathing.
Postural kyphosis
Postural kyphosis is characterised by an exaggerated forward curvature of the upper spine (thoracic spine), often referred to as a "hunchback" posture. Unlike other forms of kyphosis, postural kyphosis is typically caused by poor posture rather than a structural abnormality in the spine, and does’t necessarily lead to back pain, but can in some individuals. It’s commonly seen in teenagers and in adults, especially those who spend long periods sitting or hunched over.
Signs of Postural Kyphosis:
Rounded Shoulders
Back Pain or Discomfort: Particularly after long periods of sitting, standing, or poor posture.
Fatigue: Because the muscles in the back are forced to work harder to maintain an abnormal posture, it can lead to fatigue and muscle strain.
Difficulty with Posture: Individuals may find it difficult to maintain an upright, straight posture without feeling strain or discomfort in the back.
Neck and Shoulder Pain: Due to the forward position of the spine, there can also be tension in the neck and shoulders, leading to pain or tightness.
Decreased Flexibility: As the spine maintains an abnormal curve, flexibility, especially in the upper back, may be reduced.
Myofascial pain syndrome
Myofascial Pain Syndrome (MPS) is a condition characterised by chronic pain in the muscles and the surrounding connective tissue (the fascia). It’s often caused by the development of trigger points—tight, sensitive areas within muscles that can cause referred pain in other parts of the body. These trigger points can be active (causing pain all the time) or latent (asymptomatic until pressed or triggered).
Symptoms of Myofascial Pain Syndrome:
Localised Muscle Pain: The pain is often felt in specific muscles, typically in the neck, shoulders, back, or hips. It’s often described as aching, deep, or dull, but it can also feel sharp depending on the muscle involved.
Trigger Points: Trigger points are small, tight knots within the muscle that are often tender to the touch. When pressed, they can cause referred pain in another area of the body. For example, a trigger point in the shoulder may cause pain down the arm or into the neck.
Referred Pain: One of the hallmark features of MPS is that pain can radiate from the trigger point to other areas of the body. For instance, a trigger point in the upper back could cause pain in the head, resulting in a tension headache.
Muscle Stiffness: The affected muscles may feel tight or stiff, limiting mobility or causing difficulty with everyday activities like bending or lifting.
Pseudo Weakness: You may experience a sensation of muscle weakness, even though the muscle itself is not necessarily damaged. This can happen because of the persistent tension and discomfort.
Pain with Activity
Poor Sleep