Rib Pain: Causes and Solutions for Teens - Orthopedics

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Costochondral tenderness?


Hello Doctor, I am 14 years old and recently started experiencing unexplained pain in my left chest.
I had a chest X-ray and heart examination, both of which showed no issues.
The pain is usually sharp, and there is a specific point on the lower right side of my ribcage (between two ribs) that hurts when pressed.
Could this indicate a problem with my ribs? This has been going on for 2 months without improvement.
Is it possible that poor posture is causing this? Thank you.

Qiu Haoxuan, 10~19 year old female. Ask Date: 2020/06/21

Dr. Li Wenhong reply Orthopedics


Hello: If cardiac and pulmonary issues are ruled out, and X-rays do not reveal any skeletal abnormalities, it may be costochondritis, which is common in adolescents.
The exact cause is unknown, but it may be due to overuse leading to localized inflammation.
Depending on the symptoms, local ice or heat therapy can be applied, along with oral anti-inflammatory pain relievers.
It is advisable to avoid rapid turning or quick lifting of the upper limbs.
Typically, symptoms may persist intermittently for 4 to 6 months.
Changhua Hospital, Orthopedics, Dr.
Li Wen-Hong.

Reply Date: 2020/06/21

More Info


Rib pain in teenagers can be concerning, especially when it persists for an extended period, as you have described. Given your age and the nature of your symptoms, it is essential to consider various potential causes and solutions for rib pain.


Possible Causes of Rib Pain
1. Muscular Strain: One of the most common causes of rib pain, especially in adolescents, is muscular strain. This can occur due to activities such as sports, heavy lifting, or even poor posture. If you have been engaging in physical activities or have a habit of slouching, this could lead to muscle strain around the rib cage.

2. Costochondritis: This is an inflammation of the cartilage that connects a rib to the sternum. It can cause sharp pain in the chest area, which may worsen with certain movements or when pressing on the affected area. Costochondritis is often benign and can resolve with time and conservative treatment.

3. Rib Fractures or Bruises: Although you mentioned that X-rays showed no issues, it is still possible to have a rib bruise or a hairline fracture that might not be visible on an X-ray. This can occur from trauma or even from intense coughing.

4. Postural Issues: Poor posture can lead to muscle imbalances and strain, particularly in the upper body. If you spend long hours hunched over a desk or device, this could contribute to your rib pain.

5. Referred Pain: Sometimes, pain in the rib area can be referred from other areas, such as the abdomen or spine. Conditions affecting the spine, such as herniated discs or muscle spasms, can manifest as rib pain.


Solutions and Management
1. Rest and Activity Modification: If your rib pain is due to muscular strain or costochondritis, resting the affected area and avoiding activities that exacerbate the pain can be beneficial.
2. Heat and Cold Therapy: Applying heat or cold packs to the affected area can help alleviate pain. Heat can relax and soothe tense muscles, while cold can reduce inflammation and numb sharp pain.

3. Over-the-Counter Pain Relief: Non-prescription medications such as acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) can help manage pain and reduce inflammation. However, be sure to follow the recommended dosages and consult with a healthcare provider if you have any concerns.

4. Posture Correction: Focus on maintaining good posture, especially when sitting for long periods. Ergonomic adjustments to your workspace can help reduce strain on your back and ribcage.

5. Physical Therapy: If the pain persists, consider consulting a physical therapist. They can provide exercises to strengthen the muscles around your ribs and improve your posture, which may alleviate pain.

6. Follow-Up with a Healthcare Provider: Since your pain has lasted for two months, it is advisable to follow up with a healthcare provider. They may recommend further evaluation, such as an MRI or CT scan, to rule out any underlying issues that may not have been visible on the initial X-ray.


Conclusion
While rib pain can be alarming, many cases in teenagers are due to benign causes such as muscular strain or costochondritis. By implementing conservative management strategies and seeking further evaluation if necessary, you can effectively address your symptoms. Remember, it is essential to listen to your body and consult with a healthcare professional if your pain worsens or does not improve with home care.

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