Many people experience pain in the ribs of the back at some point. The pain may be sharp or dull and mild or severe.

Often, pain in this area results from a relatively minor injury and eases with time. However, it can sometimes indicate a more serious medical condition that requires specialist care.

This article looks at some common causes of pain in the back of the ribs, as well as the associated symptoms and typical treatments.

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Injury is a possible cause of back rib pain.

Injuries from falls and physical activity can lead to back rib pain. Common rib-related injuries include:

  • pulled muscles
  • bruised ribs
  • fractured and broken ribs

If pain following an injury is long-lasting or severe, it may be due to a fractured or broken rib. To detect this kind of injury, a doctor may use an X-ray or MRI.

Treatment options for fractured or broken ribs vary. Many people with fractured ribs just need rest and pain relief medication. Surgical intervention is sometimes necessary, but only in severe cases.

This is an injury to the muscles between the ribs, called the intercostal muscles. A strain occurs when these muscles tear, often due to strenuous physical activity.

Common symptoms of an intercostal muscle strain include:

  • sharp, severe pain in the upper back or ribs
  • stiffness and tension in the upper back muscles
  • spasms in the intercostal muscles

To treat this type of strain, doctors often recommend pain medication and physical therapy.

Rib fractures sometimes result from strenuous exercise or high-impact falls. However, preexisting conditions can weaken the ribs so that they are prone to fracture easily, often during less intensive activities.

Osteoporosis, for example, causes a person’s bones to lose the minerals that they need to stay strong. With a low mineral density, the bones can fracture quite easily.

This is a common condition in older adults, especially females. Symptoms of osteoporosis include soreness and pain.

Healthcare providers often diagnose the issue with X-rays, and they may also test the person’s kidney and thyroid function.

Some treatment options for osteoporosis include:

  • doing gentle strength training, such as yoga or tai chi
  • reducing alcohol consumption and cigarette smoking, if applicable
  • taking calcium and vitamin D3 supplements
  • taking medications that reduce the risk of fractures

Fibromyalgia causes widespread pain in the muscles and bones. Researchers are unsure what causes it, but it is more common in females than in males.

Beyond the pain, fibromyalgia often occurs with:

  • fatigue
  • headaches
  • paresthesia, numbness or a burning sensation, usually in the extremities
  • depression
  • anxiety
  • cognitive disturbances, such as problems processing and remembering information

Because fibromyalgia has such diverse symptoms, doctors may recommend a variety of interventions, including:

  • improving sleep quality
  • practicing relaxation techniques
  • starting cognitive behavioral therapy
  • getting regular cardiovascular exercise
  • taking medications, including antidepressants and anticonvulsants

A pulmonary embolism occurs when a blood vessel in a lung is blocked, often by a blood clot.

Pulmonary embolisms are serious and relatively common. Research shows that they are responsible for around 100,000 to 200,000 deaths per year in the United States alone.

Aside from pain in the back of the ribs, a pulmonary embolism can cause the following symptoms:

  • coughing
  • coughing up blood
  • sweating
  • headaches and lightheadedness
  • shortness of breath
  • rapid breathing
  • anxiety
  • an irregular heartbeat

A pulmonary embolism can be dangerous if the person does not receive treatment.

Typically, treatment involves anticoagulation medication. This thins the blood, making it harder for clots to form.

Individuals who do not tolerate anticoagulants usually receive a different type of medication that prevents the blood from clotting.

Certain conditions that affect the lungs can also cause back rib pain.

For example, pleurisy occurs when the lining of the lungs becomes inflamed. This can lead to pain in the chest, shoulders, and back ribs.

Researchers know that several underlying conditions can cause pleurisy. For this reason, the treatments of pleurisy are varied.

Lung cancer can also cause pain in the chest and ribs. It is life threatening, and a leading cause of cancer-related death in the U.S.

Other symptoms of lung cancer include:

  • coughing
  • shortness of breath
  • coughing up blood

The best course of treatment depends on the cancer’s type and stage, as well as factors specific to each individual. A person may need to undergo surgery, chemotherapy, and radiation therapy.

Back rib pain is often the result of a relatively minor injury. However, it can be a symptom of a more serious health condition.

For this reason, anyone with persistent or severe back rib pain should contact a healthcare provider for guidance.