Rib and chest wall pain (costochondritis): causes and when to worry
Why the ribs and the joints at the front of the chest can become painful, how it differs from heart-related pain, and when chest pain needs emergency help.
The ribs join the breastbone through cartilage, and the joints and muscles of the rib cage can become irritated, causing sharp or aching pain at the front or side of the chest. This is known as costochondritis when it affects the cartilage. It can be frightening because chest pain makes people think of the heart, but it is usually harmless and settles by itself.
When to get urgent help
Call 999 straight away if back or chest-area pain comes with any of these.
- Chest pain or pressure, breathlessness, sweating or feeling faint
- A band-like pain around the chest or abdomen with weakness or numbness in the legs
- Difficulty passing urine, loss of bladder or bowel control, or numbness in the saddle area
What it can feel like
- Sharp or aching pain at the front or side of the chest
- Pain that is worse when you move the upper body, lie down, take a deep breath, or press on the ribs
- Tenderness over one or more rib joints beside the breastbone
- Pain that may follow heavy coughing, an unaccustomed workout or a minor knock
Common contributors
- Irritation of the cartilage joining the ribs to the breastbone
- Strain of the small muscles between the ribs after coughing or exercise
- Stiffness in the mid-back joints where the ribs attach
- Often no clear cause is found
General self-care
These are general comfort measures many people find reasonable. They are not a treatment plan, and what suits one person may not suit another.
- The NHS says the condition often improves by itself over a few weeks to several months
- Keep gently active and avoid positions that clearly aggravate it
- Warmth can be comfortable for some people
- A pharmacist or GP can advise on anti-inflammatory painkillers such as ibuprofen, which are not suitable for everyone
- Gentle, comfortable deep breathing helps prevent the chest from feeling stiff
When to see your GP
See your GP promptly, or call NHS 111, if you have any of the following:
- Pain after a significant fall, accident or blow
- Pain that is constant, severe, or waking you at night regardless of position
- Unexplained weight loss, a high temperature or feeling generally unwell
Consider seeing your GP if:
- Any new chest pain you cannot explain should be checked by a doctor
- Pain that is not improving after a few weeks
- Pain with a fever, cough producing coloured phlegm, or a swollen, red, hot rib joint
Where an osteopath fits in
There is limited good-quality research showing that hands-on treatment changes the course of rib and chest wall pain, so I do not claim that osteopathy treats it.
What an osteopath can usefully do is assess how the mid-back and ribs move, work out whether your pain behaves like a mechanical rib problem, and advise on movement and breathing, once any medical cause for chest pain has been ruled out by a doctor. If your symptoms do not fit, I will refer you on rather than treat. If the assessment suggests you need your GP, a physiotherapist or a specialist instead, I will tell you.
If you would like your symptoms assessed, you are welcome to book an appointment. Osteopathic care is not right for everyone, and if something needs medical attention first, I will tell you.
Common questions
How can I tell if chest pain is my heart?
You cannot reliably tell yourself. The NHS says to call 999 for sudden chest pain that spreads to the arm, neck or jaw, a feeling of tightness in the chest, chest pain with breathlessness, a racing heartbeat or coughing up blood, and not to drive yourself to A&E.
How long does costochondritis last?
The NHS says it often improves by itself over a few weeks to several months.
Sources and further reading
Links open in a new tab. Sources were checked in October 2026.
Related guides
This page is general information to help you understand common aches and pains. It is not medical advice and cannot diagnose your problem. If you are worried about your symptoms, please speak to your GP or call NHS 111.