Pain in Pregnancy Part 5: Rib Pain

Another common location for pain during pregnancy is the ribs! It's of course more common in the 2nd and 3rd trimesters, and like other types of pain during pregnancy, it's not something you just need to live with!

What causes rib pain during pregnancy?

1. Growing baby - as the uterus and baby grow, they take up more real estate in the abdomen. This can put more stretch and pressure on the ribs, which can hurt.

2. Growing breast tissue - the increase in size and weight can also tug on the ribs causing discomfort.

3. Postural changes from the above two body changes - the center of gravity changes, and so does your posture. This can put different strain on the ribs.

4. Heartburn/Acid Reflux can also mimic musculoskeletal rib pain. Hormonal changes in pregnancy can relax the muscles of the esophagus, making heartburn/acid reflux more common. Additionally, the baby taking up more space can also put pressure on the stomach/esophagus.

What do I do to relieve rib pain during pregnancy?

I’ll always recommend physical therapy for any pains during pregnancy, including rib pain. Improving mobility can help improve rib pain, and learning about posture, movement, and positioning are all things to help keep it at bay.

1. Specific stretching: depending on what specifically is happening to you, certain stretches can be wildly helpful. 

   1. Example: Doorway pec stretch: simply stretching the pectoralis muscles can help reduce the pull on the rib cage from the top down. I suggest holding at least 30 seconds, but ideally closer to 2 mins.

2. Specific strengthening: again, specific to your individual case, there are a variety of strengthening exercises that can help reduce your rib pain. 

   1. Example: Banded pull apart: this works the opposite muscles to the pecs - the rhomboids and middle traps. Creating that balance can decrease tension on the ribs and help with postural awareness.

3. Posture: making adjustments to how you are sitting, standing, and moving can deload your ribs.

4. Positioning in sitting and in bed: using pillows, blankets, and towels to support your body when laying or sitting can also help deload areas of discomfort. Rule of thumb is to fill in the gaps where your chair or bed doesn’t support. For example - placing a pillow under your belly when laying on your side can be a great way to decrease tension across the lower rib cage.

Red Flags for rib pain - when to seek medical attention:

Generally, rib pain is just pain, not a sign of something more serious. However, if you have any of the following symptoms, you should seek immediate medical counsel from your doctor. They can be symptoms of more serious conditions like preeclampsia or a urinary tract infection. 

• Sudden, severe pain under the right rib cage.

• Pain under the right rib that is persistent or worsens and is accompanied by:

  • Severe headache

  • Vision changes (like spots or blurred vision)

  • Nausea and/or vomiting

  • Sudden swelling of the face and hands

  • High blood pressure

• Pain accompanied by fever, chills, or pain in the back (which could indicate a Urinary Tract Infection/kidney infection).

Contact your health care provided right away if you have symptoms like:

• Vaginal bleeding or fluid leakage

• Fever

• Burning sensation when urinating

• Numbness, tingling, or weakness in the legs, buttocks, or genitals

• Intense, sudden, or cyclical pain (which could indicate contractions)

If you aren’t able to figure out how to relieve your pain, a PT can absolutely help! Physical therapists are experts in how the human body moves and functions, we can get to the root cause of your pain, and prescribe a specific program for you to work on. Additionally, we can actually work on you - improving muscle tone, joint mobility, and decreasing pain. 

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About the author: Dr. Caitlyn Hauswirth-Varis, PT, DPT, OCS, CFMT, CF-L1

Caitlyn is an expert in pelvic floor physical therapy, pregnancy and postpartum, and is board certified in orthopedic physical therapy. She has helped countless soon-to-be moms get out of pain during their pregnancy, and actually feel good throughout the process.

Disclaimer: This blog post is for informational purposes only and does not substitute for professional medical advice. Please consult with a qualified healthcare professional for personalized guidance.