Rib Pain From Coughing?

By Andrea M. Jensen CHES AE-C

2 min read

Yep, it can happen.

Thought you could only hurt your ribs in an accident? Well, there are a lot of ways to hurt ribs - accidents, sports, reaching/lifting/twisting, or sneezing and coughing.

Yes, coughing.

When you have asthma, you can hurt your ribs by coughing during an asthma attack or while you are sick with bronchitis or pneumonia.

How do you know if you have injured your ribs?

The most obvious is pain (it can be sudden and sharp, or come on gradually.) You may also have tenderness and swelling. Your doctor may want to make sure it's not something serious, so it would be a good idea to check in with him or her.

Just like other strained muscles, these injuries are graded on a scale of 0-3, depending on how serious they are. Grade 1 may take 2-3 WEEKS to heal. Grade 2 may take 2-3 MONTHS to heal, and Grade 3 may need surgery.

How can you help rib pain?

An over-the-counter pain reliever is usually the first choice for injuries, as is an ice pack (many doctors recommend using an ice pack for only 20 minutes at a time.)

Prescription cough medicine can also help. When I pulled a muscle in my ribs from coughing during a bout with bronchitis, my doctor gave me a prescription cough medicine to calm my cough. Usually, doctors WANT you to cough to keep your lungs clear. But my doctor could see how much pain I was in and knew that would cause me to take shallow breaths - which could allow pneumonia to develop in my lungs.

Light pressure against your ribs can help reduce pain if you need to cough or move around. Sounds weird, but it worked for me. I used the palm of my hand to gently press against my ribs, but some people will use pillows to gently apply counter pressure if they need to cough.

If in doubt, call your doctor so you know what you are dealing with and how they want you to treat your rib pain. And try to be patient. Notice I said, "try?"

Anyone else experienced rib pain from a pulled muscle or broken rib due to asthma?

This article represents the opinions, thoughts, and experiences of the author; none of this content has been paid for by any advertiser. The Asthma.net team does not recommend or endorse any products or treatments discussed herein. Learn more about how we maintain editorial integrity here.

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shellzoo Member
I have dislocated a rib and physical therapy had me do exercises to get it back in place. That was from a fall but sometimes with my asthma cough I feel it get out of place and I just do my exercises and it goes back. I guess once you have dislocated a rib, it can happen again.
1. Leon Lebowitz, RRT Moderator & Contributor
 Hi Shellzoo and thanks for chiming in here with your own personal experience. We appreciate you sharing with the community. Leon (site moderator)
2. kats Member
 I have broken ribs from coughing, developed coscondritis...pneumonia from trying to avoid the ER and steroids. Not fun, wears me out the older I get. Currently, I am struggling again because I just can't afford to go in to an Urgent care. So I am using my nebulizer treatments to try to rid myself of the tight chest muscles. Sniffing peppermint through a towel with warm heat from a bowl. Drains out the mucus beautifully
janeth Member
I've had to go to an osteopath a few times to get a dislocated rib pushed back in. Usually this is an issue from having a bad cold, not my regular asthma issues, when I'm sneezing AND coughing a lot. Physical therapy sounds like a good idea. I've also had costochondritis at least once, which is inflammation of rib cartilage. I didn't know before I had it that ribs have joints, although that makes sense. Since I can't take NSAIDS, I can only take acetaminophen, get a massage, heat therapy, try not to cough or sneeze too hard (easier said than done). I think I got the costochondritis once from over-zealous gardening.
1. Leon Lebowitz, RRT Moderator & Contributor
 Hi again, JanetH and thanks for this response as well. We appreciate your input. Leon (site moderator)
janeth Member
As another comment, as a teenager, I once developed pleurisy as a complication from bronchitis during a very cold, damp spring. It took FOREVER to recover from, and that causes its own rib pain.
1. Leon Lebowitz, RRT Moderator & Contributor
 HI again, JanetH and thanks for your post(s) here. Pleurisy can be a serious condition to deal with, as you well know. I'm sorry you've gone through this (as well as the other conditions you've shared with the community, below). How do you manage all of this now? Leon (site moderator)
Ambersmom Member
My husband broke a rib because of severe coughing when he had the H3N2 Flu & pneumonia several years ago. It healed out of alignment and still bothers him years later. I've had moderate to severe persistent asthma for 7 years (occupational) with bronchitis several times a year since. The intense daily (and nightly) coughing sure rattles the old ribcage and spine! My sternum is so sore that slight finger pressure feels like a stab. The intense pain and tightness around the sternum which are worse at night (and especially in winter), was scary until I realized the direct correlation between the pain and asthma/bronchitis coughing. So much coughing has affected the spine too. Standing or sitting without back support quickly becomes painful now. Sometimes when Has anyone else ever hear of or gotten a "shock" sensation in their chest from severe coughing? There's probably a lot of unusual things that people with respiratory conditions could relate to amongst ourselves that others might find hard to believe or understand. 
1. Leon Lebowitz, RRT Moderator & Contributor
 <inline-mention username="Ambersmom" user-id="4131664"/> Hi Ambersmom, and thanks for your post. You point out some interesting aspects of managing this condition. There certainly are some unusual 'aches and pains', that can be associated with asthma. While I am hopeful others in the community will respond to your inquiry and share their own personal experiences, I thought you might be interested in some of the pertinent articles. we have published, right here on our <a href='http://asthma.net' target='_blank'>asthma.net</a> community website. For your convenience, here is a link to some of those articles: https://asthma.net/search?s=pain. I do hope you find them to be both interesting and helpful. All the best, Leon (site moderator <a href='http://asthma.net' target='_blank'>asthma.net</a>)
2. Andrea M. Jensen CHES AE-C Contributor
 <inline-mention username="Ambersmom" user-id="4131664"/>, Sounds like you and your husband have had a rough time! It must be rough to have a bone that has healed out of place. I've done that on my toes, but a rib is another problem. Must be painful for him! Do you see a specialist for your asthma? It makes me cringe to hear how bad your coughing is. Most people just use a rescue inhaler and don't realize that they also need a daily, controller inhaler to keep the swelling down in the lungs. The only time I usually have a bad cough is when I have pneumonia or bronchitis and have a lot of swelling in my lungs. It usually gets worse when my albuterol is wearing off and it's time for another nebulizer treatment. I do get the "shock" sensation in my chest if I have a sudden or severe asthma attack or when I have pneumonia and I am coughing really hard. Hope you can get some answers from your doctor. If you can't, you may want to find someone else to treat you! Good luck! Andrea
Ambersmom Member
Andrea, Thank you for your kind words and encouragement! Thankfully, my husband's rib usually doesn't bother him so much now except with stormy weather coming. It's a relief to know others have felt that shock sensation from coughing. I wouldn't wish that on anyone. But, living with an "invisible illness" makes you doubt your own sanity at times. My 1st time in the trauma unit, newly diagnosed with asthma at 50 by a pulmonologist, an ER physician actually said, "Adults don't get asthma, it's something else." SMHID (That would have left me speechless, if I could talk at the time...) Between the tunnel vision, respiratory alkalosis, reduced consciousness and some confusion I didn't pick up much, but THAT little gem is crystal clear. (There was also talk about intubation and from the seizure-like tremors, they must have administered a boat-load of albuterol). I see a pulmonologist regularly and use 
1. Melissa.Arnold Community Admin
 <inline-mention username="Ambersmom" user-id="4131664"/> Holy cow, I can't believe a doctor said that about you! It's true that they can't be expected to be experts on everything, but asthma is extremely common when it comes to presenting in the ER for treatment. That he would suggest it's just a pediatric issue is just wild to me, and I have no medical training. UGH. Looks like the rest of your post got cut off -- we'd be interested in what you have to say if you have the time. Let us know if you need any help! -Melissa, <a href='http://asthma.net' target='_blank'>asthma.net</a> team
2. Andrea M. Jensen CHES AE-C Contributor
 <inline-mention username="Ambersmom" user-id="4131664"/> I get it! It is indeed an invisible illness - and even harder when you don't wheeze from asthma. I have cough variant asthma and rarely wheeze. Instead, my symptoms are a tight chest, bad cough and lungs that feel like they are on fire. Sadly, that doctor is very outdated on his knowledge of asthma. Adult onset asthma is quite common! Even as a Certified Asthma Educator, I often have doctors try to "school me" about asthma. I'm not saying I know more than a medical doctor, but when it comes to someone who has never heard of Adult Onset Asthma, then yes I do! I have also met doctors who don't believe that not all asthma sufferers wheeze. That's always a battle. They just go with the stereotypical symptoms they learned in med school! Andrea
Ambersmom Member
Thank you. It's incredible how many times my LPN husband had to educate other nurses, doctors & even a couple of RTs about severe asthma. The rest of the post in reply to was about 2 controllers, rescue inhaler, Singulair tab & 2 nebulizer solutions, plus prednisone as needed for asthma flares and bronchitis. Rescue inhalers are stashed around the house, plus a plug-in nebulizer (and back up unit) and battery-powered portable nebulizer. Even with all the meds At first I was in the ER/hospital frequently but have since learned when and how to intervene and keep most asthma attacks from spiraling out of control, and to manage bouts of bronchitis (something I never had pre-asthma). Thankfully my pulmonologist fills prednisone Rx upon request without question, because he trusts my judgement from experience. So, there's not much if anything we could do differently - this is just one of those hard to control severe asthma cases. 
1. Andrea M. Jensen CHES AE-C Contributor
 <img src="/content/images/2021/04/18/927dbd677a534e9a6ae1305664d3d9a4_medium.jpg" alt="National Asthma Guidelines Stepwise Chart Adults " class="uploaded-image"/> <inline-mention username="Ambersmom" user-id="4131664"/> I get it - I really do! My Middle Son has severe asthma, and it was very difficult to keep him out of the hospital when he caught a cold. It would always morph into pneumonia. This happened at least once a year. We also made many changes in our home to make it allergy & asthma friendly (tore out old carpet, refinished wood floors, put a 13 MERV rated filter in our furnace, used standing air cleaners, used asthma friendly cleaners, etc. But - all to no avail. My son started on a biologic to manage his severe asthma back in 2007, and was on it for 7 years. It's the only thing that would keep him out of the hospital. Has your doctor considered a biologic to treat your asthma? The Updates to the national guidelines were released in Dec 2020. I'll attach a chart for you so you can see which "step" you are on. If you are on Step 5 or Step 6, biologics are listed as an option to treat hard to control asthma. Selecting a biologic will depend on which type of asthma you have - your asthma specialist should explain it to you. They are expensive - but copay assistance is available. Good luck! Andrea
Ambersmom Member
Andrea, Thank you so much for your responses and detailed information. I'm sorry your son has had such a struggle with his asthma. My pulmonologist had checked into the possibility of biologic treatment, but my my asthma was induced by extended workplace exposure to strong bleach and chlorine fumes (for over a year past initial symptom onset), and is not eosinophilic asthma. I have no allergies nor detectible IgE antibodies. So, biologics would have no benefit. It's a bit ironic - for 27 years as a public health virologist, I cultured tens of thousands of influenza viruses from clinical specimens and never got the "flu" all those years. But once I developed asthma, went into forced retirement, always get vaccinated and rarely leave home, I now somehow manage to get flu or another respiratory virus from my husband (who also gets vaccinated) each year and a severe case of bronchitis that lingers for over a month. Several other short bouts of bronchitis hit when local farmers burn their fields each spring, major CA wildfires, bad weather on a doctor visit day, July 4th (smoke from the community display drifts right to our house), our street gets re-oiled & graveled, freak Sahara dust storms, etc.
1. Melissa.Arnold Community Admin
 Your hubby is so generous with his love! hahaha. You poor thing. <3
2. Ambersmom Member
 <inline-mention username="Melissa.Arnold" user-id="3030220"/> Hahaha 😀 When we promised to share everything with each other 34 yrs ago, we weren't thinking about respiratory viruses LOL Have a good night and stay safe 😀
Ambersmom Member
Hi again Andrea, I hit post too soon - oops. But it gave me a chance to look up and download the guidelines for a clearer view. I am on step 5, (or 5+) with 2 to 3 blasts or tapers of oral prednisone a year. 
1. Sidney Saleh- Kurtz Community Admin
 Hi @ambersmom! As Andrea attached, the stepwise approach for asthma management is a great way to see what step we're on. Here's a link with a larger view of a similar chart in case you're interested: <a href='https://getasthmahelp.org/asthma-management-adults.aspx' target='_blank' rel='noopener noreferrer ugc'>https://getasthmahelp.org/asthma-management-adults.aspx</a> -Sidney, <a href='http://Asthma.net' target='_blank'>Asthma.net</a> moderator
Ambersmom Member
Hi Sidney, Thanks for the link - I'll check it out. 😀 I also found and downloaded the pdf of the entire December 2020 guidelines document last night and found the chart Andrea posted. Thanks to the kind people on this forum 
1. Leon Lebowitz, RRT Moderator & Contributor
 <inline-mention username="Ambersmom" user-id="4131664"/> Hi again, Ambersmom - thanks for your kind words. It is WE who should be thanking YOU for being an active member here in the community. We value both your input and your feedback! Warm regards, Leon (site moderator <a href='http://asthma.net' target='_blank'>asthma.net</a>)

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