What Causes Anterior Rib Pain in Pregnancy?

Anterior rib pain is quite a common medical complaint in pregnancy.  Often this is experienced at the very bottom of the rib cage.   The pain is nagging, constant, aching and can become sharp and stitch like especially after sitting for long hours.  The majority of my patients experiencing this pregnancy symptom find sitting in the car the worst aggravating factor.  I put this down to the less upright sitting position which further decreases the space you have between your pelvis and your rib cage and therefore for the baby gets further squished up into your rib cage.  Using a lumbar support pillow on your desk chair or car seat could greatly reduce your symptoms by restoring the lumbar curve and opening up the ribs.  We also have a travel lumbar support pillow which is great for those that travel on public transport.

What causes anterior rib pain in pregnancy?

The main cause of the pain is muscle tightness and inflammation in intercostal muscles which are located in between the ribs and function in forced expiration like occurs with a sneeze or the laboured breathing of exercise. The other culprits are the diaphragm and the oblique abdominal muscles.

This pain often starts in the middle of the second trimester but I have had patients (myself included) who experienced this pain from around the 16 week mark which I put down to a sudden increase in size.  I have found that this pregnancy symptom occurs more frequently in women that have a more pear shaped body as they have a slender lower rib cage and wider hips.

I believe that having wider hips contributes to rib pain in pregnancy as when sidelying as is recommended in pregnancy, there is a greater stretch put onto the muscles of the flank due to the greater distance between the widest part of the hip and the rib cage.  This stretch can result in muscle tightness which then impacts the mobility of the ribcage causing irritation of the rib joints and the associated ligaments and muscles.  As a pear shaped woman myself, this was a major contributing factor to my rib pain.  Once I started sleeping with the pregnancy belly support pillow, my symptoms reduced over a week till they were gone. I found that after the 16 week mark of pregnancy, I was unable to sleep comfortably without this pillow because of the strain on my side.

Another cause of anterior rib pain in pregnancy is the pressure of the organs and baby trying to make room for themselves puts pressure on the ribs and also the diaphragm (the breathing muscle). This is especially the case during the later part of the 2nd trimester and early 3rd trimester as

What can you do to decrease your pregnancy related anterior rib pain?

A natural reaction to pain is to decrease movement through the area and to breath in a more shallow way using only the upper part of the lungs and rib cage.  Over time, this lack of movement makes the issue worse and increases the rib cage joint stiffness and muscle tightness in the area.

Getting more movement is the key to decreasing the pain.  This can be done in several ways.

Diaphragm exercise:

Tie a scarf or neck tie around the bottom part of your rib cage.  Practice breathing and expanding the lower part of your rib cage and making the scarf or tie tighten.  This is to reprogram your brain to breath using the whole rib cage not just the top part.  This encourages the diaphragm to drop into the abdominal cavity and get a good stretch and thereby reducing any tightness.

Diaphragm Inhibition:

This is a technique that I do to my patients that you can easily do to yourself.  In a seated position, slump slightly forwards therefore reducing tension in your stomach muscles.  Use your fingers to gently put pressure up under the lower border your rib cage in the direction of your head.  Move along the border of your ribs till you find a point that is tender.  Hold the pressure on that point till it starts to fade.  Make sure that you keep breathing normally during this exercises.  Stop if there is too much pain or you are becoming dizzy or are finding breathing difficult.

Rib side bending exercise:

Bend your elbows and place your hands on your rib cage at approximately the level of your bra strap.  Your hands are going to act as a fulcrum around which you will move your rib cage.  Gently apply pressure using your right hand and side bend towards the right.  Repeat on both sides for as many times as you feel comfortable.

Rib rotation exercise:

Sitting on a chair (swivel desk chair is best) with good strait posture. Gently turn to one side and grip onto the back of the chair.  Gently pull yourself into the rotation movement as far as comfortable.  Hold this position for 10 seconds or for as long as comfortable.

Products to help your pregnancy related anterior rib pain

A pregnancy body pillow to improve alignment of your entire body when lying. The weight of your baby, uterus, breasts etc, drags towards the bed, this puts the muscles  ligaments etc on the top part of your body on stretch.  This can be quite uncomfortable whilst sleeping an have implications in your waking yours.  Using a body pillow enables you to position yourself in a way that causes the least amount of pressure on your ribs as well as the surrounding muscles.

A pregnancy belly support pillow to support and lift the belly when you are lying on your side to reduce drag and strain on the ribs. This is what I used in my pregnancy after developing discomfort in the muscles in my side and sharper pain in my left lower ribs. It helped me so much that it came everywhere with me!

A pregnancy belly support brace to more evenly distribute the weight of your belly and take strain off your abdominal muscles which then pull on the ribs.

The BellyBra is a maternity singlet with a thick support band that fits under the belly to gently lift the belly to relieve pain and reduce muscular tension.  This can help with anterior rib pain by taking strain off the abdominal muscles which then in turn enable the ribs to move more freely reducing irritation and pain.

The information provided in this post is of a general nature and for educational purposes.  This information does not replace professional medical assessment and advice.  We strongly recommend contacting a medical professional if you are experiencing any unusual or new symptoms.

Make sure you’re getting the right support and check out out extensive range of total support pillows here!