Why Do Your Ribs Hurt During Pregnancy?

Rib pain during pregnancy usually happens because the growing uterus pushes upward and outward against the rib cage, which limits how the ribs move and strains the muscles between and around them. NHS Fife's pelvic health physiotherapy team describes it as very common and says it generally occurs in the third trimester, from 28 weeks onward.

The rib cage itself changes shape to make room. A physiology review by LoMauro and Aliverti in the journal Breathe reports that the average angle of the lower ribs at the breastbone increases from 68.5° at the beginning of pregnancy to 103.5° at term, and that the resting position of the diaphragm moves 5 cm upward as the uterus grows. This post covers the causes of rib pain, what eases it, where gentle chiropractic care fits, and the one kind of rib pain that needs a same-day call to your provider.

What Causes Rib Pain in Pregnancy?

Rib pain in pregnancy is discomfort along the lower ribs, under the bust, or around the side and back of the rib cage that begins as the uterus rises toward the chest.

Physiotherapy teams at NHS Fife and the Royal Berkshire NHS Foundation Trust list these causes:

• The baby growing bigger. Pressure from the expanding uterus reduces how freely the ribs can move.

• The baby's position and kicks. A baby pressing or kicking under one side of the rib cage can cause one-sided pain.

• Larger breasts. The added weight puts more strain on the upper back and the ribs attached to it.

• Pregnancy hormones. They affect muscles and ligaments, including those around the ribs.

• Heartburn and digestion. Indigestion can feel like rib discomfort.

• Inflamed rib cartilage. Royal Berkshire lists costochondritis, an inflammation where the ribs join the breastbone, as another possible cause.

Most women have more than one of these at the same time.

When Does Rib Pain Start in Pregnancy?

Royal Berkshire's maternity physiotherapy leaflet says it usually starts toward the end of the second trimester, around 27 weeks, and continues into the third. NHS Fife puts the usual start at 28 weeks onward.

That timing matches the anatomy. LoMauro and Aliverti note that the rib cage expands in the third trimester, with its side-to-side diameter and the measurement around the lower chest both larger than after delivery.

What Helps Rib Pain During Pregnancy?

The aim is to give the ribs more room and take load off the upper back.

Posture. NHS Fife advises against slouching and suggests a chair with good lower back support. Royal Berkshire recommends a rolled-up towel as a lumbar support so you are not slumped in the chair. Slumping folds the rib cage down onto the bump, which is the opposite of what sore ribs need.

A better bra. Both teams recommend a well-fitting, supportive bra. NHS Fife specifies wide straps and soft material, and suggests avoiding underwires.

Heat or ice. Royal Berkshire suggests heat pads or ice for about 10 minutes at a time. Ask your OB or midwife how to use heat safely during pregnancy.

Gentle stretches. NHS Fife's guide names five: side stretches, cat stretches, pelvic circles, child's pose and thread the needle. Gentle stretching and exercise help maintain flexibility and strength in the upper back muscles.

Breathing. NHS Fife suggests diaphragmatic breathing, which is slow breathing that lets the lower ribs widen on the way in.

Sleep support. A pregnancy pillow helps you hold a comfortable position and reduces pressure on the ribs.

Smaller meals. If heartburn is part of the picture, Royal Berkshire's advice is to eat little and often.

When Is Rib Pain a Warning Sign?

Most rib pain in pregnancy is mechanical. Pain just below the ribs that comes with other symptoms is different.

The NHS lists "pain just below the ribs" among the symptoms of pre-eclampsia as it progresses, along with:

• Severe headaches

• Vision problems, such as blurring or seeing flashing lights

• Vomiting

• Sudden swelling of the feet, ankles, face and hands

The NHS instruction is to get medical advice immediately if you notice any symptoms of pre-eclampsia. Royal Berkshire also flags sudden, acute rib pain with vision changes as a possible sign of HELLP syndrome, a serious complication.

Royal Berkshire's leaflet names two more reasons to see a doctor: rib pain that follows eating, which can point to the gallbladder, and sharp pain after a long bout of coughing, which can mean a rib injury. NHS Fife adds that if pain continues after you have tried the measures above, or you have severe pain after coughing or sneezing, speak to your doctor or midwife.

In the United States, the CDC's urgent maternal warning signs include trouble breathing, chest pain, and a headache that will not go away. Call your provider or seek care right away for any of them. Do not book a chiropractic visit for rib pain that fits this section until a medical provider has checked you.

Can a Chiropractor Help With Pregnancy Rib Pain?

Chiropractic care can address the mechanical part: stiff joints where the ribs meet the mid back, and tight muscles around them. It cannot change the fact that the baby needs the room.

Each rib attaches to the spine at the back. When the mid back is stiff from slumped sitting or from carrying more weight in front, the ribs attached to that section can move less freely. Gentle adjustments to the mid back, soft tissue work and posture changes aim to restore that movement.

The pregnancy research on hands-on care is about low back and pelvic pain, not rib pain, so set expectations accordingly. The main summary is a 2015 Cochrane review of 34 randomized trials involving 5,121 women, which found that manual therapy with exercise and education may be of benefit for low back and pelvic pain, and reported no lasting side effects in the studies that tracked them.

At Barto Family Chiropractic, prenatal chiropractic care uses gentle, pregnancy-safe techniques and specialized positioning. Dr. Stephanie tailors chiropractic adjustments to each patient, and not all adjustments are done by hand. Our post on whether prenatal chiropractic is safe during pregnancy explains what a visit involves.

Does Rib Pain Go Away After Birth?

The pressure that causes most pregnancy rib pain ends at delivery, because the uterus is no longer pushing up under the ribs. The Breathe review found that the lower chest is wider in the third trimester than it is postpartum, which shows the rib cage narrows again after birth.

The upper back can stay sore after delivery from feeding positions and carrying a newborn. The posture habits that helped during pregnancy keep helping then. Our article on chiropractic care for posture and tech neck covers the same rounded-shoulder pattern.

FAQ

Why do my ribs hurt on one side only?

One-sided pain can come from the baby's position or kicks under that side of the rib cage. Pain just below the ribs with headache, vision changes, vomiting or sudden swelling is a pre-eclampsia warning sign and needs medical advice immediately.

Can the baby break or bruise my ribs?

Kicks can make the ribs very sore. Royal Berkshire's leaflet notes that sharp, acute pain after prolonged coughing can indicate a rib injury and should be checked by a doctor.

How should I sit to ease rib pain?

Sit tall with your lower back supported, using a rolled towel or small cushion. Avoid slumping, and change position often.

Is underwire bad for rib pain in pregnancy?

NHS Fife recommends a well-fitted supportive bra with wide straps and soft material, and suggests avoiding underwires.

What stretches help sore ribs in pregnancy?

NHS Fife lists side stretches, cat stretches, pelvic circles, child's pose and thread the needle. Move slowly and stay within a comfortable range. Ask your provider before starting if you have been told to limit activity.

Does rib flare go back after pregnancy?

The Breathe review reports that the lower chest is wider in the third trimester than it is postpartum, which tells you the rib cage does narrow again after birth. How quickly varies from person to person.

How should I sleep with rib pain?

Side lying with a pregnancy pillow is the usual answer. Our post on how chiropractic care can improve your sleep has more ideas for getting comfortable at night.

Prenatal Chiropractic Care in Monroeville, PA

Dr. Stephanie Parrish has focused on prenatal and pediatric care since starting her practice in 2014 and is Webster certified through the International Chiropractic Pediatric Association. You can read about that method in our guide to the Webster Technique in prenatal care.

If rib and upper back pain are making it hard to sit, breathe deeply or sleep, and your OB or midwife has ruled out a medical cause, we can check how your mid back and ribs are moving.

Visit Barto Family Chiropractic or call 412-793-3300 today. Contact us for more information.