What Causes Rib Pain During Pregnancy?

Here is why you may experience pain in the ribs when you are pregnant.

  1. The growing baby and uterus:As the baby grows, the uterus expands, taking more room in the womb. It comes to a stage where all the organs are pushed towards the ribs, building pressure in the muscles and making breathing difficult . Those with bigger babies and shorter waists are highly prone to rib fractures during pregnancy.
  2. The baby’s movements and intrauterine position:The position and movement of the baby will put constant pressure on the ribs, creating discomfort and pain in the ribs. The frequency of the movements increases each day, getting harder and stronger Also, the breech position of the fetus will put additional pressure on the rib cage, causing pain
  3. Increasing breast size:As the breasts grow, their increasing weight puts more pressure on the rib cage and lower back. This not only alters your posture but also draws your shoulder down, causing pain in the ribs and back
  4. Urinary tract infections:Rib pain is one of the side effects of UTI. As the urinary infection spreads towards the kidneys, it causes a burning sensation and increases the frequency of urination, causing pain and discomfort in the ribs
  5. Hormonal changes:The relaxin and progesterone hormones affect all the muscles, ligaments and joints of the pelvic region and spine. It, therefore, leads to a rib cage and back pain

     Rib flaring

What is rib flaring?

Rib pain during pregnancy can be a persistent problem, especially during the third trimester. Your rib cage may feel mildly sore or extremely tender and bruised. You may have discomfort on either side, or both sides, though it is commonly worse on the right side of the ribs. Pain occurs in and under the ribs as your uterus grows.

What causes rib flaring?

The demand for oxygen is increased in pregnancy because the basal metabolic rate and the mass of the expectant mom increase as well. It is estimated that a woman will require about 20% more oxygen than normal at term. She also exhales more carbon dioxide which triggers the already sensitive respiratory system to increase the respiratory rate slightly. Hence, it is this lowering of the carbon dioxide that leads to pregnant women to becoming breathless on activity. Your diaphragm will have to work harder which may result in the feeling of ‘getting a stitch’ as the diaphragmatic muscles fatigue.

Many expectant women will experience the baby beginning to press up under her ribs and chest. This is the uterus ascending as the abdomen becomes stretched upward and outward with the growing baby. It may also make you feel short of breath. This ascending uterus thus progressively obstructs the descent of the diaphragm, which is needed for deep breathing. It can force the diaphragm upwards by at least 4cm towards the end of pregnancy. Hence this rising pressure pushes the rib cage out sideways and forwards, resulting in pain in the front of the lower ribs, also known as rib flare. This pressure on your ribs and diaphragm may also result in shoulder pain, because there are nerves in the diaphragm which can refer pain into the shoulders.
As your breasts become larger, they also place pressure on your ribs. During pregnancy, your breasts may increase by one full cup size or more. The extra weight pulls your shoulders forward and down, and places strain on the upper back, neck, and often results in pain around the rib cage.

As the baby grows, motion of the ribs and thoracic spine becomes restricted affecting chest and diaphragm movement. The lymphatic system requires the diaphragm to work as a pump to aid the flow of lymph back into the venous system and heart. Fluid and electrolyte balance is affected leading to fluid retention in the body (as seen clearly at the ankles).

What can I do to get relief?

Rib pain during pregnancy can cause the greatest discomfort when you are in a sitting position. Practicing good posture is especially important. Try to make sure that you sit up straight with your shoulders back. Slouching will compress your abdomen and result in more pain.

Here is a really effective exercise for temporary relief. Stand facing a wall. With your feet 40cms from the wall, cross your arms in front of your face. Then lean your crossed arms on the wall sliding them up the wall above your head and stretching yourself up as far as possible. Hold the position for as long as comfortable. This lifts the diaphragm and rib cage up off the uterus. Practicing doorway chest stretches can also be helpful because they, too, will help rotate the shoulders up and back, which can also help lift the ribs away from the uterus.

It is especially important to have a supportive bra that is not too tight. Under wire bras may put too much extra pressure on your ribs. Now may be a good time to invest in a good nursing bra. They usually offer nice support without being too tight and will be useful once your baby is born. Stretching and prenatal yoga are great for keeping your body long and loose. The less compressed you are, the less your rib cage will hurt.

Breathing and relaxation exercises may also be effective. There are a variety of hands on techniques that can help to gently stretch and lift your ribs away from the uterus. Applying these techniques to your breasts, chest and abdomen, can really relieve a lot of pain and pressure from your body, though you will need a friend or partner to help you. Scheduling a visit to your physiotherapist may also help provide relief from rib pain during pregnancy. A combination of massage, gentle mobilizations, postural training, Pilates, and support/kinesiotape can be very effective.

NOTE: If you are having rib and flank pain that goes through to your back, and or burning or pain with urination, you should contact your health care provider. This could be an indication of a urinary tract infection.

When To Call The Doctor?

You could experience rib pain usually in the later stages of pregnancy. Contact your doctor immediately if the following symptoms accompany the pain:

  • Nausea
  • Headache
  • Dizziness
  • Floaters in eyes

Rib pain during pregnancy usually disappears after the uterus drops in the last weeks of pregnancy. As you near the due date, the space in the abdomen region increases and the pressure under the ribs reduces.

In the meanwhile, you can follow a few tips to get some relief from the pain.

What Can You Do To Help Relieve Rib Pain During Pregnancy?

Though there is no cure for this pain, you can take a few measures for temporary relief.

  1. Wear loose-fitting clothes:Avoid tight-fitting clothes as they add pressure and aggravate the rib pain. Wear loose clothing that is comfortable and easier to breathe in. Also, get a maternity bra or a nursing bra that can take the pressure off the rib cage.
  2. Lean back:Rib pain worsens when you lean forward. So, try to maintain your posture by leaning backward. This also relieves pressure from the heavy breasts. Stretching back expands the space in the belly and eases the strain on the muscles of the rib cage and lower back.
  3. Use pillows for support:Use pillows to prop yourself up beneath the bump to take off the strain from the rib muscles. It relieves most of the soreness and pressure from the body.
  4. Take short breaks:Do not remain in the same sitting or standing position for too long. Move around, take short walks or indulge in mild exercise.
  5. Get a massage:Ask your partner to massage on the sides and rib region to help relieve muscle stress and tension or give us a call at frombumps2babies and book in for a pregnancy massage 07920192881
  6. Warm water bath:Taking a warm shower will soothe and relax the painful muscles. It provides short-term relief from rib soreness.
  7. Use support aids:There is a wide range of supportive aids such as rib braces, body pillows, maternity belts, lumbar seat pillows and belly bras to support the lower body. They also relieve rib cage pain.
  8. Exercise:Indulge in light exercises such as yoga and swimming.

In some cases, you may be able to prevent this pain to some extent. Find out how next.

Can You Prevent Rib Pain During Pregnancy?

Yes, you will be able to prevent rib ache in some cases, by remaining active and performing mild exercises. Exercise prevents excess weight gain, which may otherwise contribute to rib pain.

You should also eat a well-balanced diet and follow a healthy lifestyle.

You may experience mild rib flares during pregnancy, no matter how careful you are. But if the pain is severe or sudden, you should check with the doctor. They will determine the cause and suggest the appropriate treatment. Do not take any pain medication without consulting your doctor, engage in extreme physical activity or lay pressure on the tummy.

Take a look at our Pregnancy Masterclass held monthly in Boldmere called  where we discuss all the minor irritations in pregnancy and when to seek help plus get a free 40 + page ebook.  Held Tuesday evenings 6.30-8.30pm.