Trigger Points Around Ribs - How to identify and treat

Trigger Points around the Ribs


Ribs with abdominal muscles represent an area that might feel hard to reach, meaning that you won’t find trigger points around ribs that easily.

‘How can you self-treat a trigger point if it’s unreachable? I have a pain, which feels like a bad bone bruise under my lower left rib. I know it is under the rib because when I press lightly on the rib it doesn’t hurt. Pain is present when I twist to the right coming from the underlying muscle. How can I treat it though if it is under my rib?’

Hi there,

there are two layers of muscles in between each set of ribs. These are called the intercostal muscles. In the front of your body, the abdominal muscles attach to the lower edge of your lowest rib. These abdominal muscles are in three layers all running in different directions.

In the back, the quadratus lumborum and the ileocostalis muscles attach to the lower ribs.

The muscles attach via very short tendons. There are many layers of muscles, and some of them run quite deep.  So, your discomfort may be coming from the insertion of the tendon into the ribs.

Or, the problem could come from a trigger point in the deep muscles. You need to search in a band about 2 inches below where you feel your ache and might find triggers there. These muscles can refer pain up under the ribs. If you find triggers here, use the principles of ischemic pressure to switch them off. Followed by gentle heat.

If the pain comes from a tendon, then acupuncture or a cortisone injection can be helpful.


This is general information. Because I can’t examine you and find out the exact location of trigger points around ribs, as always, you need to see a qualified health professional for a specific diagnosis.



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(2) comments

Sally March 17, 2010

Thank you so much. I have been treated 5 years w/epidurals, TP’s, and pain meds. I refuse to give up. Treatment related to degenerative disc. And there your website is with “Life After Pain. Praise God! I want to know if I am battling a specific disease, i.e. MS or another. I am not asking you to diagnose via web. Maybe you would know the specialty I need to have work-up?

Dr. Kuttner, I have had pain left at mid-scapula for 3wks nonstop. I did have the cortisone injection – but no relief. If I keep my left arm bracing my left side cheat while lying down can make the pain stop instantly. When I move my left arm, the pain is back. I am wondering if I need PA chest x-ray to rule out rib fracture or pursue an acupuncturist. Oh, a part of the scenario is I have a superficial feeling like a hand on top of the area.
At 4AM, I was awakened with horrific femur pain. My right femur felt like it was twisted with the bone at breaking point. Now, mid-afternoon, my right quad feels extremely weak with soreness. When these episodes occur, my husband has to help me move my leg. In the past the same leg has awakened me with it twisted inward and I could not straighten it. My husband has helped me many times with this leg.

Can you point to a specialty? I plan to devour everything on your website

Ahmed Mabrouk April 27, 2013

thank you for these information doctor it was really helpful

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