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"Why do my first 2 ribs hurt?"


I am 47 years old and have pain in the first two left ribs where they meet the sternum. X-rays are normal, and the pain has come and gone at intervals over the last fifteen years. As I am a smoker, I am very worried this may be cancer.


Chest pain is a concerning symptom. There are many possible causes, some of which are minor and some of which are very scary. This requires evaluation by your primary care doctor.

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Firstly, anytime there is chest pain the first thing that must be ruled out is your heart causing this pain. Angina, or chest pain caused by a limited flow of blood to the heart, can be a sign of heart disease and impending heart attacks. Smoking is a risk factor for heart disease and as people age the age of 50 the risk of heart disease increases. This should be evaluated. Cancer can cause pain, however it is less likely. Most often lung cancer causes cough, bloody cough and/ or shortness of breath. An x-ray without any mass should be fairly reassuring that there is no lung mass. Rib pain is often caused by inflammation of the muscles and ligaments. Known as costochondritis, this inflammation can take a long time to heal given that the ribs are constantly moving (with each breath is moves and therefore it takes a long time to heal). Other causes include pericarditis, pleurisy, pneumonia, pulmonary embolism, esophageal spasm, aortic dissection and many other. Talk to your doctor. Good luck!

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