Rib pain is a common and often distressing symptom in people with breast cancer. It may be sharp, dull, or aching, and can present either constantly or only during movement, coughing, or lying down. Understanding the reasons behind rib pain in breast cancer is essential to finding the right treatment and getting relief.
Why Does Breast Cancer Cause Rib Pain?
Several conditions related to breast cancer may lead to rib pain. These include:
Cancer Spread to the Ribs (Rib Metastases)
Breast cancer often spreads to bones, and the ribs are a common site. This spread is called bone metastasis. When cancer cells reach the ribs, they can weaken the bone, cause inflammation, and create pain. Patients might also notice swelling or tenderness near the affected ribs.
Rib Fractures from Weakened Bones
Cancer in the ribs or long-term cancer treatments can weaken bones, increasing the risk of rib fractures. These may occur after minor trauma or even from coughing or twisting. Rib fractures cause sharp pain that worsens with deep breaths or movement.
Surgical Scarring and Rib Pain
Breast surgery, including mastectomy or lumpectomy, can lead to scar tissue formation. Over time, this scar tissue can pull on nearby structures, irritate nerves, and cause pain in the ribs and chest wall. This pain may appear months or even years after surgery.
Radiation-Induced Intercostal Neuralgia
Radiation therapy, a common treatment for breast cancer, can sometimes damage the intercostal nerves (nerves that run between the ribs). This may result in a type of nerve pain called intercostal neuralgia. The pain can be burning, shooting, or tingling, and may wrap around the chest.
Referred Pain from Spinal Metastases
Sometimes, rib pain is not from the ribs at all. Breast cancer can spread to the spine, leading to vertebral involvement. If cancer affects the thoracic spine, it may irritate spinal nerves, which in turn refer pain to the chest or rib cage. Similarly, a vertebral compression fracture—sometimes called a “broken back bone”—can also irritate spinal nerves. This irritation may cause pain that feels like it originates in the ribs. This referred pain can mimic other causes and is often missed without imaging. Spinal metastases may also lead to back pain or even spinal cord compression if untreated.
Treatment Options for Rib Pain in Breast Cancer
The right treatment depends on the cause of the rib pain. Some effective options include:
Medications
Medications are often the first step in managing cancer pain. These medications are selected based on the type and severity of pain experienced:
- Non-opioid pain relievers: Acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help reduce pain and inflammation.
- Opioids: When pain is more severe, medications such as oxycodone, morphine, or hydromorphone may be needed. These are especially useful in pain from fractures or bone metastases.
- Anticonvulsants and antidepressants: Medications like gabapentin, pregabalin, duloxetine, or amitriptyline can target nerve pain, especially if the pain is burning, tingling, or shooting.
- Steroids: Short courses of corticosteroids like dexamethasone can help decrease inflammation from spinal metastases and nerve compression.
- Bone-strengthening medications: Bisphosphonates (e.g., zoledronic acid) and denosumab help preserve bone density and may relieve pain from bone metastases.
- Topical treatments: Lidocaine patches or capsaicin cream may help in cases of localized nerve-related pain near surgical scars.
Radiation Therapy
Radiation can shrink tumors in the ribs or spine and relieve pain caused by bone metastases. This is a key treatment when pain stems from localized cancer growth.
Surgical Interventions
If rib pain comes from a fracture or localized tumor, surgical stabilization or tumor removal may be considered. Surgery can also help release painful scar tissue when other treatments have failed.
Nerve Blocks and Injections
For nerve-related rib pain, such as radiation-induced intercostal neuralgia, targeted nerve blocks may offer relief. These include intercostal nerve blocks and longer-lasting procedures like intercostal neurolysis.
Bone Tumor Ablation and Kyphoplasty
Advanced techniques like bone tumor ablation and kyphoplasty help treat painful lesions in the spine or ribs. These minimally invasive options destroy cancerous tissue and stabilize weakened bones to relieve pain.
Physical Therapy and Supportive Care
Rehabilitation plays a key role in easing rib pain and restoring mobility. Physical therapy focuses on posture correction, stretching tight chest muscles, and strengthening the back and core. Gentle exercises can improve breathing and reduce strain on the chest wall. Therapists may also use techniques such as myofascial release and desensitization to treat nerve pain after surgery or radiation.
Supportive care therapies enhance recovery and comfort. Acupuncture may reduce pain by stimulating nerve pathways and releasing endorphins. Therapeutic massage can help relax tense muscles around the ribs and shoulder. Breathing exercises improve chest expansion, which may be limited after surgery or radiation. Mind-body practices like yoga and meditation also support emotional well-being during cancer recovery.
Common Concerns and When to Seek Help
Many patients worry that any rib pain means their cancer has returned or spread. While rib pain can result from metastases, it can also arise from scarring, nerve irritation, or treatment side effects. It’s important not to panic—evaluation and imaging can clarify the cause and guide treatment.
If you have breast cancer and develop new or worsening rib pain, talk to your care team. Sudden or severe pain can be a sign of a compression fracture, bone metastases, or spinal complications. Prompt treatment can prevent further damage and improve quality of life.
At Red Butte Pain Solutions, we treat rib pain, back pain after surgery, nerve pain, and cancer pain. Our team offers solutions whether your pain stems from radiation therapy, spinal metastases, or broken back bones, we’re here to help. Call us at 602-633-4334 or Schedule now to get the care you need.