Costovertebral Joint Sprain

The costovertebral joint connects the spinal vertebrae to the ribs. Extreme or repeated force on the rib cage and spine can provoke injury to this joint, tearing connective tissue or affecting the cartilage.


Sudden pain in the upper back and ribs which can either strike at the moment of injury, i.e. during an activity, or afterwards, such as the following morning. Occasionally this pain can spread into the shoulder blades, upper arms or the chest area. Rigidity in the spinal or rib area is also common. You may experience some muscle spasms near to the costovertebral joint. Most symptoms are likely to occur along one side of the ribcage and spine. These symptoms, especially pain, can often be worsened with physical activity such as bending, lifting or twisting, and also during sneezing or coughing.


The injury can be caused due to prolonged wear on the costovertebral joint, particularly due to overuse. Repetitive bending or twisting motions, backward arching movements, or heavy lifting can all lead to this condition. This is more likely if the relevant muscles and structures in the back are not fully strengthened, for example due to a lack of warm ups or from overestimating your ability to carry out extensive strenuous activities. These same movements can also cause the injury following a single traumatic incident. Incorrect technique, such as during lifting, can contribute towards injury in these instances.


A doctor will use a physical examination and any necessary scans to diagnose the injury and make sure that no more serious spinal injuries are present. Generally the costovertebral joint sprain heals in a short amount of time if the injured party takes appropriate steps to ensure that they rest from any potentially damaging activity until all pain and other symptoms have gone. Taking regular showers or baths can also be beneficial, as can using anti-inflammatory pain medication (e.g. ibuprofen) to relieve symptoms and potentially quicken the healing time. While the injury recovers it is important to keep correct posture in order to lessen any strain on the injured joint. Sometimes a doctor might fit you with a brace for this purpose.

Physical Therapy and Recovery

Ask about suitable exercises that will maintain motion and combat stiffness in the back without causing any pain; these should be undertaken as early as the doctor recommends. After the symptoms have ceased you should make a responsible and gradual return to regular activity, preferably with the assistance of a physical therapy program. This can help you to stretch and strengthen important muscles. Full recovery time varies but can take on average between 1 and 3 weeks. However, it is crucial to note that tissue recover takes longer – around 6 weeks – so returning to activity should be incremental.


Maintain good posture as much as possible. Avoid the trappings of overuse by training responsibly and stretching and strengthening important muscle groups. Do not exercise when your muscles are weak, and always warm up before activity. Learn the correct techniques for all of your activities if applicable; this is especially important for lifting, where bad technique can be very damaging. If possible, try to limit the amount of repetitive bending and twisting work that your spine needs to carry out.

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