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Rib flare in pregnancy

Last reviewed dd mmm yyyy. Last edited dd mmm yyyy

Authoring team

  • rib flare is a condition that occurs secondary to the growing uterus pressing against the lower costal rib margins (as well as related to movement of the growing fetus increasing pressure against the costal margins)
    • generally presents in the third trimester
    • more often affects right anterior costal margin; may be bilateral

  • other causes of chest wall pain/chest pain (e.g. Tietze's syndrome, trauma, PE) must be considered

  • Advice for patients (1)
    • try to change position frequently and avoid sitting on low chairs and other positions which bring your ribs close to your pelvis
    • temporary relief may be achieved by lifting the arm on the affected side and bending sideways away from the ache
    • sitting cross-legged (tailor fashion) with hands on head also gives some relief
    • a suggested exercise to gain relief is (2):
      • 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.
    • analgesia - regular paracetamol may bring some relief

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