Lupus can literally be a pain in your side. The most common type, systemic lupus erythematosus (SLE), can cause pain or discomfort in your ribs, chest, or back. More than 13,000 members of MyLupusTeam say that they have experienced this symptom.

“I have had pain that comes and goes on the left side right underneath my rib cage, and it radiates around to the back side also,” wrote one member. “It puts me down and hurts so much.”

Another member shared similar experiences. “The pain comes and goes,” they commented. “It is so sensitive to the touch, and when I twist or turn around too fast, oh boy it hurts so bad. … The worst is when I can’t breathe because of the inflammation, and it feels like my ribs are poking my lungs or organs.”

Read on to learn about what might cause rib pain with lupus and nine ways to help manage it.

What Causes Lupus Chest and Rib Pain?

Lupus can cause complications — secondary conditions that develop as a result of another health condition. Several lupus conditions may lead to rib or chest pain. Alternatively, rib pain may be a result of other issues unrelated to your lupus.

1. Costochondritis

Lupus commonly leads to joint pain and swelling and may affect the joints in your upper body. Costochondritis, an inflammation of the joints connecting your ribs to your breastbone, is more common in people with lupus.

Costochondritis pain typically:

• Develops in your ribs in the front or back of your body
• Increases when you cough, sneeze, or take a deep breath
• Worsens when you press on your ribs
• Travels from your ribs to your shoulders or arms

Costochondritis is more common on the left side of the upper rib cage. That’s why lupus chest pain often affects only the left side. If you experience lupus chest pain when lying down, it could be due to lying on your left side, where the pain is most severe.

One MyLupusTeam member described their experience with this type of pain. “When I had costochondritis a few years ago, it was extremely painful, especially when I laid down. It would wake me at night, and it was difficult to get into a comfortable position,” they said.

2. Organ Inflammation

During lupus, your immune system may attack your organs, causing them to become inflamed. “I get [rib pain] when my pancreas swells up,” wrote a member.

White blood cells are stored in your spleen, and when lupus causes your white blood cells to grow too quickly, your spleen may swell. Up to 46 percent of those with lupus may experience splenomegaly (an enlarged spleen), which may lead to pain or a feeling of fullness under your ribs on your left side.

“I get pain when my spleen is inflamed,” posted a member. “It happens to me a lot when flares are going on. Just like everything else, my spleen and liver get inflamed.”

3. Lung Conditions

About half of all people with SLE develop lung-related problems. Some lung conditions that may lead to chest pain include:

• Pleurisy (also called pleuritis) — Inflammation of the tissue covering your lungs
• Pleural effusion — A buildup of fluid around the lung
• Pneumonitis — Swelling of the tissue that makes up the lungs

Tell your doctor if you have other symptoms potentially connected to a lung condition, such as shortness of breath, coughing, or fever.

4. Heart Conditions

People with lupus are seven to nine times more likely to have a heart attack than the general population. Women between the ages of 35 and 44 living with lupus are 50 times more likely to have a heart attack than women in the same age range who don’t have lupus, according to Hospital of Special Surgery. In addition to chest pain and discomfort, a heart attack can cause shortness of breath, sweating, nausea, dizziness, and pain in your back, shoulders, arms, neck, or jaw. Get emergency medical help if you think you’re experiencing a heart attack.

Lupus can also lead to other cardiovascular conditions that cause chest or rib pain, including:

• Myocarditis — Swelling of the heart tissue
• Pericarditis — Inflammation of the tissue that covers the outer surface of the heart
• Endocarditis — Inflammation or growths on your heart valves

5. Other Causes of Chest Pain or Rib Pain

In some cases, you may develop rib or chest pain because of factors that don’t have anything to do with your lupus.

Gastroesophageal reflux disease (GERD), a condition that causes heartburn, can sometimes produce symptoms that mimic costochondritis. For example, GERD can lead to chest pain or pressure that travels to your back or arms or gets worse when you lie down. This was the case for one MyLupusTeam member. They wrote, “My son used to have [rib pain] so severely, for years, but recently, he was put on omeprazole and has not had it happen for quite a while.”

Additionally, several types of arthritis can cause pain in your spine or nearby ribs.

If you’re having ongoing rib pain, tell your doctor. Your health care team can recommend tests that help diagnose any pain-triggering conditions.

9 Ways To Treat Rib Pain While Living With Lupus

When your lupus or its complications are causing rib pain, you may be able to try both home remedies and prescription therapies. Read on to discover how to relieve rib or chest pain with lupus.

1. Take Over-the-Counter Pain Relievers

Conditions like costochondritis can often be treated with nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen (Advil), naproxen (Aleve), or aspirin. However, kidney disease is a potential side effect of NSAIDs, and people with lupus who take NSAIDs frequently may have an increased risk of blood pressure and heart damage. Ask your doctor before using these treatments if you’re living with both costochondritis and lupus and you’ve experienced lupus-related kidney problems.

2. Try Heat or Cold Therapy

Putting a heating pad or hot water bottle on the painful area may help ease the pain. Alternatively, you may find that ice packs work better.

“Warm packs on the rib cage are great,” said one MyLupusTeam member.

“I recommend taking a warm bath,” suggested another.

3. Wear Loose-Fitting Clothing

One member with rib pain suggested avoiding clothes or undergarments that are tight around the chest area. “Try wearing a camisole or looser sports bra for a few days (no underwires) while taking ibuprofen, aspirin, or another anti-inflammatory,” they advised.

4. Get Some Rest

Multiple MyLupusTeam members have suggested resting as much as possible when rib pain flares up. One commented, “Mostly when these episodes happen, Tylenol and a lot of rest is the best treatment for me.”

5. Ask Your Doctor About Prescription Medicine

If home remedies aren’t working well to control your rib pain, talk to your health care team about other potential therapies. For example, prescription pain relievers, antidepressants, and anti-seizure medications are all sometimes used to treat costochondritis pain.

One MyLupusTeam member with costochondritis wrote that their pain is “always worse when lying down, so I just take some prescribed anti-inflammatories before bed and that helps.”

6. Try Prednisone Treatments

Corticosteroids such as prednisone may help lessen rib pain caused by inflammation. If prescribed, your doctor will likely warn you about the serious side effects of taking these drugs long term.

A member shared that they were prescribed prednisone for a severe episode of pain: “My rib pain went away and I could breathe again,” they said.

Another agreed: “A little prednisone helped a lot.”

7. Stick With Your Lupus Treatment Plan

One of the main goals of lupus treatment is to control your symptoms, including pain and swelling. Following the treatment plan suggested by your health care team may help limit your rib pain. If your current treatment options aren’t working as well as you’d like, tell your rheumatologist.

“After two months of treatment (hydroxychloroquine, Benlysta, and prednisone), the attacks and pain are starting to lessen,” posted a MyLupusTeam member.

8. Go to Physical Therapy

Physical therapy may help relieve pain and improve muscle flexibility for those with swelling or stiffness in the tissues near their ribs.

One MyLupusTeam member with costochondritis reported, “I was advised to go to physical therapy for chest exercises using a resistance band because if you don’t exercise, you will get stiffness in the chest. It seems like it does the trick.”

9. Know When Rib Pain Is Serious or Life-Threatening

Heart attacks and rib fractures can sometimes feel like costochondritis pain. Get emergency medical care if you experience rib or chest pain along with other common symptoms of a heart attack, like difficulty breathing, sweating, nausea, or pain that spreads to your arms, neck, or jaw. Talk to your rheumatology specialist about a possible broken rib if you experience pain or tenderness when you move around or notice bruising in your chest area.

Connect With Others Who Understand

On MyLupusTeam, more than 231,000 people with lupus and their loved ones come together to ask questions, give advice, and share their stories with others who understand life with this condition.

Have you experienced rib pain while living with lupus? How do you manage it? Share your experience in the comments below, or start a conversation by posting on your Activities page.