Pain in the middle of the first rib in the chest may be caused by trauma, intercostal neuritis, pleurisy and other diseases. 1. Trauma. Fracture of the ribs due to a fall, etc., leading to the above symptoms. 2. Intercostal neuritis. Patients with intercostal neuritis are usually caused by viral infections, or due to traumatic nerve compression, so the patient will have chest pain in the middle of the ribs, and may also aggravate the pain when coughing or sneezing, it is recommended that the patient in the guidance of the doctor to use such as ibuprofen extended-release capsules, aspirin enteric-coated tablets and other pain relief drugs. 3. Pleurisy. Pleurisy is usually caused by fungal or bacterial infections. Patients will have the above symptoms along with accompanying symptoms such as fatigue, fever, cough, etc. They can usually be treated with gatifloxacin dispersible tablets or metronidazole tablets under the guidance of a doctor. Patients should go to the hospital in time and follow the doctor’s instructions for symptomatic treatment and medication.