Some cases of bilateral axillary rib pain are due to physiologic factors, such as strenuous exercise. Excluding physiological factors may be related to diseases, the main causes include intercostal neuralgia, pleurisy, pneumonia and bone metastases. 1. Physiological factors: after strenuous exercise, the amplitude of thoracic activity is relatively large, and the surrounding muscles are tense, which will easily cause the accumulation of lactic acid, and there will be corresponding symptoms. 2. Pathologic factors (1) Intercostal neuralgia: Infection or immune factors lead to intercostal nerve injury, which can also cause related symptoms, usually accompanied by radiating pain. (2) Pleurisy: closely related to infection, causing localized irritation of the pleura, which will cause local pain and discomfort. (3) Pneumonia: Intra-pulmonary infection, aggravation of the condition and stimulation of the pleura will also cause corresponding symptoms, usually accompanied by cough and fever. (4) Bone metastasis: Bone metastasis of tumor, causing local tissue destruction will also cause related symptoms. Once bilateral axillary rib pain continues to aggravate, it is necessary to consult a doctor in time for observation and diagnosis of the cause of the disease, and carry out standardized treatment under the guidance of the clinician, so as to avoid delaying the condition.