The causes of pain in the middle of two ribs are mainly external injury, inflammation, etc., as follows: First, external injury: it may be subjected to external force, extrusion injury, which leads to pain in the soft tissues of intercostal area, or the intercostal nerves are damaged, so that pain occurs. Second, other factors: there may be intercostal nerve damage or vertebral fracture, the intercostal nerve will have radiating pain, so that there will also be pain in the middle of the two ribs. Third, inflammation: there may be inflammation of the lungs, or aseptic inflammation of the intercostals, bacterial infection leading to local inflammation, which can also lead to pain and discomfort between the two ribs.