Pain in the ribs and posterior back can occur for two main reasons: in the first case, due to trauma or strain to the intercostal muscles around the ribs, or the musculature of the lateral obliques, medial obliques, and latissimus dorsi, as well as the musculature of the posterior back, such as the scapular lift and rhomboid muscles. For example, excessive force for lifting, lifting heavy objects or twisting the back may lead to injury to these muscle tissues. Alternatively, continuous muscle contraction may lead to soft tissue strain and inflammation due to cold, resulting in significant pain. In the second case, herpes zoster occurs on one side, such as the back and ribs, because the viral infection of herpes zoster invades the intercostal nerves, and the inflammatory irritation of the intercostal nerves forms inflammatory edema, which can cause irritation of the intercostal nerves and lead to significant pain in the intercostal area.