isability and workers' compensation costs are increasing at a rate that exceeds health care costs in general. The largest unrecognized cause of disability is a condition referred to as non-specific musculoskeletal pain, or more recently myofascial pain syndrome (MPS). Although this diagnosis is considered controversial, vague, and confusing by many practitioners, it is clinically useful in providing a framework for recognizing and treating employees with acute pain. To achieve the goal of early return to work, it is imperative that occupational health nurses become actively involved in the management of pain conditions. Professional literature recently has begun defining criteria for pain conditions with a common feature of trigger points. One trigger point pain syndrome receiving attention in the British literature, but relatively unknown in United States nursing literature, is a condition known as painful rib syndrome (PRS). The purpose of this article is to provide occupational health clinicians with the knowledge to assess, identify, and participate in treating clients with PRS. The discussion compares PRS and MPS and suggests that PRS may be a variant or type of MPS. Although accurate diagnosing and immediate interventions may not prevent acute conditions from becoming chronic, it may prevent chronic pain conditions from becoming permanent disabilities.