10 Causes for Pain Below the Ribs & Treatment Options

1. Chest & Lungs

>

2. Pain Below the Ribs

Read about

Pain below your ribs can be caused by your GI tract, like GERD, indigestion, gallbladder disease, or constipation, or problems with your lungs, like pneumonia. You may also have nausea, bloating, chest pain, coughing, or pain that’s worse when you breathe in.

Written by

Chandra Manuelpillai, MD.

Assistant Professor, Department of Emergency Medicine at Boston University School of Medicine

Last updated June 27, 2023

Tooltip Icon.Speech Bubble Icon.2

Copied to clipboard

Most common questions

Causes

Next Steps

Emergency symptoms

Treatment

Table of Contents

Tooltip Icon.Speech Bubble Icon.2

Copied to clipboard

Written by

Chandra Manuelpillai, MD.

Assistant Professor, Department of Emergency Medicine at Boston University School of Medicine

Last updated June 27, 2023

Pain below the ribs quiz

Take a quiz to find out what’s causing your pain.

Buoy Chat Icon.Take symptom quiz

7 most common causes

Stomach Ulcer

Illustration of a doctor beside a bedridden patient.

Dyspepsia

Constipation

Pneumonia

Gastritis

Gallstones

Pain below the ribs quiz

Take a quiz to find out what’s causing your pain.

Take pain below the ribs quiz

Most common questions

Pain below the ribs can be caused by a variety of factors, including medical conditions related to the abdominal organs like gastritis or inflammation of the pancreas, musculoskeletal problems like muscle strain or costochondritis, or even referred pain from other organs like the heart, spleen, or kidneys.

Read about the 9 most common causes for pain below the ribs

It is important to consult with a healthcare provider to determine the underlying cause of your pain below the ribs. They may perform a physical examination, order diagnostic tests such as imaging studies or blood tests, and develop a treatment plan based on the specific cause of your pain.

Buoy Chat Icon.

Check my symptoms

Was this information helpful?

Thank you! Buoy values your feedback. The more we know about what’s working – and what could improve – the better we can make our experience.

Pain below the ribs can have many potential causes, some of which are emergency situations. If you are experiencing severe and sudden pain with other symptoms, such as chest pain, shortness of breath, dizziness, or fainting, it’s important to seek medical attention right away. If the pain is mild and persistent, it is less likely an emergency, but should still be evaluated to determine the potential cause. Read more

Take the quiz above to help decide if emergency care is needed.

Was this information helpful?

Thank you! Buoy values your feedback. The more we know about what’s working – and what could improve – the better we can make our experience.

Pain below the ribs can be caused by various conditions and it’s important to first identify the underlying cause before attempting to treat the pain. However, there are some common strategies that may help relieve your pain, from over-the-counter medications and light stretching, to breathing exercises and lifestyle changes. If the pain persists or worsens, you should seek medical attention from a healthcare professional.

Read more about treatments for pain below the ribs

Was this information helpful?

Thank you! Buoy values your feedback. The more we know about what’s working – and what could improve – the better we can make our experience.

If you are experiencing pain below the ribs, it’s a good idea to see a medical provider for an evaluation, especially if the pain is severe or persistent, or if it is accompanied by other symptoms. In some cases, pain below the ribs can be a sign of a more serious condition, such as a heart attack or pulmonary embolism (a blood clot in the lungs), so it’s important to seek medical attention promptly.

A medical provider can perform a physical exam, order any necessary tests or imaging studies, and provide a diagnosis and appropriate treatment. If you are experiencing severe or persistent pain below the ribs, seek medical attention right away.

Was this information helpful?

Thank you! Buoy values your feedback. The more we know about what’s working – and what could improve – the better we can make our experience.

✨ BETA

Take our pain below the ribs quiz

Your response today was provided by ChatGPT trained on the proprietary content of this page. Please note, this tool is for information purposes only and not intended to be used as a substitute for professional advice. You assume responsibility for decisions made with your individual medical situation.

Was this information helpful?

Thank you! Buoy values your feedback. The more we know about what’s working – and what could improve – the better we can make our experience.

Receive a FREE Health Pack today!

Click here to see if you qualify

What causes pain below the ribs?

Pain below the rib cage may be caused by organs in the chest cavity (which are protected by your ribs) or ones just below it. These include the lungs, diaphragm, intestines, stomach, and gallbladder.

Pain below the ribs can feel dull or sharp. The pain may go away quickly or be ongoing. Depending on what’s causing the pain, you may only feel discomfort on one side of the body.

The conditions that cause pain below the ribs usually cause other symptoms as well. These symptoms include fever, nausea, vomiting, bloating, chest pain, coughing, back pain, or pain that gets worse when you inhale.

Some conditions that cause pain below the ribs, such as a pulmonary embolism, can be life-threatening and require emergency treatment.

If you experience chest pain, difficulty breathing, or have upper abdominal pain that radiates to the jaw, neck, or arm, call 911.

Are you looking for the Spanish version? Find it here.

Causes

1. Constipation

Symptoms

• Abdominal pain
• Nausea
• Bloating
• Hardened stool that’s difficult to pass
• Less frequent bowel movements (generally, fewer than three a week)

Constipation occurs when bowel movements become harder, more difficult to pass, and/or happen less frequently than normal. It’s common to get constipation for short periods of time. However, for some people, constipation can be a chronic problem.

Constipation is usually caused by a low-fiber diet, not drinking enough water, and lack of exercise.

How you treat constipation depends on what caused it.

• Eat more foods rich in fiber (such as fruit and vegetables)
• You may need to take a fiber supplement
• Drink more water
• Get more exercise
• Set up a “bowel routine” by trying to have a bowel movement at the same time each day

2. Indigestion

Symptoms

• Pain in the upper abdomen, including below the ribs
• Feeling full during a meal
• Feeling uncomfortably full after a meal
• Nausea
• Bloating
• Heartburn

Indigestion (dyspepsia) is often caused by your eating habits. It can occur if you eat too much or too quickly, eat greasy or spicy food, or drink too much caffeine, alcohol, or carbonated drinks.

Smoking and anxiety can also cause indigestion. Certain medications (antibiotics, pain relievers) and vitamin and mineral supplements can also trigger this condition.

How you treat your indigestion depends on what caused it. If you follow these tips for two weeks and don’t notice any improvement, see your doctor to rule out more serious conditions.

• You may need to eat smaller, lighter meals and eat them more slowly.
• Avoid spicy and greasy foods, caffeinated and carbonated drinks, and alcohol, as these can irritate your stomach.
• Quit smoking.
• Try to manage stress with techniques such as meditation.
• If you think that a medication is causing indigestion, talk to your doctor about taking a different drug that may be easier on your stomach.

Pro Tip

Some patients think the longer they have symptoms, the worse it must be. While any time you have symptoms lasting more than 2 weeks you should discuss it with your doctor, it does not necessarily mean your symptoms are more life threatening. —Dr. Chandra Manuelpillai

3. GERD

Symptoms

• Heartburn
• Regurgitation of acidic/sour material
• Chest pain
• Difficulty swallowing
• Sore throat
• Hoarse voice

Gastroesophageal reflux disease (GERD) is when acid in the stomach travels back up the esophagus and causes symptoms. It is a very common disorder and reported in up to 28% of the population in North America.

Everyone has some amount of reflux but it usually does not cause bothersome symptoms. There is a muscle in between the esophagus and stomach, the lower esophageal sphincter (LES), that helps to prevent food or acid from going back up. When the LES is weakened, acid can travel up the esophagus more easily and cause symptoms.

Treatment can include lifestyle modifications, over the counter medications for milder symptoms, or prescription medications for more severe symptoms. Lifestyle modifications include changing what you eat, like fatty or spicy food, and avoiding triggers that worsen your reflux symptoms. Weight loss and not smoking are also important lifestyle modifications.

OTC medications include antacids like Tums or Milk of Magnesia or Pepto-Bismol. Prescription medications include histamine 2 receptor antagonists (h3RA) or proton pump inhibitors (PPI). These medications decrease the amount of acid produced in the stomach, which helps to decrease symptoms. PPIs are prescribed for more severe symptoms.

4. Ulcer

Symptoms

• Pain in the upper abdomen, including below the ribs
• Bloating
• Inability to tolerate fatty foods
• Heartburn
• Nausea

An ulcer is a sore that develops in the stomach (peptic ulcer) or small intestine (duodenal ulcer). The sores form when the acids that help digest your food eat away at the lining of either organ.

Some ulcers develop due to a chronic infection of H. pylori, a type of bacteria. It’s not known how H. pylori infections spread, but it may happen through close contact (such as kissing), water, or food.

Other ulcers are caused by regularly using certain medications. Nonsteroidal anti-inflammatories (Advil, Aleve, indomethacin) are the most common culprits.

Treatment depends on what caused your ulcer. If it’s due to H. pylori, you’ll be prescribed antibiotics. If a medication you take caused your ulcer, your doctor will likely lower your dose or switch you to a different medication. They may also recommend medications that block or reduce the amount of acid your body produces.

5. Gastritis

Symptoms

• Pain in your upper abdomen that may get better or worse when you eat
• Nausea
• Vomiting
• A feeling of fullness in your upper abdomen after eating

Gastritis is an inflammation of the lining of your stomach. It may occur suddenly (acute gastritis) or gradually (chronic gastritis).

The causes of gastritis are the same as those of ulcers: H. pylori infection or regular use of certain medications. Drinking too much alcohol can also cause gastritis.

Treatment is similar to that of ulcers. If your gastritis was caused by drinking alcohol, you may need to cut down on or stop drinking.

6. Pneumonia

Symptoms

• Difficulty breathing that may worsen when you’re active
• Sharp chest pain that is worse when inhaling and coughing
• Shortness of breath
• Fatigue
• Fever and chills
• Nausea
• Vomiting
• Diarrhea

Pneumonia is an inflammation of the lungs. It is caused by a bacterial or viral infection. Pneumonia may be mild or life-threatening. It is most serious in infants, young children, people older than age 65, and people who have a weak immune system.

If you think you have pneumonia, see your doctor.

Treatment depends on the type of pneumonia you have. Antibiotics are used to treat bacterial pneumonia but not viral pneumonia. Your doctor may also recommend treating your symptoms with cough medicine and fever and pain relievers like ibuprofen or acetaminophen.

Bacterial infections often improve within a few days of starting antibiotics. However, it may take weeks or months to fully recover from both bacterial and viral pneumonia.

7. Gallbladder disease

Symptoms

• Pain in the right upper abdomen
• Pain that worsens when you breathe in, press on the right side of your upper abdomen, and after you eat fatty foods
• Nausea and/or vomiting
• Fever and/or chills
• Yellowing of skin and whites of eyes
• Dark urine
• Clay-colored stools

Conditions that affect the gallbladder cause pain under the ribs on your right side because that is where the gallbladder is located. The gallbladder stores bile, which is necessary for digestion.

Gallstones are a common cause of gallbladder pain. These stones may be as small as a grain of sand or as large as a golf ball. You may develop just one gallstone or several at the same time.

It isn’t clear why gallstones occur. It may be that your gallbladder has a problem releasing bile. Or your bile may contain too much cholesterol or a chemical called bilirubin.

Sometimes gallstones don’t cause any symptoms. Sometimes, when the gallstones are blocking your gallbladder from releasing bile, they cause pain in the right upper belly right under the ribs. You may also have nausea or vomiting. It is often worse after eating.

If the gallstone remains stuck, you may develop an infection called cholecystitis. This causes inflammation of the gallbladder. If cholecystitis is untreated, it can cause life-threatening problems such as gallbladder rupture and severe infections.

The treatment of gallstones depends on how severe your symptoms are and how often they occur. If the pain is mild and occurs only occasionally, treatment may be as simple as taking pain medication and avoiding fatty foods.

If you get symptoms often or your symptoms are severe, you may need to have surgery to remove your gallbladder. If your gallbladder becomes infected, you will need to be admitted to the hospital for antibiotics, IV fluids, and pain medications. You’ll likely have to have your gallbladder removed as well.

Pro Tip

The ribs are a very important structure in our body. They protect multiple of our vital organs including those in our chest wall, such as the heart and lungs, as well as those in the upper abdomen including the diaphragm, stomach, liver, gallbladder, and spleen. —Dr. Manuelpillai

8. Splenic or hepatic flexure syndrome

Symptoms

• Sharp pain or cramps under the left or right side of the ribs
• Pain that worsens when inhaling
• Bloating
• Constipation
• Increased gas
• Belching

Splenic and hepatic flexure syndromes are caused by trapped gas or stool in your intestines. Flexures are areas of the intestine that make sharp turns.

Splenic flexure syndrome occurs when gas or stool become trapped in the splenic flexure. This is in the upper left part of your abdomen (over your spleen). In hepatic flexure syndrome, the gas or stool is trapped in the hepatic flexure (over the liver). This is located in the upper right part of your abdomen.

Splenic and hepatic flexure syndrome are not dangerous, but they can be extremely painful.

They can be treated with over-the-counter pain and gas-relief medications. Constipation can be treated with laxatives if necessary. Stretching that affects the abdomen, like certain yoga poses, may also help you release the gas. The best way to prevent them is to avoid gas-producing foods such as beans, broccoli, and dairy products.

9. Side stitch

Symptoms

• Sharp and/or crampy abdominal pain, usually on the left or right side

Side stitches usually occur when you’re exerting yourself, such as when you run.

The cause of side stitches is unknown. Experts think it may be related to not drinking enough, drinking sugary drinks, or eating too much or too soon before you exercise. You may also experience a side stitch if your abdomen and/or diaphragm are irritated.

You can relieve the pain of side stitches by resting, stretching, and drinking water.

10. Pulmonary embolism

Symptoms

• Difficulty breathing that may worsen when you’re active
• Chest pain
• Coughing that may produce blood
• Fast heartbeat

A pulmonary embolism (PE) is a blood clot in a blood vessel in the lungs. PE blocks blood flow to your lungs and lowers the level of oxygen in your blood. The lungs may become damaged.

These clots usually don’t form in the lungs. Instead, they develop in the lower leg, then break off and travel through your blood vessels to your lungs. Blood clots in the leg are called deep vein thrombosis (DVT). People with DVT may also have leg pain and swelling.

PE and DVT are life-threatening conditions. If you have symptoms, you should call 911 or go to the ER immediately.

Treatment depends on the severity of the clot. A large, life-threatening clot may require surgery or clot-dissolving medications called thrombolytics. Less dangerous clots can be broken up by your body with the help of blood-thinning medications called anticoagulants.

Other possible causes

There are other conditions that may also cause pain below the ribs, but it is usually not one of the main symptoms:

• Heart attack (pain is usually in the chest but may be in upper abdomen)
• Kidney stones
• Appendicitis

When to call the doctor

• Symptoms don’t improve after 1 week

Dr. Rx

The more details you include, the easier it is to determine the cause of your symptoms. So make sure you include the location of your pain and if it seems to move or radiate to another location, pain description (sharp, dull, burning, pressure, etc), how long it lasts, when it occurs (after eating, with exertion, etc), if anything makes it better or worse, and any associated symptoms. —Dr. Manuelpillai

Should I go to the ER for pain below the ribs?

You should go to the ER if you have the following:

• Sudden severe abdominal pain
• Uncontrolled vomiting
• Unable to eat or drink
• Vomiting blood or a substance that looks like ground coffee
• Coughing up blood
• Bloody or black diarrhea
• Dizziness or confusion
• Blue lips or nail beds
• Heart palpitations
• Chest pain
• Upper abdominal pain that radiates to the jaw, neck, or arm
• Upper abdominal pain with dizziness, sweating, chest pain, or difficulty breathing
• Fever with yellowing of the skin and whites of eyes

Treatments

At-home care

• If the pain is from a digestive issue like indigestion, over-the-counter antacids and other acid blockers can help.
• If the pain is from constipation, lifestyle changes like eating more fiber, drinking more water, and exercising can help. Use of over-the-counter stool softeners can provide additional relief.
• Avoid certain foods that are likely to cause gas and/or irritate your stomach, such as fatty and spicy foods.
• Limit your use of medications that can lead to ulcers (if that’s not possible, ask your doctor if you can switch to a different medication).
• Gentle stretching or light exercise may help to alleviate pain and reduce muscle tension. However, be sure to avoid any activities that may exacerbate the pain.
• Apply heat or ice: Depending on the cause of the pain, applying heat or ice to the affected area may help to reduce pain and inflammation. You can use a heating pad, warm towel, or ice pack for 10-20 minutes at a time, several times a day.
• Practice deep breathing: Taking slow, deep breaths can help to relax the muscles in the area and may help to alleviate pain.

Chandra Manuelpillai, MD.

Assistant Professor, Department of Emergency Medicine at Boston University School of Medicine

Dr. Manuelpillai is a board-certified Emergency Medicine physician. She received her undergraduate degree in Health Science Studies from Quinnipiac University (2002). She then went on to graduated from Rosalind Franklin University of Medicine and Sciences/The Chicago Medical School (2007) where she served on the Executive Student Council, as well as was the alternate delegate to the AMA/ISMS-MSS G…

Read full bio

Was this article helpful?

270 people found this helpful

Tooltip Icon.

Copied to clipboard

Read this next

Slide 1 of 4

10 Rib Pain Causes

Rib pain or pain in the chest wall that feels like it comes from a rib may be caused by traumatic injury, muscle strain, joint inflammation, or chronic pain, and ranges in severity. Rib cage pain can be associated with bruising, difficulty taking a deep breath, joint pain, and more. Read more below to learn what may be causing your rib pain and when to seek treatment.

Read more

Rib Pain on Both Sides Symptoms, Causes & Common Questions

Rib pain on both sides can be caused by inflammation of the cartilage known as acute costochondritis (chest wall syndrome), atypical chest pain, or normal occurrence of chest pain. Read on below for more information on causes and relief options.

Read more

Rib Pain That Gets Worse When Breathing, Coughing, Sneezing, or Laughing

The ribs enclose many organs, so rib pain from coughing, breathing, sneezing or laughing can have a variety of causes, including pulmonary, musculoskeletal and cardiac issues that range in severity. Read more below to learn what may be causing your rib pain from coughing, breathing, sneezing, or laughing, and how your doctor may treat it.

Read more

Abdominal Pain: Causes & When to Be Concerned

Abdominal pain is usually a sign of a common illness or infection. Other causes include indigestion, a stomach ulcer, IBS, or food poisoning.

Read more

10 Rib Pain Causes

Rib pain or pain in the chest wall that feels like it comes from a rib may be caused by traumatic injury, muscle strain, joint inflammation, or chronic pain, and ranges in severity. Rib cage pain can be associated with bruising, difficulty taking a deep breath, joint pain, and more. Read more below to learn what may be causing your rib pain and when to seek treatment.

Read more

Rib Pain on Both Sides Symptoms, Causes & Common Questions

Rib pain on both sides can be caused by inflammation of the cartilage known as acute costochondritis (chest wall syndrome), atypical chest pain, or normal occurrence of chest pain. Read on below for more information on causes and relief options.

Read more

Rib Pain That Gets Worse When Breathing, Coughing, Sneezing, or Laughing

The ribs enclose many organs, so rib pain from coughing, breathing, sneezing or laughing can have a variety of causes, including pulmonary, musculoskeletal and cardiac issues that range in severity. Read more below to learn what may be causing your rib pain from coughing, breathing, sneezing, or laughing, and how your doctor may treat it.

Read more

Abdominal Pain: Causes & When to Be Concerned

Abdominal pain is usually a sign of a common illness or infection. Other causes include indigestion, a stomach ulcer, IBS, or food poisoning.

Read more

10 Rib Pain Causes

Rib pain or pain in the chest wall that feels like it comes from a rib may be caused by traumatic injury, muscle strain, joint inflammation, or chronic pain, and ranges in severity. Rib cage pain can be associated with bruising, difficulty taking a deep breath, joint pain, and more. Read more below to learn what may be causing your rib pain and when to seek treatment.

Read more

Rib Pain on Both Sides Symptoms, Causes & Common Questions

Rib pain on both sides can be caused by inflammation of the cartilage known as acute costochondritis (chest wall syndrome), atypical chest pain, or normal occurrence of chest pain. Read on below for more information on causes and relief options.

Read more

Rib Pain That Gets Worse When Breathing, Coughing, Sneezing, or Laughing

The ribs enclose many organs, so rib pain from coughing, breathing, sneezing or laughing can have a variety of causes, including pulmonary, musculoskeletal and cardiac issues that range in severity. Read more below to learn what may be causing your rib pain from coughing, breathing, sneezing, or laughing, and how your doctor may treat it.

Read more

Abdominal Pain: Causes & When to Be Concerned

Abdominal pain is usually a sign of a common illness or infection. Other causes include indigestion, a stomach ulcer, IBS, or food poisoning.

Read more

Symptoms, Causes, Tests, and Treatment

Costochondritis is an inflammation of the cartilage in the rib cage. It can happen due to infection, injury, and other health conditions.

This condition usually affects the cartilage where the upper ribs attach to the breastbone, also known as the sternum, in an area known as the costosternal joint or costosternal junction.

Chest pain caused by costochondritis can range from mild to severe. Mild cases may only cause your chest to feel slightly tender or some pain when you push on the area.

More severe cases may get worse with certain movements as well as with deep breaths. The condition often goes away within a few weeks or months, but some cases may require treatment.

People with costochondritis often experience chest pain in the upper and middle rib area on either side of the breastbone. This pain can gradually increase over time, or come on suddenly.

Additional symptoms can include:

• pain that becomes worse when lying down
• pain that becomes worse when there’s pressure on your chest, like when you wear a seatbelt
• pain that intensifies with coughing or deep breaths
• pain that increases with physical activity

It’s important to note that symptoms like chest tightness and radiating pain can indicate other conditions, including a heart attack. Seek immediate medical care if you’re experiencing persistent, intense chest pain.

The exact cause of costochondritis in most people is unknown. But conditions that may cause it include:

• trauma to the chest, such as blunt impact from a car accident or fall
• physical strain from activities, such as heavy lifting and strenuous exercise
• certain viruses or respiratory conditions, such as tuberculosis, that can cause joint inflammation
• severe coughing

There’s some research that suggests costochondritis occurs more often in women, especially those who are athletes. You may also be at a higher risk for this condition if you:

• participate in high-impact activities
• recently had a physical trauma or fall that affected the chest area
• have allergies and are frequently exposed to irritants

While there’s no test to diagnose costochondritis, your doctor will most likely ask a series of questions and do a series of tests to determine the source of your chest pain.

Lab tests

Typically, lab tests aren’t needed to diagnose costochondritis, but depending on your personal health history, your doctor may do some tests to see if your chest pain could be due to other issues like pneumonia or coronary heart disease.

X-rays and ECGs

Your doctor may want you to get an X-ray to make sure there’s nothing abnormal going out with your lungs.

If you’re dealing with costochondritis, your X-ray should look normal. They may also recommend an electrocardiogram (ECG) to make sure your heart isn’t the cause of your chest pain.

Many times, diagnosing costochondritis is a matter of eliminating other possible, more serious causes.

See your doctor right away if you have trouble breathing or are feeling intense chest pain.

Always seek immediate emergency care when you have abnormal and debilitating pain in your chest. It can indicate something serious, such as a heart attack.

Getting care as soon as possible limits the possibility of complications, especially if an underlying issue is causing your costochondritis.

Costochondritis can be treated in several ways.

Most cases of costochondritis are treated with over-the-counter medications. If your pain is mild to moderate, your doctor will probably recommend nonsteroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen (Advil) or naproxen (Aleve).

Your doctor may also recommend:

• prescription-strength NSAIDs
• oral steroids or injection of a steroid into the area involved
• transcutaneous electrical nerve stimulation (TENS), which is a mild electric current that is delivered to the area via a small, battery-powered device

Lifestyle changes

Your doctor may tell you to make permanent lifestyle changes if you have persistent or chronic costochondritis.

Some types of exercise can aggravate this condition, including rowing and weightlifting. Manual labor may also have a negative effect.

Your doctor may also recommend:

• rest
• physical therapy
• hot or cold therapy using a heating pad and ice

Normally, treatment of the inflammation and pain causes costochondritis to eventually go away on its own.

If you have chronic costochondritis, the pain may persist or return — even with treatment — when you exercise or engage in certain activities. In these cases, you may need to seek long-term care to make sure that costochondritis doesn’t affect your quality of life and ability to take part in daily activities.

Pains associated with costochondritis can indicate other issues. Chest pain can often mean that you’re having heart or lung issues, so see your doctor right away when you feel pain in your chest to make sure that you’re not having a heart attack or have pneumonia.

The chest pain associated with costochondritis can be a symptom of fibromyalgia. With fibromyalgia, you may experience soreness in your chest in addition to:

• pain throughout your body
• fatigue and inability to rest due to pain
• difficulty focusing or concentrating
• feelings of depression
• headaches

If you experience chest pains along with these other symptoms, talk with your doctor about getting tested for fibromyalgia. Understanding this condition can help you address the symptoms and ensure that it doesn’t interrupt your daily life.

Costochondritis is caused by inflammation and typically presents as chest pain that gets worse with certain movements or pressure. This condition usually isn’t persistent. In many cases, costochondritis goes away on its own.

Mild cases of costochondritis may disappear after a few days. Chronic cases can last for weeks or more, but most cases don’t last any longer than a year.

To lower your chances of developing persistent costochondritis, carry and lift heavy loads properly. Try doing fewer high-impact exercises or manual labor, when possible.

Seek medical attention immediately if you experience chest pain while performing any of these activities.

Middle chest pain: possible causes, treatment

Doctors call the phenomenon when a person has pain in the chest in the middle, thoracalgia. There can be a lot of reasons for the appearance of pain syndrome, from the most harmless to quite serious pathologies. In order not to miss an important “alarm bell” from your body, it is best to contact a neurologist , who will examine you and determine why your chest began to hurt.

Middle chest pain: causes

There can be many reasons why pain appeared in the middle of the chest, so it is worth considering the intensity of the pain syndrome, its frequency and the specific localization of pain. By doing this, it will be possible to narrow the search for pathology leading to unpleasant sensations.

Heart pathologies

Pain in the chest is often associated with diseases of the cardiovascular system, the heart. If you feel thoracic all the time, this may indicate an aortic aneurysm. In this case, the pain in the left or right side of the chest is felt for a long time, and it will become stronger every time the person moves from rest to physical activity. The condition is treated exclusively surgically, so hospitalization will be required to confirm this diagnosis. Pain in the center of the chest in front can also appear if a pulmonary embolism develops. The pain syndrome becomes stronger on inspiration, and taking analgesics allows you to suppress it. Compressive pain may indicate that a person has angina pectoris, and pain can also be a symptom of myocardial infarction.

Respiratory damage

If there is pain in the front in the center of the chest, and at the same time you feel interruptions in breathing, you cannot breathe deeply, cough and shortness of breath appear, the problem may be the occurrence of pulmonary diseases, which include tracheitis, pneumonia, bronchitis, pleurisy and some others. The same symptoms can occur with diseases of the diaphragm.

Injuries

Pain in front of the chest, in the middle, or between the ribs may occur in a person who has survived an accident, has been involved in a fight, or has damaged chest structures from a fall or blow. Such pains intensify when he tries to turn around, bend down, take a deep breath, and are explained by the fact that blood vessels rupture, the periosteum is damaged, cracks and fractures form. In such a situation, at rest, the pain syndrome can disappear almost completely, which gives a person a false confidence that there is no need to consult a doctor.

Diseases of the spine

The most common reason why the chest hurts in the middle is osteochondrosis, if we talk about the pathologies of the spinal column. Pain in osteochondrosis can be constant or manifest in the form of seizures. The pain will be the same in intensity and manifestation with radiculopathy in the thoracic spine. Also, pain syndrome can indicate an intervertebral hernia and congenital anomalies in the structure of the spinal column.

Neurological diseases

Causes of pain in the chest in the middle can be neuralgic in nature. The most common diagnosis in this case is intercostal neuralgia, in which it is very painful in the sternum, it radiates to the back under the shoulder blade, which makes it easy for a person to confuse pain with heart pain.

Esophageal problems

Pain in the shoulder blades and in the middle of the chest may be associated with pathologies of the esophagus. The reason in this case is, as a rule, a spasm, which manifests itself more often in the morning or after eating. Pain in the chest area is relieved by taking antispasmodic drugs. Often spasms of the esophagus are accompanied by spasm of the muscular walls of the stomach.

How to relieve pain. First Aid

Often a person who has pain in the middle of the chest does not know what to do in such a situation. Some people are in so much pain that they faint. At the same time, a strong fright is observed, the pulse rate increases, the skin turns pale. The first thing to do if suddenly a person has severe pain in the sternum, internal organs and spine:

Remove clothing that restricts the chest, prevents breathing, give a nitroglycerin tablet, which will dilate blood vessels and improve the victim’s condition.

Also, if a person has pain in the middle of the chest, it is best to ask everyone present to leave the room and ensure complete rest for the patient until the ambulance arrives.

Diagnostics

The first thing the doctor will do is to interview and examine the patient, which will narrow the search for pathology by concomitant symptoms. After that, various diagnostic procedures can be prescribed to determine the cause of the pain syndrome. 9 may be useful0003 magnetic resonance or computed tomography , x-ray , ultrasound , blood tests, etc. This will determine why there are pains in the middle of the chest that radiate to the back, upper limbs or ribs.

Which doctor to contact

If you are able to visit the clinic on your own, you can make an appointment with the general practitioner . He will determine the approximate cause of the pain syndrome and the direction of further search, as well as give you directions for diagnostic procedures and, if necessary, to specialized specialists. In the event that there is a sharp pain in the chest in the middle, it is difficult and difficult to move, it is impossible to get out of bed without pain, call an ambulance. After the examination at home, the specialist will provide first aid and determine whether you need to be taken to the hospital.

You can make an appointment with specialists online , as well as by phone 8 (812) 901-03-03.

Intercostal neuralgia – symptoms, treatment, causes, signs

This disease is treated by Neurologist

The information provided on this page should not be used for self-treatment or self-diagnosis. If you suspect a disease, you should seek help from a qualified specialist. Only your doctor can diagnose and prescribe treatment.

Article content:

• Causes
• Symptoms
• Forms of the disease
• Diagnostics
• Treatment of intercostal neuralgia
• Prophylaxis
• Complications

What is intercostal neuralgia?

Intercostal neuralgia is an inflammation of the intercostal nerves. This pathological condition is manifested by acute, paroxysmal pain in the intercostal space. Pain extends from the spine to the sternum.

How to identify the disease? The diagnosis is made on the basis of a survey and examination of the patient. To exclude diseases with a similar clinical picture, additional examinations may be prescribed. How to relieve pain and cure the disease? The main directions are symptomatic, anti-inflammatory, etiotropic treatment. During periods of remission, physiotherapy gives a good effect.

Causes

What causes neuralgia? The main reasons for the development of the disease are:

• pathology of the spine;
• curvature of the spine;
• increased or uneven load on the spine;
• uncontrolled intake of certain drugs;
• neoplasms of various etiologies in the region of the sternum, ribs, spine;
• mechanical damage to the chest and spine resulting from trauma or surgery;
• diseases of the nervous system;
• infections;
• sudden increase in intra-abdominal pressure;
• constant high loads on the abdominal muscles.

In addition, pathological changes in the intercostal nerves can occur against the background of diseases of the digestive system, respiration, thyroid gland, kidneys, immunodeficiency states. A similar clinical picture can be observed in adolescents during intensive growth of skeletal muscles.

Symptoms

The main sign of this pathology is pain in the chest. A person experiences severe, paroxysmal pain, which intensifies with a deep breath, coughing. The pain is localized between the ribs and is often accompanied by numbness, burning. Unpleasant sensations can appear in other parts of the body.

The symptoms of intercostal neuralgia are similar to those of a heart attack, but there are a few differences to distinguish between heart problems and nerve inflammation. With neuralgia, the pain is constant, does not change the intensity, while the pressure and pulse indicators are within the normal range.

How else does the disease manifest itself? In addition to pain, symptoms such as anemia or flushing of the skin, muscle contraction, hyperhidrosis can be observed. If the first unpleasant symptoms occur in women or men, you should immediately consult a doctor for an examination and a course of therapy.

Forms of the disease

By origin, there are primary (occurs independently) and secondary (is one of the symptoms of another pathology) neuralgia. In addition, reflex (is the result of a negative effect on peripheral receptors) and radicular (due to constant irritation of the roots of the spinal cord) form of the disease.

In addition, the following types of pathology are distinguished:

• musculoskeletal;
• psychogenic;
• vertebrogenic;
• chronic;
• sharp;
• during pregnancy.

Each of the above types has its own symptoms and treatment features.

Diagnosis

Many patients are interested in which doctor to contact for this pathology? The diagnosis is made by a neurologist. Neuralgia delivers extremely unpleasant sensations to the patient, but does not pose a threat to life.

Therefore, this pathology is often a diagnosis of exclusion. Its clinical signs are similar to those of many severe heart diseases. Therefore, the primary task of the specialist is to exclude these pathologies with the help of a comprehensive examination of the patient.

At the first appointment, the doctor conducts a survey of the patient, collects an anamnesis, assesses his current state of health. During the examination, the specialist determines the exact location of the pain, detects sensory disturbances, notices the characteristic forced posture that the patient takes to reduce pain.

Based on the data obtained, a preliminary diagnosis is made, after which the patient is sent for additional examinations in order to conduct a differential diagnosis.

The main methods of instrumental diagnostics are:

• ECG — diagnose possible pathologies of the heart and blood vessels;
• Ultrasound of the abdominal cavity and myocardium – exclude diseases of the heart and digestive organs with a similar clinical picture;
• MRI, CT are the most informative methods of visualization of internal organs and tissues today, they can be used to obtain clear layered images, determine the localization of the affected nerves, detect signs of destruction of their sheath or neoplasms that compress the nerves and cause attacks of pain;
• gastroscopy – with the help of this examination, pathologies of the stomach are detected, which cause pain similar in symptoms to neuralgia.

Treatment of intercostal neuralgia

How to treat intercostal neuralgia? If the pain is not associated with a herpes infection (in this case, you may need to take anticonvulsants to relieve severe pain), then the treatment does not cause any particular difficulties.

The therapy of the disease is complex and is aimed primarily at stopping the causative factor and removing unpleasant symptoms.

How to relieve pain in case of intercostal neuralgia?

The main stages of therapy in adults are listed below:

• during the acute period, the patient needs rest, he is prescribed bed rest, taking B vitamins, NSAIDs, and drugs to restore the function of the affected nerves;
• after the removal of acute attacks, physiotherapy, massage, manual therapy, acupuncture are indicated to consolidate the results and prevent relapses.

If the disease is caused by the herpes virus, then antihistamine and antiviral drugs are indicated. Treatment should be started as soon as possible, possibly even before test results are available.

The main goals of therapy in the acute period are to relieve pain and swelling of the nerves and muscle tissue. How is inflammation treated and how to get rid of pain? To relieve pain and inflammation, the patient is prescribed analgesics (intramuscularly, orally or rectally), glucocorticosteroids, muscle relaxants, sedatives, NSAIDs, B vitamins. If severe edema appears, diuretics are indicated.

What helps with very severe, excruciating pain? In this case, blockades are carried out with solutions of anesthetics along the affected nerve. During periods of remission, sanatorium treatment (therapeutic baths, mud therapy) is recommended.

If conservative treatment does not help and pain attacks are permanent, then it is necessary to conduct an additional examination of the patient in order to identify the true causes of the disease.

Prevention

To minimize the risk of developing this pathology, the following recommendations should be observed:

• do not get cold, avoid drafts;
• give up a sedentary lifestyle;
• regularly sanitize foci of chronic infection in the body;
• engage in physical education, do exercises – this will help to avoid congestion;
• strengthen the body’s immune defenses;
• avoid stress and nervous tension as much as possible;
• monitor posture;
• eat right;
• during sedentary work, regularly take breaks to warm up;
• take a multivitamin periodically;
• observe safety rules when lifting weights;
• regularly undergo preventive examinations – this will help identify possible health problems at an early stage, which will facilitate subsequent treatment and improve the prognosis.

Complications

What is the danger of the disease and what are the consequences? If untreated, the patient may experience the following complications:

• chronic pain in the chest, back, ribs, which prevent the patient from fully moving and greatly reduce the quality of life;
• respiratory failure, pneumonia;
• feeling of stiffness and weakness in the chest, decreased range of motion of the shoulders.

In severe long-term neuralgia can cause an attack of angina pectoris or provoke a hypertensive crisis. In addition, constant pain adversely affects the mental state of the patient and greatly complicates his life. He cannot sleep normally, move, play sports, perform elementary work.

• Pain in the thoracic spine. Isaikin A.I., Kavelina A.V. Neurology, neuropsychiatry, psychosomatics, 2013. p.74-78
• Symptoms of manifestation of vegetovascular dystonia in adolescence. Elzhurkaeva L.