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Pain in the rib cage area. Understanding Rib Cage Pain: Causes, Symptoms, and When to Seek Medical Help

by alexxlab

What are the common causes of pain in the rib cage area. How can you differentiate between right-sided and left-sided rib pain. When should you seek immediate medical attention for rib cage discomfort. What are the symptoms of gallstones, kidney stones, and liver problems that can cause rib pain.

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Common Causes of Right-Sided Rib Pain

Pain under the rib cage can be a concerning symptom, often indicating underlying health issues. Let’s explore some of the common causes of right-sided rib pain and their associated symptoms.

Gallstones: A Frequent Culprit

Gallstones are a common cause of right-sided rib pain. These small, hardened deposits form in the gallbladder and can cause severe discomfort when they block bile ducts. But what exactly are gallstones, and how do they form?

Gallstones typically consist of cholesterol and develop when there’s an imbalance in the substances that make up bile. While they often remain asymptomatic, they can cause intense pain when they obstruct the gallbladder’s entrance. This pain is usually felt under the right side of the ribcage.

  • High temperature
  • Constant, severe pain
  • Rapid heartbeat
  • Jaundice (yellowing of skin and eyes)
  • Itchy skin
  • Diarrhea
  • Chills or shivers
  • Confusion
  • Loss of appetite

When should you seek immediate medical attention for suspected gallstones? If you experience jaundice, severe abdominal pain lasting more than eight hours, a high temperature with chills, or pain that doesn’t subside with position changes, it’s crucial to seek emergency care.

Kidney Stones and Infections: A Painful Experience

Kidney stones are another common cause of rib pain, affecting both the right and left sides. These mineral deposits form inside the kidneys and can cause excruciating pain as they move through the urinary tract. But what causes kidney stones to form?

Dehydration is a primary factor in kidney stone formation, along with certain medical conditions. People aged 30-60 are most susceptible to developing kidney stones. The pain from kidney stones can radiate from the back to the front of the abdomen, often accompanied by other symptoms:

  • Elevated body temperature
  • Clammy skin
  • Nausea or vomiting
  • Blood in urine
  • Urinary tract infections

While many kidney stones pass naturally, some may require surgical intervention. It’s important to consult a doctor if you suspect kidney stones, especially if you experience severe pain, high fever, shivering, or blood in your urine.

Kidney infections, often resulting from untreated bladder infections, can also cause rib pain. Symptoms of a kidney infection may include:

  • Fever
  • Nausea
  • Increased urinary frequency and urgency
  • Pain during urination
  • Cloudy or foul-smelling urine
  • Blood in urine

If you experience these symptoms, it’s crucial to seek medical attention promptly to prevent complications.

Shingles: A Painful Rash That Can Affect the Rib Area

Shingles, caused by the reactivation of the varicella-zoster virus (the same virus responsible for chickenpox), can lead to pain in the rib area. But how does shingles develop, and what are its characteristic symptoms?

Shingles typically begins with a tingling or painful sensation in a specific area of skin, which may be located under the ribs on either side. This initial discomfort often progresses to a sharp or burning pain, followed by the appearance of a distinctive rash within two to three days.

It’s important to note that only individuals who have previously had chickenpox or been exposed to the virus can develop shingles. The rash can appear on various parts of the body, including the chest, abdomen, and less commonly, the face, eyes, or genitals.

If you suspect you have shingles, it’s essential to consult a healthcare professional for proper diagnosis and treatment. Early intervention can help manage symptoms and reduce the risk of complications.

Liver Problems: A Source of Right-Sided Rib Pain

The liver, located in the upper right quadrant of the abdomen, can cause pain under the right ribcage when affected by various conditions. But what are some common liver diseases, and how can they be prevented?

Liver diseases can result from multiple factors, including excessive alcohol consumption and poor dietary habits. Some prevalent liver conditions include:

  • Fatty liver disease
  • Hepatitis
  • Cirrhosis
  • Liver cancer

Preventing liver disease often involves lifestyle modifications such as maintaining a healthy weight, limiting alcohol intake, and following a balanced diet. Regular check-ups and early detection of liver problems can significantly improve outcomes.

When should you be concerned about liver-related rib pain? Seek immediate medical attention if you experience:

  • Yellowing of the skin (jaundice)
  • Severe, persistent pain
  • Unexplained weight loss
  • Vomiting blood or noticing blood in stool
  • High fever with shaking
  • Shortness of breath
  • Darker urine or lighter-colored stool

Left-Sided Rib Pain: Exploring Gastrointestinal Causes

While right-sided rib pain often relates to gallbladder or liver issues, left-sided pain can indicate problems with the digestive system. What are some common gastrointestinal causes of left-sided rib pain?

Stomach Ulcers: A Burning Sensation

Stomach ulcers, also known as gastric ulcers, are sores that develop on the stomach lining. These painful lesions can cause a burning sensation in the abdomen, often felt under both the left and right sides of the ribcage. But what causes stomach ulcers, and who is most at risk?

Two primary factors contribute to the development of stomach ulcers:

  1. Helicobacter pylori (H. pylori) bacterial infection
  2. Long-term use of non-steroidal anti-inflammatory drugs (NSAIDs)

While anyone can develop stomach ulcers, they are most common in men over 60 years of age. The recovery period for a stomach ulcer typically ranges from one to two months with proper treatment.

If you suspect you have a stomach ulcer, it’s important to consult a healthcare professional for diagnosis and treatment. Seek immediate medical attention if you experience symptoms such as:

  • Vomiting blood
  • Passing sticky, dark stools
  • Severe, persistent abdominal pain

When to Worry: Red Flags for Rib Pain

While occasional, mild discomfort in the rib area may not be cause for immediate concern, certain symptoms should prompt you to seek medical attention without delay. What are the warning signs that indicate a potentially serious condition?

  • Persistent pain on either side of the rib cage
  • Yellowing of the skin or eyes (jaundice)
  • Severe, unrelenting pain
  • Unexplained weight loss
  • Vomiting blood or noticing blood in stool
  • High fever accompanied by shaking or chills
  • Shortness of breath or difficulty breathing
  • Darkening of urine color or lightening of stool color

If you experience any of these symptoms, it’s crucial to seek immediate medical evaluation to rule out potentially life-threatening conditions and receive appropriate treatment.

Differential Diagnosis: Distinguishing Between Various Causes of Rib Pain

Given the diverse range of conditions that can cause rib pain, how can healthcare professionals differentiate between them? What diagnostic tools and techniques are employed to pinpoint the underlying cause?

Accurate diagnosis often involves a combination of approaches:

  1. Detailed medical history: Understanding the patient’s symptoms, their duration, and any accompanying signs.
  2. Physical examination: Assessing the specific location and nature of the pain, as well as checking for other physical symptoms.
  3. Laboratory tests: Blood tests to check for infection, inflammation, or organ dysfunction.
  4. Imaging studies: X-rays, ultrasounds, CT scans, or MRIs to visualize internal structures and identify abnormalities.
  5. Specialized tests: Such as endoscopy for suspected gastrointestinal issues or liver function tests for suspected liver problems.

By employing these diagnostic tools, healthcare providers can more accurately determine the cause of rib pain and develop an appropriate treatment plan. This comprehensive approach ensures that potentially serious conditions are not overlooked and that patients receive the most effective care for their specific situation.

Prevention Strategies: Minimizing the Risk of Rib Pain

While not all causes of rib pain are preventable, there are steps individuals can take to reduce their risk of developing certain conditions associated with rib discomfort. What are some effective prevention strategies for common causes of rib pain?

Gallstone Prevention

  • Maintain a healthy weight
  • Eat a balanced diet rich in fiber and low in saturated fats
  • Stay hydrated
  • Exercise regularly

Kidney Stone Prevention

  • Drink plenty of water throughout the day
  • Limit sodium and animal protein intake
  • Consume adequate amounts of calcium from dietary sources
  • Avoid excessive vitamin C supplementation

Liver Disease Prevention

  • Limit alcohol consumption
  • Maintain a healthy weight
  • Practice safe sex and avoid sharing needles to prevent hepatitis
  • Get vaccinated against hepatitis A and B
  • Avoid exposure to toxins and chemicals

Stomach Ulcer Prevention

  • Avoid long-term use of NSAIDs without medical supervision
  • Quit smoking
  • Limit alcohol consumption
  • Manage stress through relaxation techniques or therapy
  • Practice good hygiene to reduce the risk of H. pylori infection

By adopting these preventive measures, individuals can significantly reduce their risk of developing many of the conditions associated with rib pain. However, it’s important to remember that regular check-ups and early intervention are key to maintaining overall health and catching potential issues before they become severe.

Treatment Options: Managing Rib Pain and Its Underlying Causes

Once the cause of rib pain has been identified, what are the available treatment options? How do these treatments vary depending on the underlying condition?

Gallstone Treatment

Treatment for gallstones depends on the severity and frequency of symptoms:

  • Watchful waiting for asymptomatic gallstones
  • Pain management for mild symptoms
  • Cholecystectomy (surgical removal of the gallbladder) for severe or recurrent cases
  • Medications to dissolve small gallstones (less common)

Kidney Stone Treatment

The approach to treating kidney stones varies based on their size and location:

  • Increased fluid intake and pain management for small stones
  • Extracorporeal shock wave lithotripsy (ESWL) to break up larger stones
  • Ureteroscopy to remove or break up stones in the ureter
  • Percutaneous nephrolithotomy for very large or complex stones

Liver Disease Treatment

Treatment for liver diseases depends on the specific condition and its severity:

  • Lifestyle changes, including alcohol cessation and weight management
  • Antiviral medications for viral hepatitis
  • Immunosuppressants for autoimmune liver diseases
  • Liver transplantation for end-stage liver disease

Stomach Ulcer Treatment

The treatment of stomach ulcers typically involves:

  • Proton pump inhibitors (PPIs) to reduce stomach acid production
  • Antibiotics to eradicate H. pylori infection
  • Discontinuation or modification of NSAID use
  • Protective medications to coat the stomach lining

It’s important to note that treatment plans should be tailored to each individual’s specific condition and circumstances. Always consult with a healthcare professional before starting any treatment regimen for rib pain or its underlying causes.

Living with Chronic Rib Pain: Coping Strategies and Quality of Life

For some individuals, rib pain may become a chronic condition. How can those living with persistent rib discomfort manage their symptoms and maintain a good quality of life?

Pain Management Techniques

  • Over-the-counter pain relievers (under medical supervision)
  • Heat or cold therapy
  • Gentle stretching and exercises as recommended by a physical therapist
  • Relaxation techniques such as deep breathing or meditation
  • Acupuncture or massage therapy (with approval from a healthcare provider)

Lifestyle Modifications

Adjusting daily habits can help manage chronic rib pain:

  • Maintaining good posture
  • Using ergonomic furniture and equipment
  • Avoiding activities that exacerbate pain
  • Getting adequate sleep and rest
  • Managing stress through counseling or support groups

Dietary Considerations

For some conditions causing rib pain, dietary changes can be beneficial:

  • Following a low-fat diet for gallbladder issues
  • Reducing sodium intake for kidney stone prevention
  • Avoiding trigger foods for those with stomach ulcers
  • Maintaining a balanced, nutrient-rich diet to support overall health

Living with chronic rib pain can be challenging, but with proper management and support, many individuals can maintain a good quality of life. Regular communication with healthcare providers is essential to adjust treatment plans as needed and address any new or worsening symptoms promptly.

What are the causes of rib pain?

Right-sided pain under ribs

Gallstones

Gallstones are small stones that can form in the gallbladder (a small organ under the liver). They are usually made up of cholesterol and don’t tend to cause symptoms. Sometimes they get stuck in the entrance of the gallbladder, which can cause severe pain under your ribs on the right side.

Gallstones can cause complications. If this happens, you may also experience:

  • a high temperature
  • constant pain
  • a fast heartbeat
  • jaundice
  • itchy skin
  • diarrhoea
  • chills or shivers
  • confusion
  • a loss of appetite

If you think you might have gallstones, visit your doctor. You should seek immediate medical help if:

  • you develop jaundice
  • you have abdominal pain for more than eight hours
  • you have a high temperature and/or chills
  • your pain is severe and cannot be relieved by changing position

More information

Find out more about gallstones

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Kidney stones and infections

Kidney stones are the result of a build up of minerals on the inner lining of the kidney. They are most common in people aged 30-60. While they can be caused by different medical conditions they are also often caused by dehydration.

They can cause severe pain under the right-hand side and left-hand side of your rib cage or your back and sometimes this pain can spread to the front of your tummy area. Other symptoms you may experience include:

  • a high temperature
  • feeling clammy
  • nausea or vomiting
  • blood in your urine
  • urine infections

Kidney stones can often pass on their own without medical intervention, but sometimes they may need to be removed surgically.

You should visit your doctor if you think you have kidney stones, and seek emergency help if:

  • the pain is severe
  • you have a high temperature
  • you experience shivering or shaking
  • there is blood in your urine

More information

Find out more about kidney stones

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Kidney infections are usually the result of a bladder infection that travels up to your kidneys.

If you have a kidney infection you may experience pain under your ribs in your back as well as:

  • a fever
  • nausea
  • needing to pee more than usual
  • needing to pee suddenly
  • pain when peeing
  • smelly or cloudy urine
  • blood in your pee

You should visit your doctor if you have symptoms of a kidney infection.

More information

Find out more about kidney infections

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Shingles

Shingles is caused by the same virus that causes chickenpox, so if you’ve previously had chickenpox you can develop shingles. But if you’ve never been exposed to the chickenpox it’s not possible to develop shingles.

The area underneath your right or left ribs is a common place to experience symptoms, however you can develop shingles on other parts of the body including your chest, tummy and less commonly face, eyes or genitals.

Shingles often begins with a tingling or painful area of skin which can then become sharp or burning in nature. It then typically causes a rash that tends to develop two to three days after the pain begins.

You should visit your doctor if you think you have shingles. They will be able to diagnose you and provide the appropriate treatment.

More information

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Liver problems

If you have a problem with your liver it can cause pain under the right side of your ribcage. Your liver plays an important role in digestion and fighting infections, so if it is not functioning properly it can have serious implications.

Common liver diseases include:

Liver problems can be caused by a number of different factors, including alcohol consumption and diet. But there are ways to prevent some liver diseases, such as losing weight if you are overweight and cutting down on your alcohol intake.

If you think you are suffering from liver disease you should see your doctor.

When to worry

If you have persistent pain on the right side of your rib cage you should visit a doctor. You should seek immediate medical attention if you:

  • have yellow skin
  • have severe pain
  • have lost weight without trying to
  • are vomiting blood or there is blood in your poo
  • have a high temperature and you are shaking
  • feel breathless

Or if your urine is darker than usual and your poo is lighter.

Left-sided pain under rib

Gut problems

Stomach ulcers

Stomach ulcers are sores that occur on the lining of your stomach and they cause a burning pain in your abdomen, which can be felt under the left side and right side of your ribs.

Anyone can get a stomach ulcer, but they are most common in men over the age of 60. They are usually either caused by the Helicobacter pylori (H.pylori) bacteria or by taking non-steroidal anti-inflammatory (NSAIDs) for an extended period of time.

It takes around one to two months to recover from a stomach ulcer.

If you think you have a stomach ulcer, visit your doctor.

Seek immediate medical attention if you start vomiting blood, your poo is sticky and dark, or you have sudden and severe abdominal pain which gets increasingly worse.

More information

Find out more about stomach ulcers

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Indigestion

Indigestion can feel extremely painful, and since the pain occurs in your chest and ribcage it can be worrying. But indigestion is not usually serious, and can be treated at home.

If you have indigestion you may experience:

  • heartburn
  • bloating
  • nausea
  • excessive wind
  • acid reflux

You can usually treat indigestion by:

  • reducing your intake of tea, coffee, cola, and alcohol
  • sleeping with your head and shoulders propped up
  • maintaining a healthy weight (check your BMI here)

You should visit your doctor if you experience:

  • persistent indigestion
  • severe pain
  • losing weight without trying
  • trouble swallowing
  • vomiting frequently
  • iron deficiency anaemia
  • the sensation of a lump in your stomach
  • blood in your vomit or stools

Or if you are over 55.

More information

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Gastroenteritis

This is a gut infection, which can cause diarrhoea and vomiting. It can cause pain on the right and left side of your rib cage.

If you have mild gastroenteritis then you don’t need to visit a doctor, but seek medical advice if you experience:

  • dehydration
  • excessive vomiting
  • severe pain
  • persistent high temperatures
  • vomiting for more than 1-2 days
  • diarrhoea for more than 3-4 days
  • an infection that was obtained abroad
  • if you have a weakened immune system
  • if you are pregnant
  • if you are elderly or have an underlying health condition

More information

Find out more about gastroenteritis

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Other gut problems that can sometimes cause pain under your ribs include:

  • diverticulitis
  • Crohn’s disease and ulcerative colitis
  • constipation
  • irritable bowel syndrome

Aorta problems

The aorta is the main blood vessel which goes from the heart down to the tummy. It can cause pain on the left side of your rib cage if it becomes swollen. This is known as an abdominal aortic aneurysm or AAA (pronounced triple-A).

Aortic aneurysms can be dangerous, and if they burst they can be life-threatening.

You’re more at risk of developing an AAA if you:

As well as rib pain, aortic aneurysms can cause:

  • a pulsing feeling in your tummy
  • persistent abdominal pain
  • lower back pain

You should get immediate medical help if you experience the symptoms of a burst AAA. These include:

  • severe pain in your tummy or lower back, which comes on suddenly
  • feeling dizzy
  • sweaty and pale skin
  • your heart beating faster than usual
  • feeling short of breath
  • passing out

Pancreatic problems

Your pancreas helps your gut digest food and regulate blood sugar. Sometimes your pancreas can become inflamed, causing pain in your upper left abdomen which can be felt under your ribs.

You may also experience:

Pancreatic problems can be caused by acute pancreatitis, chronic pancreatitis, or pancreatic cancer.

You should see a doctor if you experience sudden and severe abdominal pain. You should also see a doctor if:

  • your skin becomes yellow (jaundice)
  • you are persistently vomiting
  • you experience unexpected weight loss
  • you have back or stomach pain that is worse when you lie down or after eating
  • you have indigestion
  • you have a fever or are shivering
  • you experience changes in your bowel movements

Problems with your spleen

Your spleen is located under your lower left ribs. If it becomes enlarged, is damaged or it ruptures then you will experience pain under your left lower ribs.

Sometimes your spleen can become enlarged if you have an infection, such as glandular fever.

You should see your doctor if you have symptoms of glandular fever, such as:

  • a high temperature
  • an extremely sore throat
  • swollen glands
  • extreme fatigue
  • tonsillitis that isn’t improving

Your spleen can also be damaged during a sickle cell disease crisis, or if you experience trauma.

When to worry

If you have persistent pain on the left side of your rib cage you should visit a doctor. Seek emergency medical help if you experience:

  • difficulty breathing
  • mental confusion
  • sweating more than usual
  • lightheadedness or dizziness

Other causes of rib pain

Angina

Angina is a type of heart pain that is caused by narrowing of the arteries, which provide the heart muscle with blood.

At first it may only be noticeable when you exercise because the additional blood needed can’t pass through the narrow arteries. This can cause chest pain.

Heart attack

Severe chest pain is the most common and well-known symptom of a heart attack. It is caused by the coronary artery suddenly becoming blocked and so cutting off the heart’s blood supply.

Gastro-oesophageal reflux disease

Gastro-oesophageal reflux disease is an umbrella term for a number of different conditions, such as acid reflux heartburn, and oesophagus inflammation (oesophagitis).

This disease can cause chest pain.

Costochondritis

Costochondritis causes sharp and severe pain, which gets worse when you move, breathe deeply, or exercise.

It is caused by inflammation of the soft cartilage between the bony rib cage structure.

Strained chest wall muscle

Your rib cage is surrounded by lots of different muscles to enable it to move when you breath. Sometimes heavy lifting, stretching, or a sudden movement can strain one of these muscles which causes pain in the affected area.

Usually this time of rib cage pain is worse when you move or breath.

Anxiety

Anxiety is an extremely common cause of chest pain, sometimes so severe it is mistaken for heart disease.

Less common causes of rib pain

For more information on some of the less common causes of rib pain, click the links below:

Rib Pain: Causes, Diagnoses, & Treatments

The ribs protect some of your body’s most important organs inside your chest—including your heart and lungs. As a cardiologist, I focus on this area of the body and I understand how complex it can be to distinguish between all the vital systems that converge around the ribs when pain appears.

In this article we’ll explore:

What Causes Rib Pain?

There are 12 ribs on each side of your chest, and they run from your spine in the back to your sternum, or breast bone, in the front. They are connected to your breast bone by cartilage, which is a strong but flexible tissue that allows the rib cage to expand during breathing. Muscles called intercostal muscles run between adjacent ribs and help move the chest wall, especially during breathing. Pain in your rib cage can come from any of these components. If you’re experiencing pain between or around your ribs, paying close attention to your symptoms can help you identify the cause.

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Symptoms to Watch For

Since there are a variety of causes that can lead to pain in your ribs, it can be helpful to chat with a doctor about any other symptoms you’re experiencing. These symptoms can be clues to what’s causing your pain.

The following are just some of the symptoms that often appear with pain in the ribs:

When you use the K Health app, we’ll ask you about many symptoms related to your pain in order to get a full picture of what’s going on with your health. Here are the most common symptoms our users reported experiencing with their rib cage pain:

  • Flank pain
  • Shoulder pain
  • Shortness of breath
  • Shoulder blade pain

Rib Pain from Coughing

If your ribs hurt when you cough or sneeze, it could be because coughing causes repeated movement of your intercostal muscles, as well as other muscles like the muscles in your abdomen. When you’ve got rib pain from coughing too much, this repeated movement, particularly if it’s frequent and forceful, could result in a pulled muscle causing pain or sore ribs. A cold can also cause pleuritis, which is inflammation of the lining of your lungs and the inner aspect of your chest wall (called pleura).

I hear from many users who complain of cough, but a little less than 1% also experience pain in their ribs with coughing. According to data from over 8,000 health dialogues within the K Health app, women aged 26-55 are 18% more likely to report this type of pain with coughing compared to men of the same age. So while it’s relatively rare, it is more common among women.

Possible Conditions Causing Rib Cage Pain

Our app works by showing you how doctors have diagnosed symptoms like rib cage pain in people like you in the past. But since we’ve had over 8,000 chats with users who reported pain in their ribs, we took a look at the conditions most commonly associated with this symptom.

Here’s what you need to know about these conditions:

  • Injuries: Musculoskeletal chest pain can be caused by trauma or injury to the ribs, intercostal muscles, or skin and other tissues overlying the ribs. This is very common. Costochondritis, or inflammation of the cartilage that connects your ribs to your breast bone, is another musculoskeletal cause of rib pain.
  • Infections: Infections including upper respiratory infection, bronchitis, or pneumonia can also cause pain in your ribs. In this case, the pain may be caused by the infection itself, a pulled rib muscle from coughing, or by pleuritis, or inflammation of your pleura, the inside chest wall. Other causes of pleuritis include autoimmune disorders, certain medications, or injury to your ribs or adjacent structures.

Other Less Common Conditions

  • Pulmonary embolism: A pulmonary embolism is a dangerous condition and a medical emergency, in which a blood clot gets lodged in the arteries that supply the lungs.
  • Fibromyalgia: Fibromyalgia is a condition associated with musculoskeletal pain in different parts of your body, as well as fatigue and mood complaints.
  • Shingles: Shingles is caused by a viral infection (the same one that causes chicken pox) that results in a painful rash, as well as other symptoms.

Other causes may include a sprain in the muscles of your neck (cervical sprain) or inflammation in your stomach (peptic ulcer disease), parts of your body which are located nearby. Rib or chest pain is also commonly associated with mood disorders, like anxiety. Lung cancer may also cause rib cage pain, although it is a less common cause.

How to Address Your Rib Pain and Possible Treatments

Your rib cage is a collection of bones and tissues, and any of these components can cause rib pain, so it’s important to explore the cause. Anti-inflammatory drugs like ibuprofen can help with pain. If your pain is caused by cough, you can try a cough suppressant. While I always recommend a personal assessment, here are the most common ways people address their pain:

  • Speak to a primary care doctor: Most people with rib cage pain are evaluated by a primary care doctor, who will ask them questions, examine them, and order any appropriate tests, like an x-ray of the ribs.
  • Take over-the-counter painkillers: Try taking anti-inflammatory medications, like ibuprofen (Advil or Motrin) or acetaminophen (Tylenol).
  • Try a cough suppressant: If your pain is associated with a cough, you could try a cough suppressant, such as dextromethorphan (Robitussin) to give your ribs a rest from the coughing motion.
  • Watch for serious symptoms: Rib or chest pain may be a sign of a serious health issue, so it’s important to seek care if you have severe pain, especially if associated with other symptoms like difficulty breathing, fainting, irregular heartbeat, or profuse sweating.

Prevention Tips

Here are some things you can do to avoid or minimize pain in your ribs:

  • Protect your rib cage while it’s injured or hurting. The ribs protect some of your most vital organs, and you want to avoid any movements that could make your pain worse.
  • If you have a cold with a bad cough, try taking a cough suppressant like dextromethorphan and an anti-inflammatory agent like ibuprofen.

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How K Health Can Help

Most people with rib cage pain see a doctor, but you could start by doing a free assessment with K Health to learn how people like you with similar rib pain symptoms were diagnosed and treated. Did you know you can get affordable primary care with the K Health app? Download K to check your symptoms, explore conditions and treatments, and if needed text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Sudden sharp pain under the left rib? Reasons other than heart attack

Have you ever taken a deep breath and felt a sudden sharp pain under the left rib? You might have thought at that point of time that it is a heart attack and an end of you. Pain under the left rib can cause a lot of anxiety, especially when you’re a heart patient. As stinging the pain may be, the thought of experiencing an attack can be all the more tormenting. However, instead of rushing to conclusions, you must consider other ailments that can cause pain under your left rib. In case you feel a stabbing pain below your left rib, you need not panic as it can happen due to other reasons too. We have listed some below for you:

Costochondritis

Costochondritis refers to the inflammation of the cartilage which connects your ribs to your breastbone. You might feel a sharp pain under the left rib if you take a deep breath which can worsen while coughing or sneezing.

Costochondritis can happen due to an injury, infection and in rare cases, arthritis.

Pleurisy

Pleurisy is a condition which leads to an inflammation of the membrane around your lungs. The inflammation can be caused by a bacterial or fungal infection in the membrane. In rarest of the rare cases, pulmonary infections which lead to blood clots or pus in the lungs can also be a symptom of pleurisy. The symptoms of pleurisy could be chest pain, fever and shortness of breath.

Kidney stones

In many cases, a sharp stabbing pain can also be caused by kidney stones. Kidney stones are not easy to detect and can happen at any point of time. They usually happen when waste builds up in your kidney and does not get enough water to flow out.

In order to prevent kidney stones, you must drink enough water and not control the urge to urinate.

Gastritis

Gastritis refers to the swelling in the inner lining of your stomach. It can also cause a sharp pain under the left rib along with other symptoms such as burning pain in your stomach, nausea or a sensation of fullness of your upper abdomen.

Bacterial infections and consumption of anti-inflammatory drugs are the main reasons which lead to Gastritis.

Enlarged spleen

An enlarged spleen can also be the reason behind you experience stabbing pain under your left rib. The spleen might enlarge because of bacterial infection, parasitic infection or a liver disease.

There are high chances that an enlarged spleen gets ruptured and cause further complications. A ruptured spleen can cause internal bleeding and must be reported to the doctor as soon as possible.

Pancreatitis

Another reason of pain under the left rib is Pancreatitis. It causes an inflammation of the pancreas which further instigates pain. Pancreatitis comes with additional symptoms such as diarrhea, nausea, and vomiting.

There are two types of pancreatitis: acute and chronic. Symptoms of acute pancreatitis include fever, stomach tenderness and abdominal pain that spreads to your back. Chronic pancreatitis can bring along unintentional weight loss and pain in upper abdomen.

In case you experience pain on the left side of your rib along with cold sweat, shortness of breath, tightness in your jaw and shoulder blades, then there are high chances that you are suffering from a heart attack. In such a situation, you must not ignore it and rush to a hospital to seek medical help.

What Causes Pain Around the Ribs and Back Symptoms? How Can This be Treated?

The thoracic spine and ribs are like a “no man’s” land for many physicians, including spine experts. While many physicians are comfortable treating and diagnosing neck and low back problems when it comes to things like pain around the ribs and back symptoms, they draw a blank. So today we’ll focus on this problem through the story of a patient we recently treated. Let’s dig in.

Pain Around the Ribs and Back Symptoms?

First, let’s define what we mean by pain around the ribs and back symptoms. Basically, the pain wraps around the back of the rib, generally at least to the side and at times all the way to the front. There is also upper back pain that often accompanies this pain. The pain also is usually made worse with movement or just feels like something is “out of place” and needs to be popped back in place. Sometimes specific motions or activities will make this better or worse.

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Understanding the Thoracic Spine

The thoracic spine is between the neck (cervical) and the low back (lumbar). Its bones (vertebrae) are numbered 1-12 and the abbreviation ‘T” is used for “Thoracic”. Hence, “T6” means the sixth thoracic vertebra.

What’s unique is that the ribs attach here to the thoracic vertebrae. These both constrain and define which movements are possible. Also note that because the two are connected, what happens in the thoracic spine often happens in the ribs and vice versa. In addition, the thoracic vertebrae act as a pivot point for the ribs as you breathe in and out. This is often why patients experience pain by taking a deep breath.

There’s an immense amount going on in the thoracic spine. First, there are facets joints where the two vertebrae meet. There is a spinal nerve that exists in this area at each level. As shown to the left, that nerve begins as the thoracic spinal nerve and then continues all the way around to the front of the chest as the intercostal nerve. There’s a disc that acts as a shock absorber as well as a multitude of muscles and ligaments. Then there are two areas where each rib attaches to each vertebra (costotransverse and costovertebral joints). Realize that there can be problems with any one of these structures that can cause pain around the ribs and back symptoms.

The Top 5 Causes of Pain Around the Ribs and Back Symptoms

Our clinic has had a special interest in the thoracic spine for many years. As an example, most spinal interventionalists have only ever performed a handful of thoracic epidural or facet injections. I’ve done hundreds of each. In all of those years helping patients with pain around the ribs and back symptoms recover, these are the top five things that we see day in and out in our clinic:

  1. Thoracic Disc Bulge-The thoracic spine, just like your neck and lower back, has discs that act as shock absorbers for the spine bones. These can bulge when they get damaged and can irritate spinal nerves. This can lead to pain around the ribs and back symptoms. In particular, this could be just pain or an electrical feeling. There also may be some numbness in the back and ribs.
  2. Rib Facet Pain-The ribs attach to the vertebrae at two points each with ligaments. Doctors sometimes call these “rib facets”. Technically they’re called the costovertebral and costotransverse joints. These joints can get damaged and cause referred pain around the ribs with back symptoms. This pain is often more localized to one spot and may get worse with a deep breath. This area may also feel “out of place”.
  3. Thoracic Facet Joint Pain-The vertebral facets are the joints where each vertebra meets up with the next above or below. These can become injured or get arthritis like any joint and can cause referred pain that is usually in one spot but can extend out from the spine as well. This pain isn’t usually influenced by taking a deep breath but can be made worse or better with movement.
  4. Rib Fascial Injury-The ribs have a tough outer covering called the fascia. This is there to help control motion and when it gets injured, too much individual rib motion can happen which can cause upper back pain that wraps around the ribs. This pain is usually influenced by taking a deep breath. You may also be able to identify a painful rib by palpating the area.
  5. Muscle Trigger Points or Areas of Tendinopathy-You have muscles in your upper back that can develop areas called “trigger points” which can cause upper back pain and pain that refers around the rib. The muscles also have tendons which can get ripped up and worn out with time, leading to tendinopathy.

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How Can This Problem Be Helped? Juan’s Story…

Juan’s pain around the ribs and back symptoms with spasms began in 2007 and he presented to our clinic in 2020. Any movement, rotation, or flexion/extension made the pain worse while rest and medication made the pain better. Previously, he had tried ozone injections, steroid injections, and facet injections which provided temporary relief. Radiofrequency ablation at the T8-11 facet joints provided relief for only about 6-8 months. He had also developed tingling in his right 4th and 5th fingers and pain in his right elbow and weakness in his right hand. This was likely coming from irritation of the brachial plexus by his ribs.

We approached Juan’s problems differently, looking at what was causing all of these issues. In particular, one of the ligaments in the back of his spinal canal (ligamentum flavum) was loose and buckling which was irritating nerves. Hence, we concentrated his own blood platelets (platelet-rich plasma) to inject into that specific ligament to cause some healing and tightening. In addition, those thoracic nerves were irritated, so we used a platelet lysate to inject around the nerves (epidural using x-ray guidance). Finally, his facet joints had previously been treated with radiofrequency, which burns the nerve that takes pain from the joint. Hence, nobody had ever tried helping the joint with substances that can promote healing. So I carefully injected high dose platelet-rich plasma into those joints again using a sophisticated image guidance technology. How did he do? He’s reporting 90% relief with pain only with certain activities.

The upshot? As you can see, there’s quite a bit that can cause pain around the ribs and back symptoms. The first order of business is getting an accurate diagnosis of why you hurt, which is what we did with Juan. So rather than injecting Juan with steroids which can harm tissues or burning the nerves, we focused on what was causing his problems and tried to improve the function of the spine.

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NOTE: This blog post provides general information to help the reader better understand regenerative medicine, musculoskeletal health, and related subjects. All content provided in this blog, website, or any linked materials, including text, graphics, images, patient profiles, outcomes, and information, are not intended and should not be considered or used as a substitute for medical advice, diagnosis, or treatment. Please always consult with a professional and certified healthcare provider to discuss if a treatment is right for you.

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Back Pain and Slipped Rib

Slipping rib syndrome is a rare disorder that is known by many other names, including floating rib syndrome, lost rib syndrome, costal chondritis or costochondritis, and Tietze syndrome (for the German surgeon who discovered it). Costal chondritis, costochondritis and Tietze syndrome are sometimes used interchangeably and characterized by inflammation of the part of the rib that is cartilage.  

Though its various names appear to have nothing to do with the spine, slipping rib syndrome can cause severe back pain in your thoracic spine—or your middle back when one of your ribs shifts out of normal position. In some patients, chest wall pain is the foremost symptom. This article provides you with the basics about back pain potentially caused by slipped rib syndrome, including symptoms and when you should call your doctor.
Key anatomical structures of the human body’s rib cage related to slipped rib are illustrated. Photo Source: 123RF.com.

Slipping Rib Syndrome’s Connection to the Thoracic Spine and Pain

To better understand slipping rib syndrome and how it may develop, a quick review of the related anatomy is needed. First, you have 12 sets of ribs; one set on each side of your body. Starting at the top, the first set of ribs attach to the first thoracic vertebra (T1), and the remaining ribs make attachments down to T11. Costovertebral ligaments attach the ribs to the thoracic vertebrae.

The first 7 rib sets are connected to the thoracic vertebrae in your back and the sternum (breastbone). In the front of the rib cage and between the ribs are costochondral joints and costal cartilage. These ribs are referred to as true ribs. The cartilage is elastic and allows for expansion of the rib cage such as when taking a deep breath.

The remaining 5 ribs are false ribs. This refers to the fact that ribs 8-10 are not connected to the sternum but by a fibrocartilaginous band from the rib above. The last 2 ribs have no connection at the front of the body and are sometimes called floating ribs. That’s why these lower ribs are most often involved in slipping rib syndrome.

Another anatomical feature involves the thoracic spine’s facet joints, of which there are 24 (12 on either side at the back of each thoracic vertebrae). When a rib slips at T10 or T11, there is an opportunity for facet joint involvement that can cause considerable pain.

Slipping Rib Syndrome Causes and Risk Factors

In some people, there is an inherited risk for slipping rib syndrome. However, it’s more often caused by an injury. Traumatic injury to your rib cage, such as from physical violence—a fall, or auto accident—may result in the condition. As such, engaging in contact sports is a risk factor.

Slipping rib syndrome may also be caused by chest problems and illnesses, including asthma, bronchitis, or a severe, long-lasting cough. While slipping rib syndrome is associated with several causes, there may be no obvious cause for why it occurred.

Symptoms of Slipping Rib Syndrome

One slipping rib syndrome symptom is back pain.1 Symptoms occur when the abnormal rib movement irritates surrounding nerves and muscles, triggering inflammation and pain.

In addition to back pain, people with slipping rib syndrome also report:

  • Abdominal pain that is intense initially, but eventually subsides to an ache
  • A “popping” or “clicking” sensation in the rib cage area
  • Difficulty breathing or coughing
  • Pain with certain activities that move the rib cage, such as bending

When to See Your Doctor

Some slipping rib syndrome symptoms are not only painful, but they can be life threatening. Seek immediate medical care if you have difficulty breathing or experience chest pain, as this may indicate a serious medical emergency.

If your pain shows no signs of subsiding and/or if symptoms are interfering with your ability to perform daily tasks, see your doctor as soon as you can. Getting a proper diagnosis will put you on the right treatment path to help relieve your pain.

How Slipping Rib Syndrome Is Diagnosed

Slipping rib syndrome’s symptoms mimic those of other conditions, so it can be a challenge to diagnose properly. Your spine specialist or personal doctor will begin the diagnostic process by asking you about your symptoms—how long you’ve had them, and what worsens or eases them. Your evaluation also involves a careful review of your medical history.

Your doctor will conduct a physical exam, which can reveal if a rib is not properly positioned with your other ribs. If your doctor finds a rib out of alignment, he or she may perform the “hooking” or “hook” maneuver. With this maneuver, the doctor gently moves the misaligned rib to determine if it causes pain, and if it makes a clicking sound.

While your doctor may order imaging tests (such as an x-ray) to rule out other conditions, the hooking maneuver may be enough to confirm a slipping rib syndrome diagnosis.

NonSurgical Treatments for Slipping Rib Syndrome

If your slipping rib syndrome is considered mild or moderate, conservative treatment is usually enough to relieve pain. Your doctor may recommend one or a combination of the nonsurgical treatments below:

  • Rest
  • Cold and heat therapy
  • Medication to relieve pain and inflammation, such as a non-steroidal anti-inflammatory drug (NSAIDs)
  • Physical therapy

In addition to the therapies above, your doctor may prescribe the following to manage pain:

  • Epidural corticosteroid injection or intercostal nerve block to ease inflammation and pain
  • Botulinum toxin therapy (also known as Botox) for muscle pain
  • Massage
  • Prolotherapy to strengthen weakened ligaments
  • Ultrasound therapy to reduce muscle inflammation

Surgery for Slipping Rib Syndrome

If your chest wall and mid-back pain is severe and has not responded to non-surgical treatment, surgery for slipping rib syndrome may be an option for you. The surgical procedure for slipping rib syndrome is called costal cartilage resection or excision. This involves removing the slipped rib and the connecting costal cartilage.

Life with Slipping Rib Syndrome

Like so many medical conditions, getting an accurate diagnosis as early as possible is a key to long-term treatment success. Don’t wait to see your spine specialist or personal doctor if you’re experiencing severe middle back or chest pain. Different treatments and therapies can help relieve the pain of slipping rib syndrome, allowing you to engage in your life and the activities that enrich it.

Sudden Sharp Pain Under The Left Rib Cage – Causes, Symptoms, And Treatments

Do you experience sharp pain under your ribs? Does it make you feel like you are having a heart attack? Does this pain tend to worsen when you try and take deep breaths?

While such pain is usually common and not of much concern in most circumstances, sometimes, it could be an indication of a serious underlying health condition. Let’s understand the different conditions that exhibit symptoms of pain under your left breast or rib. Read on.

Causes And Symptoms Of Pain Under The Left Rib Cage

Sharp pain under the left rib cage could be due to a variety of reasons. Several organs are located in this region of your body – like your heart, spleen, lung, colon, kidney, pancreas, and stomach. Hence, the causes of the pain can be many.

While most of these causes can be treated right at home, some of them could be life-threatening and may need immediate medical diagnosis, followed by appropriate treatment.

The life-threatening causes of the pain under your left rib cage include:

The symptoms of a heart attack (other than pain under your left rib cage) are:

    • A sudden feeling of dizziness
    • Fatigue
    • Nausea
    • Heartburn
    • Indigestion
    • Cold sweat
    • Shortness of breath
    • Tightness, aching, or pressure in your chest that spreads to your jaw, back, or neck (1)

This is also a heart-related condition that can cause pain in that area. It occurs when the blood traveling to your heart lacks oxygen. Its symptoms are similar to that of a heart attack – like dizziness, shortness of breath, fatigue, sweating, etc. (2).

This condition is caused due to the swelling of the membrane (pericardium) surrounding your heart. There are four types of pericarditis:

  • Acute Pericarditis: Its symptoms last for less than 3 weeks.
  • Incessant Pericarditis: Its symptoms are continuous and may last for 4-6 weeks.
  • Recurrent Pericarditis: Its symptoms keep recurring every 4-6 weeks.
  • Chronic Pericarditis: The symptoms usually last longer than 3 months.

The symptoms of pericarditis are:

  • Sharp pain in the middle or left of your chest
  • Fatigue
  • Cough
  • Unusual swelling of your abdomen/leg
  • Heart palpitations
  • Shortness of breath
  • A slight fever (3)

Your digestive tract may also be causing the pain under the left rib cage. The digestive causes of the pain under your left rib cage are:

• Gastrointestinal Disorders

Gastrointestinal disorders include conditions, such as irritable bowel syndrome, hemorrhoids, constipation, perianal abscesses, etc. The digestive causes of the pain under the left rib cage are:

As we have already mentioned, there are other organs located in the upper left abdominal region of your body, and issues with them can also trigger a sharp pain under your left rib cage.

Such issues include:

  • Kidney stones – They are hard calcium deposits that form in the kidneys and later move towards the bladder, causing extreme pain while passing.
  • Pancreatitis – Inflammation of the pancreas.
  • An enlarged spleen – The spleen is located in the upper portion of the left rib cage and is normally about the size of your fist. An enlarged spleen is caused due to liver infections, cirrhosis, etc.

Certain infections may also be responsible for the sudden ache in the left part of your chest like:

  • Pneumonia, which causes sharp chest pain while coughing.
  • Pleurisy – an infection that causes the membrane surrounding your lungs to become inflamed.
  • A collapsed lung
  • Broken ribs
  • Endocarditis, which causes an infection in the inner lining of your heart.
  • Appendicitis – A condition that causes inflammation of your appendix.
  • Costochondritis – A condition that causes inflammation of the cartilage that connects a rib to the breastbone.

If you have developed any of the above health conditions, you are at a higher risk of developing pain under your left rib cage. Hence, it can be said that all these conditions act as risk factors for this pain.

It is best to consult a doctor immediately if you experience any of the other symptoms of the life-threatening conditions listed above. Your doctor or cardiologist is most likely to carry out the following diagnostic analysis to rule out other conditions associated with the pain under your left rib cage.

Diagnosis

Your doctor will begin with a physical examination and may ask whether you have a family history of a heart condition. If they suspect you have heart disease, you may be asked to take an electrocardiogram test to rule out the possible causes (4).

Other tests include blood, urine, and/or stool test to look for other potential causes like kidney stones or pancreatitis.

If the cause of the pain is not yet determined, you may be asked to undergo an X-ray, CT scan, or MRI scan so that your doctor can take a better look at your organs and areas of inflammation (if any).

Once the cause of the pain is determined, your physician will prescribe treatments accordingly.

Treatments

Treatments are usually prescribed based on the cause of the pain.

If any inflammation is causing the pain, you may be asked to take NSAIDs to relieve the pain and swelling (5).

Bacterial infections may need you to take antibiotics, while conditions like kidney stones that are hard to pass may require surgery.
Immediate lifestyle changes or open bypass surgery may be needed for those whose upper left abdominal pain is associated with heart conditions like a heart attack (6).

Most often, the pain could be due to gas or other esophageal issues, and it will ease away on its own (7). However, given the other serious indications of pain in the lower left rib, it is wise to pay close attention to your body when it is in pain and get help immediately if you fear an emergency like an attack.

Expert’s Answers For Readers’ Questions

When to see a doctor for pain in the lower-left side of your chest?

The cause of the upper left abdominal pain could vary from something as minor as heartburn to something as severe as a heart attack. If you feel that you are experiencing symptoms of any of the life-threatening conditions listed above, along with lower left chest pain, see a doctor immediately.

What organ is under my right rib cage?

The liver is located at the lower right end of the rib cage. The right kidney and gallbladder are also located under the right rib cage.

What organ is below the left rib cage?

The organs located under the left rib cage or around its surrounding area are the heart, spleen, left lung, colon, left kidney, pancreas, and stomach.