Chest pain, even when isolated to the right side, is a common symptom arising from various causes. While many people associate chest discomfort with the heart, right-sided pain is more frequently linked to non-cardiac structures, including the lungs, the digestive system, or the chest wall itself. Determining the exact location and characteristics of the pain can help narrow down the possibilities. Because the chest cavity houses several vital organs, any unexplained or persistent chest pain should be evaluated by a healthcare professional to rule out serious conditions.
Musculoskeletal and Structural Causes
The chest wall, composed of bone, cartilage, and muscle, is a frequent source of right-sided chest pain. One common cause is costochondritis, which involves inflammation of the cartilage connecting the ribs to the sternum. This inflammation typically causes a sharp, aching, or pressure-like pain that worsens when pressing the affected area or taking a deep breath. When costochondritis affects the right ribs, the pain is highly localized and often benign.
Another structural cause is an intercostal muscle strain, affecting the muscles between the ribs that facilitate breathing and movement. These strains often result from excessive coughing, strenuous exercise, or sudden, awkward movements. The resulting discomfort is usually localized, tender to the touch, and sharpens with specific movements like twisting, bending, or deep inhalation.
Traumatic events, such as a fall or a direct blow, can lead to a bruised or fractured rib on the right side. A rib fracture is painful because the ribs move constantly with respiration, and the pain may persist for several weeks. Even minor trauma can cause inflammation of the surrounding tissue, contributing to pain exacerbated by movement and deep inhalation.
Gastrointestinal and Organ-Related Pain
Pain originating in the abdominal cavity can often be perceived in the right chest area due to referred pain. This occurs because the nerves supplying internal organs share pathways with nerves supplying the skin and muscle. The gallbladder, situated in the upper right quadrant of the abdomen, is a frequent source of this discomfort.
Conditions like cholecystitis (gallbladder inflammation) and gallstones often cause pain that radiates upward to the right shoulder blade or the lower right chest. This pain, often described as sharp or severe, frequently begins after eating a fatty meal, which stimulates the gallbladder to contract. The discomfort from a gallbladder attack (biliary colic) can last for minutes to hours and is sometimes accompanied by nausea or vomiting.
The liver can also contribute to right chest pain if it becomes inflamed or enlarged due to conditions like hepatitis or an abscess. This discomfort is typically experienced as a persistent, dull ache rather than the sharp pain seen with gallstones. Irritation of the liver’s capsule can cause discomfort felt close to the lower right rib cage.
Gastroesophageal reflux disease (GERD) is a digestive issue where stomach acid flows backward into the esophagus, causing heartburn. Although classic heartburn is felt centrally, the irritation can sometimes be perceived on one side of the chest, mimicking other pain forms. This discomfort is often worse after lying down or consuming acidic or spicy foods.
Pulmonary and Serious Vascular Conditions
The right lung and its lining, the pleura, are direct sources for some serious causes of right-sided chest pain. Pleurisy involves inflammation of the pleura, causing the two layers of the lining to rub against each other during respiration. This friction produces a sharp, stabbing pain that worsens with deep breathing, coughing, or sneezing.
Pneumonia, a lung infection, can cause localized chest pain, particularly if the infection is concentrated in the right lower lobe near the chest wall. The pain is typically accompanied by systemic symptoms such as a high fever, chills, a productive cough, and shortness of breath. The infection irritates the lung tissue, contributing to the painful sensation experienced on the affected side.
A pneumothorax, or collapsed lung, occurs when air leaks into the space between the lung and the chest wall, preventing the lung from fully expanding. This condition presents with a sudden onset of sharp, severe pain on the right side, accompanied by tightness and acute shortness of breath. A collapsed lung requires immediate medical attention as it can rapidly compromise respiratory function.
A pulmonary embolism (PE) is a life-threatening vascular condition where a blood clot, often originating in the leg, travels to and blocks an artery in the lung. The resulting blockage causes sudden, severe chest pain that is described as sharp and is worse upon deep inhalation. This pain is frequently accompanied by shortness of breath, a rapid heart rate, and sometimes coughing up blood.
When to Seek Emergency Medical Care
Certain symptoms accompanying right-sided chest pain indicate a medical emergency. Any sudden, severe, or crushing chest pain that does not resolve within a few minutes must be evaluated immediately, as this can signal a pulmonary embolism or other acute cardiopulmonary event.
Emergency care is also necessary if the pain is accompanied by difficulty breathing or sudden, unexplained shortness of breath. Other warning signs include:
- Dizziness, lightheadedness, or fainting, which can signal a dangerous drop in blood pressure or oxygen saturation.
- Sweating or nausea.
- Pain that radiates into the jaw, arm, or back (even if rare for purely right-sided pain).