Pain under the right ribs is a common concern, stemming from various sources. Understanding these origins helps individuals recognize when to seek medical attention.
Common Non-Organ Related Causes
Pain under the right ribs often stems from musculoskeletal factors. Muscle strain, from exercise or sudden movements, is a common cause, affecting intercostal muscles and causing soreness or sharp pain.
Direct rib injury, like bruising or fractures, causes discomfort. Trauma can damage rib bones, intensifying pain with breathing or movement. A stress fracture from repetitive motion may also cause persistent rib pain.
Costochondritis, inflammation of cartilage connecting ribs to the breastbone, causes sharp or aching pain worsening with deep breaths. Nerve pain, like intercostal neuralgia, results from irritated nerves between ribs, causing sharp, shooting, or burning sensations. Shingles can also cause significant pain and a rash in this area.
Referred pain from the back or spine can be felt under the right ribs. Problems in the thoracic spine or lower neck send pain signals to the front. This pain may be a dull ache, varying with posture. Evaluating physical activity and recent injuries helps identify the source.
Conditions Affecting Internal Organs
Internal organs in the right upper abdomen can cause pain under the right ribs. An inflamed or enlarged liver can cause discomfort. Hepatitis or fatty liver disease may lead to a dull ache or fullness.
The gallbladder, beneath the liver, is a frequent pain source. Gallstones can block bile ducts, causing sudden, intense pain (biliary colic). If inflamed (cholecystitis), pain can be severe and persistent, often with fever and nausea, radiating to the back or shoulder blade.
The right kidney can cause pain, especially from stones or infections. Kidney stones cause sharp, excruciating pain moving through the urinary tract, often radiating from the flank or back to under the ribs. A kidney infection can also cause a dull or sharp ache in the right flank, extending to the rib area, often with fever and urinary symptoms.
Digestive issues can cause pain under the right ribs. Indigestion and heartburn (acid reflux) can cause discomfort radiating to the upper right abdomen. Duodenal ulcers cause burning or gnawing pain under the ribs, often relieved by food but returning. Irritable bowel syndrome can cause abdominal discomfort, sometimes in the upper right quadrant. Rarely, an atypically positioned appendix or unusual appendicitis may cause higher pain.
Lung or diaphragm conditions, located above abdominal organs, can also cause pain. Pneumonia can lead to chest pain under the ribs, especially during deep breaths. Pleurisy, inflammation of the lung lining, causes sharp, stabbing pain worsening with breathing. Diaphragm problems can also refer pain beneath the ribs.
When to Seek Professional Medical Advice
Seek medical advice if right rib pain is persistent or worsens. Sudden, severe pain warrants immediate attention.
Accompanying symptoms signal prompt medical consultation. These include fever, unexplained nausea or vomiting (suggesting infection or inflammation), and jaundice (yellowing skin or eyes), dark urine, or pale stools (pointing to liver or gallbladder issues).
If pain is associated with shortness of breath, chest pain, or radiates to the arm, neck, or jaw, seek emergency care. Pain after a rib injury needs evaluation for fractures or internal damage. Any pain disrupting sleep, appetite, or well-being warrants discussion with a healthcare provider.
How Doctors Diagnose the Cause
When a patient presents with right rib pain, healthcare professionals begin with a thorough medical history and physical examination. The doctor asks about the pain’s location, intensity, duration, affecting factors, other symptoms, and past medical conditions.
During examination, the doctor palpates the area for tenderness, swelling, or masses, and listens to lung and bowel sounds. This assessment helps pinpoint discomfort and indicates the underlying cause. Based on this, further diagnostic tests confirm a diagnosis.
Blood tests check for inflammation, infection, or organ dysfunction (e.g., liver function, gallbladder markers). Urine tests assess kidney function or detect urinary tract infections. Imaging studies provide visual information.
Ultrasound is often a first-line test for liver and gallbladder; X-rays check for rib fractures. CT scans or MRIs provide detailed views. If initial tests are unclear or a specialized condition is suspected, a doctor may refer to a gastroenterologist, nephrologist, or other specialist.
Citations
Shingles. MedlinePlus. [https://medlineplus.gov/shingles.html]
Fatty Liver Disease. National Institute of Diabetes and Digestive and Kidney Diseases. [https://www.niddk.nih.gov/health-information/liver-disease/fatty-liver]
Gallstones. National Institute of Diabetes and Digestive and Kidney Diseases. [https://www.niddk.nih.gov/health-information/digestive-diseases/gallstones]
Cholecystitis. MedlinePlus. [https://medlineplus.gov/cholecystitis.html]
Kidney Stones. National Institute of Diabetes and Digestive and Kidney Diseases. [https://www.niddk.nih.gov/health-information/urologic-diseases/kidney-stones]
Irritable Bowel Syndrome (IBS). National Institute of Diabetes and Digestive and Kidney Diseases. [https://www.niddk.nih.gov/health-information/digestive-diseases/irritable-bowel-syndrome]
Abdominal Pain. MedlinePlus. [https://medlineplus.gov/abdominalpain.html]