Pain under the ribcage can be a source of significant concern. It stems from various systems, such as musculoskeletal structures, the digestive tract, and respiratory organs. Pinpointing the exact location of the pain often provides valuable clues. This article provides general information about pain under the ribcage and is not a substitute for professional medical advice.
Understanding Ribcage Pain
The ribcage forms a protective bony structure around the chest cavity, safeguarding vital organs such as the heart and lungs. It consists of 12 pairs of ribs, connecting to the thoracic vertebrae and sternum (breastbone) via cartilage. The diaphragm, a muscle that separates the chest cavity from the abdomen, aids breathing. Pain in this region can manifest as sharp, dull, aching, or burning, localized or radiating.
The precise location of the pain—under the right, left, or central ribcage—indicates involved organs or structures. Pain characteristics, like constant or intermittent, worsening with movement or deep breathing, or occurring after eating, offer further insights.
Pain Under the Right Ribcage
Pain under the right ribcage often points to issues with organs in the upper right abdomen or surrounding musculoskeletal structures. The liver and gallbladder reside here, making them common sources of pain. Gallbladder problems, such as gallstones or inflammation (cholecystitis), frequently cause sharp pain that can radiate to the right shoulder blade or back, often triggered by fatty meals.
Liver conditions like hepatitis or fatty liver disease can also lead to pain. Kidney issues, including kidney stones or infections, may cause pain under the right ribcage that often extends to the lower back and sometimes into the groin. This pain is fluctuating, from sharp to dull, and may be accompanied by nausea or blood in the urine.
Musculoskeletal factors are also a common consideration for right-sided rib pain. Costochondritis, an inflammation of the cartilage connecting the ribs to the breastbone, causes sharp, localized pain that worsens with movement, coughing, or pressure. Muscle strains from intense physical activity, heavy lifting, or persistent coughing can lead to sharp, aching pain. Rib fractures or bruising from trauma also cause significant pain, particularly with breathing, coughing, or twisting.
Digestive issues can also contribute to pain under the right ribcage. Duodenal ulcers or certain types of indigestion may cause pain here. Irritable Bowel Syndrome (IBS) also causes generalized abdominal pain, which might be felt under the right ribs. Diaphragmatic spasms cause cramping or sharp pain under the ribcage.
Pain Under the Left Ribcage
Pain under the left ribcage originates from organs and structures in the upper left abdomen and chest. The spleen, pancreas, stomach, and left kidney are in this vicinity.
Spleen-related issues, an enlarged spleen (splenomegaly), can cause discomfort or fullness in the upper left abdomen. A ruptured spleen causes severe, sharp pain.
Pancreas problems, particularly inflammation known as pancreatitis, cause severe pain in the upper abdomen that may radiate to the left side and back. This condition is often accompanied by nausea and vomiting. Stomach issues, including gastritis (inflammation of the stomach lining) or stomach ulcers, result in pain under the left ribcage, along with symptoms like indigestion, nausea, and early fullness.
Colon issues, diverticulitis or irritable bowel syndrome affecting the left side, can cause abdominal pain. Constipation also leads to generalized abdominal pain. Kidney stones or infections in the left kidney can mimic ribcage pain, often radiating from the back to the front.
Musculoskeletal causes, similar to the right side, are frequent contributors to left ribcage pain. Costochondritis, affecting the left side, causes sharp, stabbing pain that worsens with movement, coughing, or pressure on the ribs. Muscle strains or rib fractures on the left side present with pain that intensifies with deep breathing or twisting motions. Heart-related pain, though usually central, may be felt under the left ribcage, described as heaviness or pressure, and may extend to the jaw, shoulder, or arm.
Pain Under the Central Ribcage
Pain under the central ribcage, also known as the epigastric region, often relates to upper digestive system issues. Gastroesophageal Reflux Disease (GERD), commonly known as heartburn, is a common cause. Stomach acid flows back into the esophagus, causing a burning sensation or pain in the chest and upper abdomen. This pain may worsen after eating or when lying down.
Peptic ulcers, sores in the stomach or duodenum lining, cause a burning or dull aching pain in the central upper abdomen. Gastritis, an inflammation of the stomach lining, also commonly causes central ribcage pain, often accompanied by indigestion, nausea, and bloating. Indigestion, or dyspepsia, is a general term for upper abdominal pain that includes bloating, nausea, and fullness.
A hiatal hernia, where part of the stomach pushes up through the diaphragm, causes central chest pain, heartburn, and difficulty swallowing. Musculoskeletal issues can also cause central ribcage pain, particularly costochondritis. Sternal pain also contributes to central pain.
When to Seek Medical Care
While many causes of pain under the ribcage are not severe, certain symptoms warrant immediate medical attention. Sudden, severe, or crushing pain, especially if accompanied by shortness of breath, chest tightness, or pain radiating to the arm, jaw, or back, may indicate a heart attack and requires emergency evaluation.
Any pain that develops after a significant injury or trauma should also be assessed by a healthcare professional. Seek medical care if the pain is accompanied by other concerning symptoms, such as fever, chills, unexplained weight loss, persistent nausea or vomiting, or yellowing of the skin or eyes.
If the pain worsens progressively, does not improve with rest, or significantly interferes with daily activities, a medical consultation is advisable. Signs of internal bleeding, such as black, tarry stools or vomiting blood, require urgent medical attention.