The Importance of the Rib Cage
The rib cage consists of 24 ribs with 12 of ribs on the left side and 12 on the right.
As explained in an article by Medical News Today, this structure houses and protects important organs in the body including the heart, lungs, liver, spleen, and pancreas. Below the rib cage are the gallbladder and kidneys.
The ribs are attached to the front of the breastbone (sternum) by cartilage and to the back by the spine.
Injury, infection, or inflammation of any of these organs, the rib bones, or the cartilage at the breastbone can cause pain in the rib cage.
What is Rib Pain?
Rib pain, or ribcage pain as it is also called, is not necessarily a medical condition of itself but rather a symptom of some underlying disorder, disease or health condition.
Rib pain can occur under the right or left rib cage, generally due to issues with the organs or tissues.
This type of pain can be a quite discomforting with the level of discomfort ranging from minor to severe. Its severity depends mostly on the cause and symptoms.
The reasons for rib pain may not be easy to determine since there are a number issues and medical problems that cause rib pain.
In fact, it can be caused by something as minor as indigestion after dinner or a serious health condition such as an impending heart attack.
“Sometimes a pain under the rib is nothing more than you slept wrong, or you exercised too hard,” says Dr. Gregory Cooper, a gastroenterologist at the University Hospitals Cleveland Medical Center, in an article published by Today.
Though some of the causes of rib pain are benign and not life-threatening, you should seek medical attention judging from the severity of the pain, the symptoms, and how long they last.
What Causes Rib Pain?
A common reason for rib pain is injury or trauma caused by a direct blow to the chest such as during a vehicular accident. Bruises, broken bones, or fractures may result and cause rib pain.
Forceful pressure on the muscle or bad posture may cause strain resulting in pain.
Additionally, rib pain may be caused by various health or medical conditions.
According to Jon Yaneff, CNP, in his article What Are the Causes of Rib Pain?, published online at Doctor’s Health Press, rib pain can be minor or serious depending on if it occurs on the left or right side.
Even though some conditions that cause rib pain may be more serious than others, you should seek medical attention if the symptoms and pain persist.
Rib Pain Caused by Injury
- Bruised ribs
- Broken or fractured ribs
- Rib cartilage injury
- Strained muscles from exercise or lifting
Rib Pain Caused by Inflammation
Costochondritis
Also known as chest wall syndrome, costochondritis occurs when the cartilage connecting the ribs to the breastbone becomes inflamed.
It may mimic symptoms of a heart attack and the pain seem to worsen when breathing or moving.
This musculoskeletal chest pain may go away on its own or require medical attention.
Gastritis
This is caused by inflammation of the stomach lining. Alcohol abuse and bacterial or viral infections commonly cause gastritis.
Fullness or bloating in the upper abdomen and a burning pain that radiates to the rib cage can cause rib pain.
Fibromyalgia
A sharp, stabbing, burning or throbbing pain felt in the upper chest or left rib cage may be due to fibromyalgia.
This condition is described in an article published by Mayo Clinic as one that causes “widespread musculoskeletal pain.”
Appendicitis
Severe infection or inflammation of the appendix, also known as appendicitis, is a known cause of a sharp pain under the right side of the rib cage.
Although the most common symptom is a pain in the abdomen, the pain may shift to other parts of the body including under the right rib cage.
Pancreatitis
Gallstones, alcohol abuse or injury can cause inflammation of the pancreas, located at the upper left side of the body. Pain can start slow and worsen, especially after eating and can be felt in the rib.
Inflammatory Bowel Disease (IBD)
Symptoms such as abdominal pain or cramps caused by inflammatory bowel disease may ‘refer’ pain to the rib cage.
Ulcerative colitis and Chron’s Disease are two types of IBD’s, and the pain caused may be felt either under the right or left rib cage.
Rib Pain Caused by Heart Problems
Pericarditis
The pericardium is a membrane that surrounds and protects the heart muscles. Pericarditis occurs when the membrane becomes inflamed, for example, due to a viral infection or rheumatoid arthritis.
Pain under the left rib cage or chest is a common symptom of this condition, in addition to weakness or fever, etc.
Heart Attack
Pain under the left rib cage is a common symptom of a heart attack, a potentially fatal condition.
It is often accompanied by other symptoms, such as shortness of breath and a squeezing sensation in the chest.
Angina
The pressure in the chest or pain under the left rib cage may be associated with angina. Narrowed or blocked arteries deprive the heart muscles of oxygen resulting in this pain.
Rib Pain Caused by Digestive Problems
Stomach Gas
Gas can accumulate under the right or left side of the rib cage due to chronic digestive disorders.
When excessive gas cause pain and discomfort on the left side, it is called splenic flexure syndrome.
When it occurs on the right side, it is called hepatic flexure syndrome. These syndromes are often associated with irritable bowel syndrome (IBS).
Stomach Ulcers
These include gastric ulcers, peptic ulcers, and duodenal ulcers which are sores that develop in the lining of the stomach or small intestine.
In addition to causing a burning stomach pain, stomach ulcers commonly cause a dull pain in the left rib cage.
Heartburn
A type of rib pain that occurs on the left side of the rib cage and often mistaken for a symptom of heart attack is that caused by heartburn or acid reflux.
Acid reflux happens when stomach acid moves backward and upwards into the esophagus.
Indigestion
Discomfort and pain under the breastbone where the ribs are attached may be caused by indigestion.
The pain or discomfort is often felt in the lower area of the rib cage and may be accompanied by a burning sensation in the upper abdomen.
Fecal Impaction
This condition can cause pain in the left or ride sight of the rib cage. Fecal impaction is due to issues with the colon that make it difficult to move the bowel.
Kidney Stones
People suffering from kidney stones complain of feeling a sharp, intense pain in the lower left rib cage.
As the name suggests, kidney stones are small stones that form when minerals and salt calcify in the kidney.
Rib Pain Caused by Lung Problems
Pulmonary Embolism
Pulmonary embolism is a dangerous and potentially fatal condition that causes rib pain.
According to an article published online at Everyday Health, pulmonary embolism result when a blood clot blocks the flow of blood to the lungs.
The sharp pain is typically felt under the right side of the rib cage
Lung Cancer
Many symptoms of lung cancer, a life-threatening condition, occur in or affect the chest.
This is according to Lung Cancer.Org. Coughing and chest pain associated with lung cancer can cause pain to radiate to the rib.
Pleurisy
A sharp stabbing pain felt especially at the left side of the rib cage may be a sign of pleurisy.
This condition occurs due to trauma or bacterial, viral, or fungal infection that causes inflammation of lung tissues.
Other Causes of Rib Pain
Gallbladder
Several problems with the gallbladder can cause sudden pain that radiates to the rib cage.
Biliary colic may result in pain when the gallbladder contracts to pump bile around the gallstones.
Acute cholecystitis also causes rib pain due to inflammation of the gallbladder.
Damaged Spleen
Located in the upper abdomen and under the left rib cage is an organ known as the spleen.
The spleen can become enlarged or damaged resulting in pain under the left rib cage or left side of the abdomen.
Liver Problems
A dull or severe pain can occur under the right rib cage due to issues with the liver.
Acute Anxiety
Rib pain may be felt in people suffering from anxiety, a condition of feeling impending doom even though there is no present danger.
With severe anxiety, a person may panic, their heart may race, or their chest may feel tight or hurt causing a feeling of rib pain.
Symptoms of Rib Cage Pain
The most obvious symptom of rib cage pain is the pain in the rib. So, the sign of pain is a symptom of itself.
Symptoms are often identified based on the location they are felt. General symptoms of this condition include the following, but may vary from one individual to another:
- A sudden sharp pain felt under the rib cage
- Dull ache in the rib area
- Sharp or dull pain in the chest or at the navel
- Pain in the rib that lasts for days or weeks
- Pain may be constant or ‘on and off’
- Pain in the rib that radiates to other parts of the body (e.g., the shoulders, neck, or jaw
- Tenderness or soreness in the rib cage
- Difficulty breathing
- Rapid breathing
- Pain that worsens when moving or breathing
- Fevers or chills
- Nausea or vomiting
The following is an informative YouTube video that provides a quick summary of some of the main causes of rib cage pain.
It is useful because it provides information on additional reasons for rib pain.
It also expands on the symptoms associated with the conditions that cause rib cage pain already discussed in this article.
This information can help a person determine if the pain felt in the rib cage is just a fleeting pain not associated with any serious condition; or one associated with a possibly serious or life-threatening condition that requires urgent medical attention.
Rib Pain Treatment
Pain can be felt on the right side or left side of the rib cage, between the ribs, in the chest, abdomen, and other parts of the body.
This usually makes it challenging to determine the root cause of the pain.
Because rib pain is caused by a variety of conditions, treatment is not a one-size-fits-all.
Some conditions that rib pain may resolve on their own while some may need minimal treatment. In other cases, emergency medical attention is required.
However, because rib pain could also be due to a serious or life-threatening condition, it is imperative to seek medical attention to rule these out, says Celeste Cooper, R.N. Cooper’s in her article, What’s Causing This Pain?, published online at Health Central.
Determining the right treatment will depend on an accurate diagnosis by a medical doctor.
Many of the causes of rib pain can be treated with medication such as NSAID’s or steroid injections to reduce pain, swelling, and inflammation or antibiotics to clear up bacterial infections.
In the case of kidney stones where the stones are too large to exit the body, surgery may be necessary.
Pain in the rib caused due to straining of the muscles between the ribs may be alleviated with chiropractic treatment such as myofascial stretches.
Eating healthier foods and avoiding fatty or spicy foods can help alleviate rib pain that is due to indigestion, heartburn, fecal impaction, and excessive gas.
Rib Pain Diagnosis
In deciding whether to treat and how to treat, your doctor will need to make a diagnosis to determine the cause of the rib pain.
Your doctor will do a physical examination and ask you questions about your medical history to find out whether an existing condition could be the cause of the pain.
You may be asked to indicate the area or areas of the body the pain is felt. Your doctor may also check for signs of inflammation or swelling which may be associated with conditions such as costochondritis.
An X-ray or MRI may be done to view the rib cage for fractures or broken ribs.
In cases where your doctor suspects the pain may be due to a heart problem, an electrocardiogram also known as an ECG or EKG may be done.
Blood tests and urine tests may help the doctor determine if you have gastritis, kidney problems, or pancreatitis.
The doctor may use an endoscope to examine the lining of your stomach if gastritis is suspected. A stool sample may also be taken and analyzed.
An X-ray, MRI or CT scan is also useful for examining internal organs and soft tissues in the body to check for inflammation or abnormalities that can cause rib pain.
Possible Complications of Rib Cage Pain
Medical complications may develop from rib pain that is poorly treated or left untreated.
This may be regardless of whether it is caused by injury, trauma, a disease or disorder.
According to an online article published at Health Grades, medical attention should be sought for persistent rib pain that occurs alone or accompanied by symptoms.
The article also stressed the importance of following the doctor’s treatment plan to reduce the risk of complications, especially those that are considered serious or life-threatening causes of rib pain.
These underlying causes include the following:
- Heart attack (cardiac arrest)
- Injury to the liver, spleen, kidneys or lungs
- Pneumonia
- Sepsis
- Abnormal heart rhythms (Cardiac Arrhythmias)
- Respiratory problems
- Acidosis and high carbon dioxide levels
Rib Pain Prevention
Preventing rib pain may not be an easy task since it can be caused by underlying conditions within the body.
In cases where improper diet or an unhealthy practice, such as lying down immediately after eating, may result in conditions that cause rib pain then a healthier diet and lifestyle can help prevent rib pain.
Indigestion, heartburn, excessive gas, and fecal impaction are some conditions that are related to an unhealthy diet or poor lifestyle.
Frequently Asked Questions About Rib Pain
Does Rib Pain Mean Broken or Fractured Ribs?
A broken or fractured rib is one of the most common reasons for rib pain. The break or fracture may have occurred due to a direct blow to the chest, for example, due to a vehicular accident, fall, or rough contact during sport.
A person may not even know that the rib is broken or fractured. This type of rib pain can be severe, especially when moving.
Diagnosis of rib pain caused by broken or fractured ribs should be done urgently to avoid injury to the spleen or kidney.
How Do I Stop the Pain in My Ribs?
The best way to stop rib pain that does not go away by itself within a few minutes or hours is to find out what is causing the pain. Rib pain is due to various diseases, disorders, and conditions that can only be accurately diagnosed and treated by a doctor.
Therefore, the best way to stop rib pain is to seek medical attention as soon as possible, especially when symptoms are persistent and severe.
Is Pain Under the Left Rib Cage Serious?
Pain under the left rib cage has often been associated with a heart attack. People, especially older adults, who experience this pain may quickly panic.
But not all pain under the left rib cage is a sign of a heart attack. Problems with other organs housed under or below the left rib cage could be responsible for rib pain.
The cause and severity of the pain may be a guide to the seriousness of it. In addition to a heart attack, left rib pain is caused by angina, pancreatitis, respiratory infections, lung disease, costochondritis, kidney stones, rib injury, and spleen disease.
How Common is Pain in the Right Rib Cage?
Pain in the right rib cage is just as common as left rib pain. There is also a myth that left rib pain is more serious than when it occurs on the right because the heart is on the left side of the upper chest.
Left-sided rib pain is often associated with heart problems such as heart attack and angina.
On the other hand, right-sided pain may be due to serious conditions such as appendicitis, pancreatitis, gallstones, or inflammatory bowel diseases. This is according to Doctor’s Health Press.
Whether the pain occurs on the right or left or below the rib cage, it is not always a sure indication of its seriousness.
This is why all pain in the rib should be considered serious unless otherwise ruled out by a doctor.
When Should I See a Doctor?
Because rib pain can be caused by minor things such as indigestion or strained rib muscles or something more serious, such as a heart attack or pulmonary embolism, deciding when you should see a doctor is a judgment call to be made by the individual.
The most important thing to do is assess the symptoms and their level of severity.
If the pain does not go away, gets worse, or interferes with your daily activities or quality of life, this may indicate a serious condition that requires medical attention.
A person should seek medical attention immediately in the following circumstances:
- If the pain or pressure in the ribs become severe
- If the pain radiates to other parts of the body, such as the shoulder, neck or jaw
- The pain quickly becomes severe
- Difficulty breathing
- Rapid heartbeat or heart palpitation
- Cold sweat or excessive sweating
- Changes in the color of the nail, lips, or skin
- Consistent coughing
- Difficulty moving
- Pain when bending or twisting the torso
- Pain accompanied by dizziness or nausea and vomiting
- Severe abdominal pain
- Mental confusion
- Fever over 101 degrees Fahrenheit
Conclusion
Rib pain should never be dismissed as something trivial, particularly because there are serious and potentially fatal conditions that cause rib pain both in the left and right side of the rib cage.
It may be better to err on the side of caution and seek urgent medical attention, especially for unexplained rib pain that is persistent and severe.
