Pain on the right under the ribs from behind from the back is an unpleasant symptom that can appear when the functioning of various organs is disrupted. If unpleasant and painful sensations appear in this area, you need the help of a rheumatologist and other specialists who work at the Yusupov multidisciplinary hospital.
Pain in the right hypochondrium can appear not only with disorders of the musculoskeletal system, but also with other systems. At the Yusupov Hospital, high-precision diagnostics are carried out, aimed at collecting the most detailed information about the patient’s current condition.
Causes
Pain syndrome accompanies various pathologies. If there are disturbances in the functioning of the internal organs, back pain on the right may occur. The cause of this symptom can be determined by diagnostic measures, during which the following diseases can be detected:
- chronic or acute pancreatitis;
- oncological diseases of the lungs or bronchi;
- pneumonia;
- pyelonephritis caused by the activity of pathogenic microorganisms. Pain on the right side of the back with this disease intensifies with sudden movements;
- pleurisy, in which the serous membrane covering the lungs becomes inflamed;
- appendicitis;
- formation of a subhepatic abscess;
- urolithiasis disease.
Localized pain on the right side of the back may indicate diseases such as a herniated disc or lumbar osteochondrosis. In addition, this symptom often occurs in women when carrying a child. Specialists at the Yusupov Hospital Therapy Clinic determine the causes of pain and develop a therapy program aimed at eliminating the root causes of discomfort.
Classification of back pain
It is impossible to independently determine why back pain occurred in the right hypochondrium, therefore, to determine its causes, you should contact the therapy clinic of the Yusupov Hospital and undergo an examination. Classification of pain by location allows specialists to determine which organs are involved in the pathological process:
- pain on the right under the scapula occurs due to a pinched nerve, damage to the serous membrane of the lungs or during an oncological process;
- back pain on the right under the ribs at the back appears when the pancreas or liver is damaged;
- pain in the center of the back is a sign of kidney disease;
- back pain radiates to the right leg due to a hernia or injury, as well as disturbances in the functioning of the urinary system.
However, laboratory results are required to make a definitive diagnosis. Patients of the Yusupov Hospital can take tests and undergo the necessary diagnostic procedures in one day without queues.
Symptoms
Back pain in the right hypochondrium is one of the signs of various disorders and diseases. Depending on the cause of its occurrence, the patient may experience other symptoms. The main symptoms accompanying back pain are in the right hypochondrium. Are:
- fever, increased body temperature and chills, indicating the body’s immune system is fighting pathogens;
- attacks of intense headache;
- signs of intoxication of the body;
- decreased blood pressure;
- stool disorders;
- shortness of breath, cough.
When these signs appear, some patients do not consider them serious enough to contact a medical facility. However, in case of diseases of internal organs, self-medication can lead to serious consequences.
At the Yusupov Hospital, patients are treated in comfortable conditions. A friendly attitude towards each client, high professionalism of employees and the use of modern technologies and techniques allow us to provide medical care that meets international requirements. The Yusupov Hospital does not refuse treatment to patients in serious condition; they are offered emergency hospitalization and high-quality treatment.
Pathology of the chest organs
The cause of pain in the right side, hypochondrium with a sharp increase in inspiration may be diseases of the chest. These include pathology: respiratory organs, heart and blood vessels, bone skeleton and muscles.
Pneumonia (pneumonia) is a common independent disease or complication of bronchitis and sepsis. Caused by pathogenic bacteria and viruses if the patient’s immunity decreases. Pain during breathing, spreading into the abdominal cavity, is observed with right-sided pleuropneumonia (lobar).
Symptoms include:
- sudden onset;
- heat;
- cough with purulent sputum, possibly with blood;
- severe malaise;
- dyspnea;
- pain in the side and hypochondrium when breathing;
- blueness of lips.
Pleurisy - accumulation of inflamed fluid in the right pleural cavity, is a complication of pneumonia, a sign of pulmonary tuberculosis. Irritation of the pleural layers causes severe pain from behind in the area of the lower ribs and in the hypochondrium with irradiation into the abdomen, the inability to deep breathe, shortness of breath, lag of the right side of the chest in the act of breathing.
The x-ray shows fluid in the pleural cavity on the right; in order to accurately find out the cause of pleurisy, it is necessary to take a repeat image after its removal
The patients have a general serious condition, severe intoxication, chills, and high temperature surges. Pleurisy can be caused by a lung abscess, a cancerous tumor, or suppurating bronchiectasis.
An extremely dangerous condition is caused by thromboembolism of the pulmonary artery trunk. If a thrombus enters a lower-order artery, then the changes are limited to the picture of pneumonia with necrosis of part of the tissue (infarction). When a branch of large diameter is blocked, the patient develops:
- sudden suffocation;
- sharp pain in the chest and abdomen;
- blue discoloration of the upper half of the body;
- cough with copious sputum and hemoptysis;
- weakness and loss of consciousness.
The disease is a complication of attacks of atrial fibrillation, thrombophlebitis of the veins of the legs and pelvis, myocardial infarction, and chemotherapy drugs.
The abdominal form of myocardial infarction is often associated with the localization of ischemia in the area of the posterior wall of the left ventricle. Compressive, burning or pressing pain occurs suddenly, is localized in the epigastrium, radiates to the stomach, back, shoulder blade, and makes breathing difficult.
The ECG shows signs of ischemia, blockades, and arrhythmias. The disease is so well known to surgeons that not a single experienced doctor will begin surgery for cholecystitis until an ECG study has been performed.
Congestive heart failure is a complication of severe heart disease affecting the myocardium. Violation of the contractility of the ventricles leads to blood retention in the extremities, abdominal cavity, and lungs. The liver is one of the first to suffer.
Overflow of the portal vein causes the release of the liquid part of the blood into the parenchyma, swelling and stretching of the capsule. The diaphragm has to work under increased load, which causes spastic contractions. Accordingly, the patient feels heaviness in the right hypochondrium and acute colic with pain when breathing.
Right-sided pneumothorax - characterized by rupture of the lung tissue, release of air into the pleural cavity with compression of the right lung. The patient experiences a sudden state of shock; due to sharp pain, he cannot breathe, and his blood pressure drops. The cause is chest trauma, fibrous-cavernous pulmonary tuberculosis, and abscess pneumonia.
The picture of multiple bilateral rib fractures is clinically accompanied by sharp pain during breathing and movement
Diseases of the musculoskeletal skeleton of the chest can cause sharp pain along the lower ribs, especially when breathing and moving. These include:
- bruises and fractures of the right ribs;
- intercostal neuralgia;
- muscle myositis;
- shingles;
- osteochondrosis of the lumbar and thoracic regions;
- strangulation of a herniated disc.
When examining the patient, the doctor detects painful points along the muscles, nerve endings, a sharp increase in pain when compressing the chest and when breathing, neurological signs (impaired sensitivity, changes in tone in the limbs).
Muscle pain
People of all ages experience muscle pain in the back. The most common cause of pain is diseases of the spine. So, with osteochondrosis or scoliosis, compression of the muscles located nearby occurs. As the disease progresses, back pain on the right under the ribs may intensify and hinder movement.
One of the methods for eliminating muscle pain in the back is physical therapy. Specialists at the Yusupov Hospital Rehabilitation Center select exercises in such a way as to strengthen the muscle corset and reduce the load on the spine, as well as eliminate the resulting pathology. Physiotherapeutic procedures in combination with massages are highly effective for back pain in the right hypochondrium.
Treatment for rib pain
The treatment plan is developed depending on the diagnosis and the reasons for the development of the pathology. For the treatment of cervicothoracic osteochondrosis and other pathologies of the spine and joints, anti-inflammatory and painkillers, antispasmodics, chondroprotectors and muscle relaxants are prescribed. Courses of massage, physiotherapy, manual therapy or osteopathy may also be prescribed.
Massage helps relieve excessive tension and pain, it has a warming and relaxing effect. However, this procedure is unacceptable for acute injuries, colds and cancer.
Physiotherapy and acupuncture help eliminate pain and muscle hypertonicity, normalize metabolic processes, eliminate inflammatory foci, restore damaged tissue and increase local immunity. To strengthen the muscle corset and healthy distribution of static load, physical therapy is necessary, which allows you to relieve spasms, increase muscle mass and correct posture. During treatment and in the future for prevention, it is necessary to follow a daily routine and get enough rest, wear comfortable shoes, avoid hypothermia and eat right.
Diagnostics
Rheumatologists at the Yusupov Hospital and other specialists draw patients’ attention to the fact that pain in the ribs on the right side of the back can be a sign of serious disorders, therefore, to establish its causes, a set of diagnostic measures is carried out using European equipment:
- study of symptoms and complaints of patients;
- physical examination of the patient;
- passing biochemical and clinical tests;
- MRI and CT;
- ultrasonography;
- stool analysis;
- performing bronchoscopy.
The diagnostic center of the Yusupov Hospital is equipped with European equipment, which allows obtaining high-precision research results. Cooperation with leading research centers allows us to perform rare and complex studies, so the specialists of the therapy clinic provide assistance even to those patients who were abandoned in other medical institutions.
Possible causes of rib pain
Most often, patients believe that pain occurs in the rib bones, although in fact the discomfort may appear due to muscle spasms or compression of the nerve roots. Main reasons
rib pain:
- pathologies of nerves and muscles;
- excessive physical and psychological stress;
- trauma, rib tumors, Tietze syndrome;
- diseases of the spine (spondylosis, arthrosis, osteochondrosis, hernias and protrusions);
- pathologies of the pleura, including tumors.
Soreness of the rib bones is a relatively rare phenomenon that occurs in severe bone diseases or injuries (fractures). If pain in the ribs appears after a bruise or fall, or a blow to this area, medical attention is required immediately, because a broken rib bone can damage the heart or lungs.
Often discomfort in the chest area accompanies colds or pneumonia. This symptom should be reported to your doctor, as it can be not only muscle spasms due to coughing, but also the consequences of deterioration of the lungs, bronchi or pleura.
Treatment
Pain in the right hypochondrium, radiating to the back, can bother people of all ages, while some patients do not perceive it as a serious symptom. If you seek medical help early, it is possible to stop the pathological process at a stage when it does not cause consequences.
Specialists at the therapy clinic, in particular rheumatologists, treat back pain in the right hypochondrium and the root causes of this symptom. Patients who experience back pain in the rib area on the right may be prescribed complex treatment depending on the type of disorder. Comprehensive therapy programs include the following activities:
- taking medications to relieve pain and inflammation;
- use of physiotherapeutic techniques;
- massages;
- drawing up a nutrition program;
- regular physical therapy classes under the guidance of experienced instructors.
Pre-registration by phone allows you to optimize the work of the Yusupov Hospital and create the most comfortable conditions for patients. Contact the Yusupov Hospital staff by phone and choose a convenient time to visit a specialist.
Pain or heaviness in the right hypochondrium
Hepatitis
Jaundice
Vomit
43649 05 April
IMPORTANT!
The information in this section cannot be used for self-diagnosis and self-treatment.
In case of pain or other exacerbation of the disease, diagnostic tests should be prescribed only by the attending physician. To make a diagnosis and properly prescribe treatment, you should contact your doctor. Pain or heaviness in the right hypochondrium: causes of occurrence, what diseases it occurs with, diagnosis and treatment methods.
Definition
The right hypochondrium is one of nine areas into which the anterior abdominal wall is conventionally divided. This area belongs to the so-called “upper floor” of the abdominal cavity.
In the right hypochondrium there are the liver, gallbladder, hepatic angle of the colon, and swollen loops of the small intestine can also be projected into this area. The organs listed above belong to the digestive system.
The liver is a parenchymal (spongy) organ with a very good blood supply. The outside of the liver is covered with a capsule in which nerve endings are located. The liver is involved in the metabolism of proteins, fats, carbohydrates, vitamins, and plays a vital role in detoxification of the body.
Harmful substances that enter the liver are subjected to “chemical” processing, which makes them less toxic to the body and promotes faster elimination through the gastrointestinal tract and urine.
In addition, liver cells produce bile necessary for digesting food, primarily fats. Bile enters the gallbladder, located on the lower surface of the liver, where bile accumulates, which is released from it into the duodenum during the next meal.
From above, the liver is adjacent to the diaphragm - a kind of muscular partition between the abdominal and thoracic cavities. From below, from the side of the abdominal cavity, the diaphragm is lined with peritoneum (which covers the entire abdominal cavity and organs located in it from the inside), and from above, from the side of the lungs, by the pleura, which lines the pleural cavity from the inside and covers the lungs from the outside. Both the pleura and peritoneum have good innervation, which is important to know to understand the causes of pain and heaviness in the right hypochondrium. The peritoneum also covers the gallbladder and intestinal loops.
Types of pain or heaviness in the right hypochondrium
The pain in the right hypochondrium can be acute, sometimes “dagger-like”, which makes you think about a serious illness. This pain is characteristic of hepatic colic and is often accompanied by nausea, vomiting, increased sweating, increased heart rate and a drop in blood pressure.
In chronic diseases and the gradual development of acute diseases, the pain is often dull, bursting in nature, or is described by the patient as “heaviness, discomfort” in the area of the right hypochondrium.
Pain syndrome can be spontaneous, or it can be provoked by food intake, alcohol, physical activity, change in body position, etc.
Possible causes of pain or heaviness in the right hypochondrium
There is only one mechanism for the development of pain: stimulation of pain receptors. As mentioned above, the peritoneum has good innervation. Also, a large number of nerve endings are localized in the wall of hollow organs (intestines, gall bladder). Therefore, inflammatory processes in these organs naturally manifest themselves as pain.
Pain also occurs when the liver capsule is stretched. This can occur due to an increase in the volume of the organ (which in most cases is associated with tissue swelling), due to the accumulation of any fluid (most often blood) under the capsule (with a traumatic rupture of the liver), or damage to the capsule.
Unpleasant sensations in the area of the right hypochondrium are caused by excessive distension of the intestinal loops by intestinal contents or gases. In addition, since the organs of the chest are located close to the right hypochondrium, in case of development of pleurisy (inflammation of the pleura), the pain syndrome can also be localized in the right hypochondrium and imitate diseases of the abdominal organs.
Diseases that cause pain or heaviness in the right hypochondrium
Among acute diseases accompanied by pain in the right hypochondrium, it is worth mentioning first of all those that require emergency surgical intervention.
These include
acute calculous cholecystitis
and
renal colic
.
Both conditions are a consequence of cholelithiasis
. Inflammation of the gallbladder (cholecystitis) develops against the background of an already advanced process of stone formation or, conversely, is the cause of the formation of stones. With renal colic, a calculus (stone) becomes wedged into narrow segments of the biliary tract, which is accompanied by severe pain, impaired bile outflow, and in more severe cases – jaundice (yellowing of the sclera and skin).
Other diseases of the biliary tract, such as
biliary dyskinesia
,
chronic cholecystitis
, cause recurrent pain in the right hypochondrium, usually associated with an error in diet.
Another disease classified as an “acute abdomen” that can cause pain in the right hypochondrium is appendicitis.
(inflammation of the appendix).
Despite the fact that the classic position of the appendix corresponds to the right iliac region, an abnormal position of the appendix in the right hypochondrium is quite common, especially in children.
Overdistension of intestinal loops can develop as part of
intestinal obstruction
.
Swelling of the liver tissue is characteristic of hepatitis (inflammation of the liver parenchyma). Hepatitis can have a variety of origins: viral hepatitis A, B, C, etc., autoimmune, toxic, incl. alcoholic. These diseases are usually accompanied by pain, as well as weakness, nausea and vomiting, yellowing of the skin and sclera, change in the color of urine and feces.
Subcapsular hematomas of the liver (accumulation of blood between the liver tissue and its capsule), as well as ruptures of the liver capsule, are usually traumatic in nature.
Among the diseases of the chest that can cause pain in the right hypochondrium, it is worth mentioning pleuropneumonia (inflammation of the lung tissue and pleura), heart failure, intercostal neuralgia and herpes zoster. The latter is characterized by the appearance of blistering-type skin rashes, which are preceded by severe pain.
Which doctors should you contact if you experience pain or heaviness in the right hypochondrium?
If sudden, progressively increasing pain appears in the area of the right hypochondrium, you should contact a doctor to exclude acute surgical pathology. If the pain is not acute, the examination can begin at or. If necessary, the patient can get advice from a hepatologist (a specialist in liver diseases) and other specialized specialists.
Diagnostics and examinations for pain or heaviness in the right hypochondrium
After a detailed survey and comprehensive clinical examination, the doctor, as a rule, needs laboratory and instrumental confirmation of the diagnosis. For this purpose, the following studies are used:
- A clinical blood test with determination of the leukocyte formula, based on the results of which one can suspect the presence of an inflammatory process in the body and determine its severity.