Pain in the ribs or under the ribs often forces people to seek help from doctors of various specialties, since it imitates angina pectoris, pleural pain, and the consequences of injury. But often pain in the ribs is a consequence of problems with the spine.
Doctors at the Osteomed Clinic in St. Petersburg very often observe in their practice patients with pain in the ribs or intercostal neuralgia. Along with the pain syndrome, other manifestations are also identified in patients, which require detailed consideration and exclusion of other pathologies. To do this, you need to make an appointment with an experienced specialist and undergo a full examination.
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.
Diagnosis and treatment
If a person begins to get sick, regardless of the nature, intensity and location of discomfort in the ribs, it is necessary to consult a doctor.
The cause of pain is influenced by a person's age and gender. To reliably determine the pathological process, it is necessary to undergo diagnostics, including techniques for visualizing the structures of the chest. These include x-rays, computed tomography, magnetic resonance imaging, and ultrasound. The results are assessed using special photographs.
Based on the results of the diagnosis, conservative treatment or surgical intervention is prescribed to help relieve discomfort. You can be treated with medications at home. In this case, the patient must eat properly and follow medical prescriptions with discipline. Meals include light dishes so as not to increase the load on the intestines.
The invasive operation is performed in a specialized department. Then the patient remains in the hospital for another week for postoperative wounds to heal, to which an antiseptic bandage is applied. For rehabilitation, physical therapy is prescribed, including training with special exercises.
Features of pain in various ailments
In case of pain in the hypochondrium, which intensifies when pressed and is accompanied by an increase in temperature, you need to call an ambulance. Unpleasant sensations can be caused by inflammation of the gallbladder, diseases of the intestines, liver and kidneys. With these disorders, the pain is often reflected or “smeared,” which may make it seem as if its source is the ribs. With Tietze syndrome, a non-infectious inflammatory process occurs in the costal cartilages. It is characterized by pain that increases with pressure or inhalation. Another dangerous condition, fibromyalgia, is accompanied by damage to soft tissues, which causes severe pain when touched and pressed. This pathology is characterized by morning swelling of the limbs. Often, discomfort is caused by excessive muscle tension. This problem also requires medical consultation, because it can occur with severe pathologies of the spine or neuralgia. How to distinguish neuralgia from osteochondrosis:
- with osteochondrosis, the pain is constant, with neuralgia, unbearable sharp pain in the ribs periodically occurs;
- Osteochondrosis is characterized by overstrain of the back muscles;
- in the case of neuralgia, pain intensifies with pressure.
Other signs may indicate that pain in the costal region is caused by pathologies of the spine:
- frequent dizziness;
- decreased back mobility;
- impaired sensitivity of the limbs;
- a feeling of “current” in the body when moving;
- crunching, crackling when turning and tilting the body;
- numbness in the chest, back, buttocks, arms;
- pressure surges.
The cause of pain in the ribs may also lie in spinal deformation. With lordosis, kyphosis and scoliosis, the entire “axis” of the body is disrupted, which causes internal organs and joints to shift, the static load to be incorrectly distributed, and constant muscle tension occurs. What you can do before seeing a doctor if your ribs hurt:
- take a pain reliever;
- wear loose clothing that does not compress the chest;
- lie down;
- try to breathe slowly and smoothly.
Chronic liver diseases in humans
Chronic liver pathologies under the influence of factors - poor nutrition, violation of doctor's recommendations, pregnancy, etc. tend to worsen, which leads to the appearance of a characteristic clinic.
Chronic hepatitis
This is inflammation in the liver, which leads to fibrotic transformations and necrotic changes in cells and tissues, while there is no disruption of the structure of the lobules. Signs of the disease are determined by the degree of damage to the gland and the type of hepatitis.
As the disease progresses, symptoms appear:
- Increased gas formation.
- Decreased appetite.
- Sleep disturbance.
- Headache.
- Loss of body weight.
- Jaundice.
- Periodic pain in the right side.
- Pain on the left side due to the enlargement of the spleen.
- Skin itching.
Based on palpation, the doctor diagnoses diffuse hepatomegaly or an increase in only one lobe, increased liver density.
Fatty degeneration
Fatty liver is an independent syndrome or a secondary one, as a result of which lipid compounds accumulate in the liver tissues.
According to statistics, the disease is most often diagnosed in obese women. In 60-70% of pictures there are no symptoms.
Obvious symptoms of disease progression:
- Abdominal discomfort.
- Aching pain in the right side (mild).
- Hepatomegaly, when touching the right side it hurts.
In some cases, fatty liver is accompanied by dyspeptic disorders and jaundice.
Cirrhotic lesion
Cirrhosis is a disease in which full-fledged liver tissue degenerates into fibrous connective structures. The severity of the clinic is based on the degree of damage to the gland and the activity of cirrhotic processes. At the initial stage, manifestations are minimal, there is no pain.
Over time, discomfort appears under the ribs, digestion is disrupted, and the temperature increases to the level of low-grade fever. As the pain progresses, it intensifies and radiates to different parts of the abdomen and back; jaundice is observed, characteristic signs are redness of the palms, transformation of the nail plates, spider veins on the body.
Tumor neoplasms
Neoplasms of benign (cysts, hemangiomas) and malignant nature (primary, secondary cancer) in the liver do not show symptoms in the initial stages. As the tumor grows, the capsule stretches, which leads to pain.
It can be different - the pain is dull, aching, bursting, sharp. Localization is the right side, irradiation is to the stomach, to the right side under the ribs, to the back, shoulder blade and shoulder. Painful sensations initially appear periodically, but over time they become constant.
Diagnosis for rib pain
Attempts at self-medication can lead to serious consequences, including death. Remember: the sooner you receive medical advice and begin treatment, the lower the price of treatment and the higher its effectiveness. You can contact for help:
- therapist;
- phthisiatrician (if there is a cough, hemoptysis, difficulty breathing, suffocation);
- neurologist, orthopedist (for numbness in the hands, crunching when moving, back pain);
- traumatologist (for bruises, falls and other injuries).
To make a diagnosis, the doctor needs not only a survey of the patient and his examination, but also data from laboratory tests and instrumental studies:
- ECG;
- radiography;
- MRI, CT;
- blood and urine tests;
- and other types of examination.
Girdle pain in the abdomen and back
Synchronous pain in the back and abdomen is a dangerous symptom, as it occurs rarely. Pain in the abdomen and back at the same time can indicate diseases of the digestive system, for example, with a peptic ulcer, it appears after eating and is accompanied by nausea and vomiting. Unbearable pain in the abdomen and back is observed during exacerbation of pancreatitis; pain can spread to the area of the shoulder blades or heart.
Inflammation of the appendix can occur suddenly; the pathological process is indicated by symptoms such as nausea, a slight increase in temperature, diarrhea and pain that simultaneously appears in the abdomen and back. The danger of appendicitis is that when the appendix ruptures, peritonitis can occur, so only surgical treatment is performed.
Simultaneous pain in the back and abdomen in women is observed with gynecological diseases:
- ectopic pregnancy;
- development of fibroids;
- endometrial proliferation;
- twisting of the legs of a cyst or fibroids;
- spontaneous termination of pregnancy.
Pain syndrome is also observed in women after childbirth. The localization of pain in the back and abdomen is explained by the fact that during labor the muscles experience severe strain.
Patients seeking help at the Yusupov Hospital can be confident that specialists will accurately determine the cause of the pain syndrome and select the most effective and safe methods to eliminate the problem.
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.
Features of symptoms
Depending on the location of the pain, we can assume its cause.
To suspect the cause and find out why the ribs hurt on both sides, front or back, you need to pay attention to several clinical features:
- It hurts when pressed - a sign of a direct pathological process in the ribs or their post-traumatic damage. Discomfort is more pronounced in the center of the injury.
- Discomfort appears during body turns, movements, walking or running - a sign of the probable development of a pathological process in the structures of the musculoskeletal system of the chest.
- Localization of pain in the middle of the chest in front of the costal arch, which includes cartilage, is a symptom of the development of chondritis or arthrosis.
- Soreness of the skin on the ribs in the form of a burning sensation, which is accompanied by itching and occurs with shingles.
- The appearance or intensification of discomfort after sleep is a specific sign of an autoimmune process. At the same time, the stiffness of movements is disturbing, there is a feeling that the hoop at the bottom of the ribs is beginning to “hug and squeeze”.
- Sharp, intense pain that persists for a long period of time and is not relieved by non-steroidal anti-inflammatory drugs indicates a possible oncological process. Aching, dull pain indicates a chronic pathology of the structures of the musculoskeletal system.
- The pain is more pronounced at the bottom and on the right, which often happens with pathology of internal organs, including the liver, bile ducts, and stomach. At the same time, there is a relationship between discomfort and food intake.
- Pain appears at the top - damage to the lungs with the spread of the pathological process to the lung tissue.
- Discomfort is localized in the front on both sides - there is a high probability of damage to the heart or respiratory system. When pain is localized in the back, spinal pathology occurs.
- Tingling – can occur mainly with the development of aseptic inflammation of the peripheral nerves and pleura.
Based on the characteristics of clinical manifestations, the nature of the pathology can be suspected. To reliably determine the cause, it is necessary to visualize the structures.
Diagnostics
The first stage of diagnosis is palpation of the abdomen.
If pain of this nature occurs, you should consult a therapist. He will conduct an initial examination and, if necessary, refer you to another highly specialized specialist - a gastroenterologist, cardiologist, or surgeon. To make an accurate diagnosis, the patient is prescribed a number of studies:
- general and biochemical blood test;
- PCR diagnostics of infectious diseases;
- general urine analysis;
- stool examination to determine the effectiveness of the functioning of the gastrointestinal tract.
If necessary, ultrasound and endoscopic diagnostics of the digestive organs and ECG are prescribed. In false cases, the doctor issues a referral for an MRI or CT scan.
Treatment
For treatment, in addition to analgesics, antiviral agents are used to eliminate the cause of the disease.
As already mentioned, pain in the left hypochondrium is just a symptom and not an independent disease. When it first appears, a mandatory comprehensive examination is necessary to help identify the cause of the painful condition and prevent its occurrence in the future. Otherwise, the process may become chronic, threatening constant pain, which leads to apathy, depression and other psychological disorders.
Call our contact center at 8 (495) 230 03 09 and we will help you make an appointment with a specialist!