Severe Right Side Pain Under Ribs and in the Back and Abdomen
See Your Doctor Immediately If You Are Having Severe Pain
The most common culprits of severe pain on the right side are gallbladder issues, which would be felt in the upper right quadrant of the abdomen, and appendicitis, which is felt in the lower right quadrant. Both of these warrant immediate medical attention. This article is not intended to diagnose or treat any problem and does not replace professional medical advice.
When to Be Concerned About Your Pain
Abdominal pain can be caused by many different issues. Some of them are very serious and some are not. So, how do you know if your pain is worth seeing a doctor about? According to Dr. Rob Lamberts, you should see a doctor if:
- Your pain wakes you up or stops you in your tracks — severe pain is always a cause for concern.
- It's lasted for 10 minutes or longer. This is more worrisome than intermittent pain.
- Your pain gets worse if you move or push on the tender area.
- You don't want to eat — this could be a sign that something is wrong with your digestive system.
- You're vomiting so much you can't keep anything down to replace the fluids that you've lost.
- You're having bloody bowel movements and abdominal pain.
You Probably Don't Need to Worry If
- The pain is mild.
- It doesn't get worse if you move or press on it.
- You still want to eat.
- You can function as normal.
That said, it's always better to see a doctor and find out it isn't serious than the opposite. Some groups are more susceptible to abdominal problems, like women (because of their more complicated abdominal anatomy), the elderly, and the immuno-suppressed. In these cases, you should be even more cautious.
Possible Causes of Pain on Your Right Side, Ribs, or Back
Location and Type of Pain
Some Other Symptoms
Treatment and What to Do
Dull pain that starts around the naval and becomes more severe as it moves to the lower right abdomen
Loss of appetite, nausea or vomiting, fever of 100-101
Surgery — this is a medical emergency
Gallbladder problems such as gallstones, biliary colic, or inflammation
Pain in the upper right abdomen that can radiate to shoulder or back — pain can vary in intensity
Nausea, vomiting, jaundice
Depends on the underlying condition — if pain is severe, see doctor immediately
Sharp stabbing pain below the ribs
Usually occurs during physical activity
They usually go away on their own
Severe pain located above the belly button
Abdominal pain that feels worse after eating, fever, nausea, tenderness when touching abdomen
Some cases go away by themselves. If you have persistent or severe pain, see a doctor.
Broken or bruised rib, usually caused by some kind of blunt trauma
Pain in the rib cage that will vary depending on the intensity of the injury
Hurts when you press it, when you breathe deeply, or when you twist
If there's a chance you broke a rib, see a doctor
Pulled abdominal muscle — usually the result of exercise or physical activity
Pain in the abdomen that worsens when you move, sudden spasms or cramping
Stiffness or weakness, difficulty walking, bending, or standing straight
Rest, compress, apply ice and heat, and use OTC pain-killers
Pain located under rib cage in upper right quadrant or in abdomen
Severity can vary. Some people have no symptoms. Others have poor appetite, nausea, vomiting, fever, and jaundice
See a doctor
Pain in the lower abdomen especially when you're bending over or lifting something
Weakness, pressure, or feeling of heaviness in abdomen, bulge in abdomen
Treatment varies; see a doctor
Diarrhea, mouth sores, fever and fatigue
See a doctor
Burning sensation or discomfort in upper abdomen and chest
Burping, regurgitation, abdominal discomfort
LIfestyle changes and antacids can usually help symptoms of acid reflux
Ectopic Pregnancy (only in women)
Sharp or stabbing pain in pelvis, either side of lower abdomen, or even shoulder or neck
Some people have no symptoms. Others have vaginal bleeding, gastrointestinal symptoms, or weakness, dizziness, or fainting
See a doctor
Common Causes of Pain on the Right Side, Under the Ribs, and in the Back
As mentioned above, there many possible reasons why you might be feeling severe pain on your right side, which is why a medical expert's diagnosis is essential to effectively treat it. Here are some of those conditions in more detail:
This condition is the inflammation of the appendix. The appendix is a four-inch long pouch of human tissue that is attached to the outer surface of the colon. It is located where the small and large intestines meet at the lower right side of the abdomen.
According to Healthline, when the appendix is inflamed, you will experience a dull pain that starts around the midsection and then moves to the lower right abdomen. At times, the infection sets off the appendix to rupture, causing severe pain on the area. In this case, surgery to remove the appendix should be done as soon as possible to prevent it from becoming fatal.
Symptoms of Appendicitis:
- Abdominal pain that starts with dull aching in the middle of the abdomen that gradually becomes more severe and becomes located in the lower right abdomen
- Some people will experience lower back or pelvic pain
- Mild fever
You should see a doctor immediately if you think you are having symptoms of appendicitis as the condition can be quite serious.
2. Cracked or Fractured Ribs
If you've experience some kind of blunt trauma to your ribs, either through a fall, through a sporting event, or a car accident, it's possible that you've injured your ribs. According to the Mayo Clinic, you should see a doctor if you have a very tender spot in the rib area or if you have trouble or pain with breathing after experiencing some kind of trauma.
3. Muscle Strain
Muscle strain can also cause right side and rib pain, especially in individuals who are working on their core muscles. Pain from muscle strain is not typically concentrated only under the ribcage but usually extends to other parts of the body as well. Additional symptoms include tenderness of the muscles in the abdomen.
Muscle strain is treatable at home using ice and compression as well as rest and over-the-counter pain medications.
4. Liver Problems
Pain on the right side of the body due to liver pain is less common than gallbladder issues, however it is possible that a condition like acute hepatitis might cause you to feel pain on the right side of your body under your rib cage (this is where the liver is located).
The liver itself does not have any nerve endings, but problems with it may cause pain in the surrounding organs and general discomfort in your abdomen. Damage to this organ may be caused by trauma or some health condition such as one of the hepatitis viruses, excessive alcohol consumption, or cirrhosis.
Symptoms of acute hepatitis will vary depending on what strain of virus is causing your symptoms, but they may include:
- Loss of appetite
- Joint pain
- Dark urine
Your doctor or a liver specialist will have to make the diagnosis to find out
5. Gallstones or Gallbladder Issues
The gallbladder is situated near the liver and can, if afflicted, trigger pain on the right side of the abdomen. There are many gallbladder issues that might cause discomfort but the most common is gallstones, which can get stuck along the passageway, causing swelling and pain and making it impossible for the gallbladder to perform its function properly.
Symptoms of gallbladder problems can include:
- Sudden and quickly increasing pain in upper right quadrant of abdomen or in the center of your abdomen, just below your breastbone
- Back pain between your shoulder blades
- Pain in the right shoulder
- Nausea or vomiting
- Tenderness in abdomen when it's touched
You should see a doctor if you're having some of these symptoms. It's possible you may need surgery.
According to HealthLine, a hernia happens when an organ pushes through the muscle or tissue that holds it in place. There are several different kinds of hernias that you can get, and some patients have reported symptoms localized on the right side of the body. You'll need to see a doctor in order to confirm that it's a hernia and they will give you instructions on what you should do next.
Symptoms of a hernia include (depending on the type):
- Bulge or lump where the hernia is (this is the most common symptom)
- Pain or discomfort in the area where the hernia is, especially when coughing, bending over, or lifting something heavy
- Weakness, pressure, or a feeling of heaviness in the abdomen
- Acid reflux
- Chest pain
- Difficulty swallowing
Some things can increase your risk for a hernia, including being pregnant, constipated, or overweight, lifting heavy weights, suddenly gaining weight, or persistently coughing or sneezing.
7. Crohn's Disease
This is a type of inflammatory bowel disease that affects the body's digestion of food — it is when the body mistakenly attacks "good" bacteria in the digestive tract. Any part of the gastrointestinal tract (which consists of the mouth, esophagus, stomach, small and large intestine, rectum and anus) may be inflamed when one is suffering from this condition.
The disease can be genetic or caused by a weakened immune system. Some experts suggest that when it comes to the colon, it can be triggered by bacteria along the walls which are not properly eradicated due to lack of fiber in the diet.
Common symptoms of this disease are:
- Abdominal cramps
- Loose bowel movements
- Loss of weight
- Fever and fatigue
- Mouth sores
Your doctor will have to diagnose you with Crohn's disease through a series of tests.
8. Heartburn or Acid Reflux
This takes place when the esophageal sphincter (the hole that connects the esophagus and the stomach) does not immediately close when food passes through it. Because the sphincter is open longer than usual, stomach acid will then puff up to the esophagus causing heartburn, sore throat, or pain in the upper chest.
- Burning feeling in chest behind breastbone after meals that lasts up to several hours
- Burning in throat
- Difficulty swallowing
9. Ectopic Pregnancy
Another possible cause of right side pain is ectopic pregnancy. This condition occurs when the mature zygote or embryo develops outside the mother's uterus inside the fallopian tube. This is usually diagnosed during the first eight weeks of pregnancy. The intensity of pain as well as symptoms vary patient by patient.
Symptoms of ectopic pregnancy include:
- Normal signs of pregnancy like missed period, sore breasts, fatigue, nausea, or increased urination
- Heavy or severe vaginal bleeding 6 - 8 weeks into pregnancy
- Belly or pelvic pain, usually 6-8 weeks after the missed period. This might worsen with movement or occur sharply on one side at first and then spread
- Pain with intercourse or during a pelvic exam
There are several treatment options available — your doctor will be able to help advise you.
If your pain is severe, getting worse, persistent, or tender to the touch, see your doctor as soon as you can. Do not wait for the pain to become more severe. Delaying medication or treatment could worsen the underlying condition if it is not identified at once.
Before You See Your Doctor
Prior to talking with your doctor, it’s important to understand your symptoms so you can give them as much information as possible.
For example, when exactly did the problem start, what kind of pain is it, and where is the center of the pain? It's also important to note if the pain worsens or lessens during particular activities or at particular times of day. For example, does it hurt when you bend over or get worse after you eat?
Knowing and verbalizing your personal observations about your pain–when, where, and what kind you're feeling–will help your doctor diagnose the problem. If possible, make a list of your symptoms that you can have on-hand at your appointment so you don't leave anything out.
At Your Doctor's Appointment
While at the doctor's, explain thoroughly the kind of pain that you are feeling and its exact location in your body. This will help your doctor ask better questions and determine the right tests you need.
If the pain came from an injury or accident, you might need an X-ray. If there are any atypical lumps or swellings, you might need an MRI
You may also need blood tests, urinalysis, or other kinds of tests.
Possible Tests Your Doctor May Order
To find out the underlying source of the pain, you will likely need a test of some kind. The following are some of the most common tests used to reach a diagnosis:
- Physical Examination. Your abdomen will be thoroughly looked at and you'll be asked a series of questions. The doctor will also ask you about other symptoms. It is common for doctors to feel the tender area to determine whether it is simply a strained muscle or if it is caused by a more serious condition.
- X-Ray, CAT Scan, Etc. Running these tests can help doctors assess the bones, organs, and other parts of the body. Any fractures or tumors can be easily seen, allowing doctors to make a diagnosis and offer treatment options immediately.
- Bloodwork. The doctor will take samples of your blood and submit it to a serious of tests.
- Magnetic Resonance Imaging (MRI). As mentioned above, this is used by doctors to have a more in-depth vision of the extent of the injury or condition. An MRI allows doctors to see soft body tissues that X-rays cannot.
Are You Facing Pain Under Ribs?
Treatment will depend on the underlying condition. Some of the most common treatments include:
- Medication. Drugs offered for rib pain can be pain killers or something to help treat the underlying illness, if applicable. Pain killers are often prescribed for trauma cases where the ribs are cracked, bruised, or fractured.
- Rest. For physical trauma causes, rest and relaxation are crucial to help the ribs heal. Strenuous movement only taxes the bones, possibly causing further damage to the ribs. Doctors may even attach a device that minimizes movement for the patient, therefore giving the ribs time to heal.
- Surgery. In some cases, surgery might be necessary. However, this is a worst case scenario and is only recommended by doctors if no other option is available. The good news is that most surgeries today end successfully.
I hope this article has been useful for you and that you know what step you need to take next. You may find reading some patient stories about pain in the right side helpful to learn from others who may have been through a similar experience as you.
- "Crohn's Disease - Topic Overview." (n.d.) WebMD. Retrieved March 15, 2017.
- DerSarkassian, Carol. Appendicitis. January 26, 2017. WebMD. Retrieved March 15, 2017.
- "Broken Ribs." (n.d.) Mayo Clinic. Retrieved March 15, 2017.
- "Ectopic Pregnancy." September 7, 2016. American Pregnancy Association. Retrieved March 15, 2017.
- "Gallstones." (n.d.) Mayo Clinic. Retrieved March 15, 2017.
- Wint, Carmella and Valencia Higuera. "Hernia." October 20, 2015. HealthLine. Retrieved March 15, 2017.
- Hiskey, Daven. "What Causes the Pain in Your Side You May Occasionally Feel While Running." June 7, 2017. Today I Found Out. Retrieved March 15th, 2017.
- "Heartburn." (n.d.) MayoClinic. Retrieved March 15, 2017.
- Lamberts, Rob, MD. "When to Worry About Abdominal Pain." August 30, 2016. QuickandDirtyTips.com. Retrieved March 15th, 2017.
- Lonneman, Kelsey. "Know the Difference: Abdominal Strain vs. Hernia." (n.d.) Braceability Blog. Retrieved March 15th, 2017.
- Ratini, Melinda DO, MS. "Symptoms of Appendicitis." March 9, 2015. WebMD. Retrieved March 15th, 2017.
- Rutherford, Anna E. MD, MPH. "Acute Viral Hepatitis." (n.d.) Merck Manual. Retrieved March 15, 2017.
- "Why Do My Kidneys Hurt? (Flank Pain)." April 21, 2015. UPMC Healthbeat. Retrieved March 15th, 2017.