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Severe Right Side Pain Under Ribs and in Back

Updated on April 25, 2016
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Trained in dentistry, Sree is currently studying lab sciences. She enjoys researching various health topics and writing about her findings.

Why Do My Ribs Hurt on the Right Side?

Pain is one of the body's natural responses to unpleasant or harmful stimulus. Pain is just the way a brain interprets information about something a body is experiencing, and it sometimes (but not always) indicates damage, injury, or illness.

Pain can be a symptom of a lot of things, depending on what kind of pain, when, and where it occurs. There are many possible reasons for pain under the right side of your ribs, and being able to pinpoint the origin of the pain makes it easier for medical professionals to diagnose the problem and recommend a solution.

But what exactly are the usual causes of severe right side pain under the ribs and in back? This article will help you get an accurate diagnosis.

Severe Right Side Pain Under Ribs

There are so many people right now who are experiencing severe pain under their ribs that also affects their backs. And there are also a lot of different possible reasons why this severe right side pain under ribs occurs. Some of the most common causes will be discussed in a separate section below.

But before that, it is important to know that apart from the typical blunt trauma or gastrointestinal ailments, right side pain under ribs can also be ascribed to a few not so common medical syndromes that affect that particular area of the body. Because of this, it is highly recommended that you consult with your healthcare professional before applying any treatment. You have to target the root cause of your pain to effectively take it away.

Right Rib Pain: Your Personal Observation

Prior to talking with your doctor, it’s important to first examine your own situation. The medical professional will likely ask pertinent questions that must be answered as fully and accurately as possible. For example, when exactly did the problem start, what kind of pain is it, and where is the center of the pain? Another important question to ask yourself is if the pain worsens or lessens during particular activities or if it abates at a certain time of day.

Knowing and verbalizing your personal observations about your pain–when, where, and what kind you're feeling–will help your doctor diagnose the problem.

What causes rib pain: it's not hard to damage a rib.
What causes rib pain: it's not hard to damage a rib.

Appointment With Your Doctor

If it is possible, before your appointment at the doctor's office, prepare a list of the common symptoms that you are experiencing with your right side pain under ribs condition. This is quite useful to not forget or miss anything that your physician needs to know about your complaint.

Explain thoroughly the kind of pain you are feeling and its exact location in your body. By doing so, your doctor would know what kinds of tests you have to undergo for proper diagnosis. If the pain came from an injury or accident, then an X-ray may have to be performed. If there are any atypical lump or swelling seen in the X-ray, then a more extensive procedure might be needed, such as a magnetic resonance imaging or MRI. An MRI will provide a more comprehensive view of your injury.

Meanwhile, if the right side pain under ribs has been recurring, a bone scan may be recommended by your doctor. This usually done to check if the pain is caused by bone cancer, which is actually very rare to happen.

There are many other probable tests that the doctor may order depending on how you articulate your problem.

Common Causes of Rib Pain

As mentioned above, there are so many possible reasons why severe right side pain under ribs is felt, which is why a medical expert's diagnosis is essential to effectively treat it. Some of these causes are discussed in detail below.

Another word of caution, though. While feeling a sudden sharp right side pain under ribs when breathing or shifting in a certain posture may not be typical a cause of concern, it is much better to seek your doctor's help as soon as possible. Do not wait for the pain to become more severe and intolerable before consulting. Delaying medication or treatment to this part of the body could worsen the underlying condition if not identified at once.

Medical professionals will consider many possible causes of rib pain during diagnosis:

  • Cracked or Fractured Ribs. It's not hard to damage a rib. People have cracked or broken ribs doing simple things like coughing or leaning over the arm of a chair to retrieve something. Everyday physical activity is sometimes enough to bruise or fracture a rib. The severity of the ache varies depending on the extent of the damage.
  • Osteoporosis. Osteoporosis is a medical condition, common in older individuals, in which bones become brittle, thin, and fragile, typically as a result of hormonal changes or calcium or vitamin D deficiency. Osteoporosis affects bones in general and not in just one specific area; although it typically becomes evident along the spine, symptoms in the rib area are not unheard of.
  • Muscle Strain. Muscle strain can also cause rib pain, especially in individuals who are working on their core muscles. However, muscle strain is not typically concentrated only under the ribcage but extends to other parts of the body as well. Additional symptoms include tenderness of the muscles in the abdomen.
  • Intercostal Strain. Intercostal muscles are several groups of muscles that run between the ribs and are responsible for the process of respiration. Pain is commonly experienced when these muscles become stressed or strained. A rapid twisting motion of the chest can also lead to soreness which can be treated with medication and rest.
  • Liver Problems. Any kind of problem with the liver can cause pain. Damage to this organ may be caused by trauma or some health condition such as Hepatitis A or B, excessive alcohol consumption, or cirrhosis. Additional symptoms may be evident, depending on the underlying condition.
  • Gallstones or Gallbladder Issues. The gallbladder is situated near the liver and can, if afflicted, trigger right ribcage pain. 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.
  • Hernia. Sometimes, right side pain under ribs is caused by something as simple as a hernia. When we eat, food goes through the esophagus, then past the hiatal, all the way down to the stomach. The passing across the hiatal opening is vital, though. The hiatal must not open too wide or a piece of the stomach may stick out from it and into the rib cage. This protrusion will then cause pain underneath the ribs. It can also cause heartburn if the hernia occurs higher.
  • Crohn's Disease. This is a type of inflammatory bowel disease that affects the body's digestion of food. 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 is triggered by bacteria along the walls which are not properly eradicated due to lack of fiber in the diet. As you may expect, the common symptoms of this disease are puking, abdominal cramps, loose bowel movement, loss of weight, lethargy, and right side pain under ribs.
  • Appendicitis. 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 small and large intestines meet at the lower right side of the abdomen. If the appendix is inflamed, then right side pain under ribs is experienced. 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.
  • Diabetic Ketoacidosis. This is a fatal condition that can be experienced by diabetes patients, most often by Type 1 diabetes sufferers. Basically, it occurs when there is a lack of insulin in the body. Without enough insulin, the body's system reacts by releasing high levels of acidic ketone (blood acid) molecules that causes the disease. The symptoms include blurry eyesight, extreme thirst, frequent urination, shortness of breath, puking, lethargy, dryness of skin, and a searing pain under the right side of the lower ribs.
  • Gastroesophageal reflux disease. Also referred to as acid reflux. It 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 under the right side of the rib cage.
  • Typhoid Fever. This is a bacterial disease caused by Salmonella typhi, which is widespread among developing countries. It is a highly contagious disease that may also be contracted by ingesting food or beverage that are infected. A person who has typhoid fever can contaminate the water system that he is using and infect those that are living closely. Typical symptoms of this disease is high fever, sore throat, exhaustion, rashes, headache, and pain under the right lower side of the rib cage.
  • Costochondritis. This condition is the momentary soreness of the costal cartilage. This cartilage attaches the ribs to the sternum. Typical causes of this disorder is viral infection or severe blow to the affected area. The aching and discomfort felt due to costochondritis is similar to that of a heart attack, which can spread out to the lower rib cage.
  • Ectopic Pregnancy. Another possible cause of right side pain under ribs is ectopic pregnancy. This condition occurs when the mature zygote or embryo develops outside the mother's uterus, which most commonly stayed inside the fallopian tube. This is usually diagnosed during the first eight weeks of pregnancy. The intensity of pain is different from each patient. Usually, the emotional pain of losing the baby is more tragic than the actual physical pain.

Of course, those are just few of the known causes of right rib pain that extends into the back. Your doctor should be able to offer more insight regarding your condition.

The possible underlying causes of rib pain.
The possible underlying causes of rib pain.

Diagnosis for Right Rib Pain

To find out the underlying source of the pain, doctors will probably perform tests. The following are some of the most common tests used to reach a diagnosis:

  • Physical Examination. The rib area 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 and judge whether it is simply a strained muscle or 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. By checking the level of chemicals in the blood, doctors can make a better diagnosis.
  • 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. Harnessing this method would allow physicians to make a much more accurate diagnosis if they cannot clearly perceive it using X-Rays or CT Scans.
  • Bone Scan. This is a special test used to find cancer in the bones. Sometimes, severe pain under the ribs are caused by bone cancer. When doctors suspect that a patient has one, this method is utilized to confirm it. During the procedure, a radioactive element (called a tracer) is injected to the patient. It then passes through the veins until it reaches the bones. A specialized camera will then take photos of the tracer inside the bones. Areas that have not taken up enough of the tracer will appear dark in the photos, which means that something is wrong with that area of the bone.

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Severe Right Side Pain Under Ribs and in Back
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Treatment for Right Rib Pain

Treatment for pain under the right side of the ribs and in back depends on the underlying condition. Since the pain is typically a symptom, the doctor will need to determine the source of the problem and recommend treatment. 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 only recommended by doctors if no other option is available. The good news is that most surgeries today end successfully, thanks to the miracles of modern science.
  • Treatment of the Root Cause. As discussed above, there are many possible underlying causes of right side rib pain. If a person is suffering from a liver problem, osteoporosis, Crohn’s disease, diabetic ketoacidosis, acid influx, and all the other medical disorders mentioned above, then this particular condition must be treated in order to complete take away the rib problem. Without curing the root cause, the pain will just recur and may even get worse as the original disease deteriorates as well.

Pain Under Right Ribs: Should I Worry?

Severe right side pain under ribs and in back may lessen after a few minutes, but this doesn’t mean that it won’t come back. Any signs of pain–especially after a trauma–should be described to the doctor immediately. If you have any underlying health conditions such as a liver or gallbladder problem, finding out as soon as possible will be in your best interest.

Pain along the rib cage is not something that you should shrug off. Regardless of how mild or infrequent the pain is, its mere presence should be a cause for concern. Remember to take careful note of any other symptoms that might be present and report them all to the medical professional.

First Aid Tips for Right Side Rib Pain

You never know the exact cause of right side pain under ribs the first time you feel it. Because of that, great care should be given to it as first aid treatment before going to the doctor. Here are some practical tips on how to do that.

  • Stay still as much as possible. Moving around may make your rib injury worse. If you suffered a fall or an accident that directly damaged your ribs, then you are more certain of what makes your ribs hurt. Broken ribs will feel inflamed when you run your hands over them.
  • Ice the hurting area on the way to the doctor. If the pain is too severe, taking an over the counter painkiller would be okay. Do not wrap your ribcage with anything as it will impede your breathing, which is the worst thing that could happen.


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    • mary 22 months ago

      I had H-phylori took all my medication then he order more labs to make sure it was all gone and it was negative after 7 month the pain is back my question does the come later?

    • smithey 19 months ago

      I had a bad pain in my right side of my back half way up, I suffered it for two before realizing that its not going to subside on its own , I had a similar pain when i worked in construction as a teenager but being younger it went away on its own.I believe its a damaged muscle which maybe affecting a nerve.I am 60 now so my recovery is much slower , so i decided to take action I got myself some organic comfrey ointment its must be organic or you will be wasting your time and money. The pain started to subside in about 3 days ,pain totally gone in two weeks. I used it for a further week and now right as rain. I suggest you see your doctor because a pain in your back could be caused by many things good luck

    • fathima 15 months ago

      Pain at right side of my back below the scapula

    • scott 8 months ago

      thx Smithey

    • deb stephens 4 months ago

      having severe pain lower right ribs shooting down to right pelvis area

    • Cynthia 7 weeks ago

      I had a pain in my right rib from the 24th tell the 28 then it moved to my back right below my shoulder blades any ideas?

    • celia 5 weeks ago

      Hi I have had a sharp pain in my right side of back under my rib cage the pain gets worse when I take a deep breath does anybody have an idea what it might be.thanks celia

    • Zsa Zsa Crump 5 days ago

      I fell off my couch twice,my nephews wife took me to ER two days ago they have been hurting for weeks ,not getting any better,when I inhale,move reach ,turn, step one of my feet to hard,,cough,I can't hardly take it! I'm disabled anyhow and it looks like to me it would be getting a little bit better ,but,No I'm going on steroids tomorrow,I just don't think it's gonna help! I think it should've already got better at least a little ! I broke three ribs years ago and they didn't hurt this bad,help please! Any ideas?

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