Right Side Chest Pain and Hard Lump Near Ribs - Surgery

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Pain below the chest near the ribs with a palpable lump?


Hello doctor, yesterday after waking up from my nap, I noticed pain in the lower right side of my chest, near the ribs.
I'm not sure if I might have strained a muscle or something similar.
Compared to the left side in the same area, when I pinch the skin on the right side, it hurts, and the pain extends down to my right waist when I pinch there as well, resembling a muscle inflammation sensation.
Last night, out of curiosity, I touched the painful area and found a small hard lump located near the right rib cage, close to the center of the chest; I didn't find anything on the left side.
This morning when I woke up, the pain was still there, but I couldn't feel the hard lump anymore.
Doctor, if it's necessary to seek medical attention, which specialty should I consult? P.S.
The right side also hurts when pinched, and I might be approaching my menstrual period (which is 10 days late).

Yin, 20~29 year old female. Ask Date: 2016/04/30

Dr. Li Zhonghuai reply Surgery


Hello! If you have felt a lump, it is advisable to see a breast surgeon to rule out any tumor issues.
Once that is addressed, musculoskeletal problems are generally easier to resolve.
However, since your menstrual period is approaching, going for an examination now may affect the interpretation of the findings.
It is recommended to check again yourself seven days after your period ends.
Avoid slouching, and try sleeping on a firmer mattress to see if that helps.
Take care! Changhua Hospital cares about you!

Reply Date: 2016/04/30

More Info


Hello! Thank you for sharing your symptoms and concerns regarding the right side chest pain and the hard lump near your ribs. Based on your description, it sounds like you may be experiencing a combination of musculoskeletal pain and possibly some inflammation in the area.
The pain you are feeling in the right side of your chest, particularly near the ribs, could be due to several factors. One common cause is a muscle strain or sprain, especially if you have engaged in any physical activity that may have overexerted your muscles. This can lead to localized pain that may feel worse when you press on the area or move in certain ways. The fact that you mentioned the pain radiates down to your right side and into your lower back could suggest that the muscles in that region are involved.

The presence of a hard lump that you felt near the ribs could be a few things. It might be a muscle knot or a localized area of inflammation, which can occur with muscle strain. Sometimes, the body reacts to injury by forming a small area of swelling or a lump, which can be tender to the touch. However, it’s important to note that lumps can also be caused by other conditions, such as cysts or even benign tumors, so it’s wise to keep an eye on it.

Given that you mentioned the pain persists and that you have a delayed menstrual cycle, it’s also worth considering that hormonal changes can sometimes lead to breast tenderness or pain in the chest area, especially if you are approaching your menstrual period. However, the hard lump you described is concerning enough to warrant further investigation.

If the pain continues or worsens, or if you notice any other concerning symptoms such as difficulty breathing, fever, or significant swelling, I would recommend seeking medical attention. In terms of which specialist to see, starting with a primary care physician would be a good idea. They can perform a physical examination and may refer you to a specialist, such as an orthopedic doctor or a rheumatologist, if they suspect a musculoskeletal issue. If they believe the lump requires further evaluation, they might refer you to a surgeon or a specialist in internal medicine.

In the meantime, here are a few self-care measures you can consider:
1. Rest: Avoid activities that exacerbate the pain. Give your body time to heal.

2. Ice Therapy: Applying ice to the painful area for 15-20 minutes several times a day can help reduce inflammation and numb the pain.

3. Over-the-Counter Pain Relief: Nonsteroidal anti-inflammatory drugs (NSAIDs) like ibuprofen can help alleviate pain and reduce inflammation.

4. Gentle Stretching: If you feel comfortable, gentle stretching of the chest and back muscles may help relieve tension.

Keep monitoring your symptoms, and if the hard lump reappears or if the pain does not improve, please seek medical attention. It’s always better to err on the side of caution when it comes to new or unexplained symptoms. Take care, and I hope you feel better soon!

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