Right Rib Pain: Causes and When to Seek Help - Pulmonology

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Hello,
Thank you for your detailed description of your symptoms. Based on what you've shared, it seems that you are experiencing localized pain in the right lower rib area, specifically beneath the breast, which is exacerbated by pressure but not by movements such as breathing, coughing, or laughing. This pattern of pain can indeed be perplexing, and it’s important to consider various potential causes.


Possible Causes of Right Rib Pain
1. Costochondritis: This is an inflammation of the cartilage that connects a rib to the sternum. It can cause localized pain that may worsen with pressure but is often not affected by breathing or movement. Given that you experience pain upon pressing the area, this could be a likely cause.

2. Intercostal Neuralgia: This condition involves irritation or injury to the nerves that run between the ribs. It can cause sharp or dull pain in the rib area, which may be sensitive to touch. However, it typically presents with more pronounced symptoms during movement or deep breathing.

3. Musculoskeletal Issues: Poor posture or muscle strain can lead to pain in the rib area. If you have been sitting or standing in a way that puts strain on your muscles, this could lead to discomfort that feels localized.

4. Organ-related Issues: While you mentioned that you had an ultrasound and MRI of the liver that showed no issues, it’s worth noting that pain in the rib area can sometimes be referred pain from internal organs. Conditions affecting the liver, gallbladder, or even the lungs can sometimes present as rib pain, although this is less likely given your previous imaging results.


When to Seek Help
Given that your symptoms have persisted for three to four months, it would be prudent to seek further evaluation. Here are some considerations:
- Consult a Primary Care Physician: They can perform a thorough physical examination and may refer you to a specialist if needed. They will assess for any musculoskeletal issues, costochondritis, or nerve-related pain.

- Consider a Rheumatologist: If costochondritis or another inflammatory condition is suspected, a rheumatologist may be able to provide further insights and treatment options.

- Physical Therapy: If your pain is related to posture or muscle strain, a physical therapist can help you with exercises and techniques to alleviate pain and improve posture.


Conclusion
While your symptoms may not indicate a serious underlying condition, it is essential to address persistent pain, especially if it affects your quality of life. Since you do not experience pain with movement or deep breathing, it may lean more towards a musculoskeletal issue rather than a serious organ-related problem. However, given the duration of your symptoms, I recommend consulting with a healthcare professional to ensure a comprehensive evaluation and appropriate management.

Take care, and I hope you find relief soon!