Rib Pain: Causes and Concerns for Family Medicine Patients

Pain beneath the rib cage?

Hello Doctor: This year, I started experiencing pain under my rib cage.
Around February, I felt a sensation of fever once, but since then, only the pain has persisted.
The pain does not last all day; it sometimes starts suddenly and then goes away after a few minutes.
Most of the time, it occurs more on the left side under the rib cage, but occasionally it is slightly to the right.
I would like to ask the doctor what might be causing this issue, as I am a bit worried it could be something serious.
In the past, I had issues with poor posture, and even experienced a mild herniated disc during high school.
However, I have been more mindful of my sitting posture lately, but the pain still occasionally occurs, which makes me a bit anxious.
I would appreciate your insights, thank you!

Miss Wang, 10~19 year old female. Ask Date: 2020/06/21

Dr. Ye Qianyu reply Family Medicine

Hello! First, are you referring to the lower edge of the ribs on the front of the chest or the back? There are many potential causes of thoracic pain, ranging from simple musculoskeletal inflammation, gastrointestinal issues, cardiac problems, spinal nerve compression, to even shingles.
Based on your description, it seems somewhat related to changes in posture, so it would be advisable to investigate musculoskeletal inflammation or spinal nerve compression.
I recommend returning to your previous healthcare facility for evaluation, as it would be quicker to identify the issue.

Reply Date: 2020/06/21

More Info

Rib pain can be a concerning symptom for many patients, and understanding its potential causes is crucial for effective management. Based on your description, it seems that you are experiencing intermittent pain in the lower rib area, particularly on the left side, with occasional discomfort on the right. This type of pain can arise from various sources, and it is essential to consider both musculoskeletal and internal organ-related issues.

One common cause of rib pain is musculoskeletal strain or injury. Poor posture, as you mentioned, can lead to muscle tension and discomfort in the rib area. Activities that involve repetitive movements, heavy lifting, or even prolonged sitting can contribute to muscle strain. Given your history of a mild herniated disc, it is possible that your spinal alignment and muscle balance may still be affected, leading to referred pain in the rib area.

Another potential cause of rib pain is costochondritis, an inflammation of the cartilage that connects the ribs to the sternum. This condition can cause sharp or aching pain, often exacerbated by certain movements or palpation of the affected area. Costochondritis is usually benign and can be managed with rest, anti-inflammatory medications, and physical therapy.

On the other hand, rib pain can also be associated with internal organ issues. For example, conditions affecting the lungs, such as pleuritis or pneumonia, can cause pain that may be felt in the rib area. Similarly, gastrointestinal issues, such as gastritis or gallbladder problems, can present as rib pain, particularly on the right side. Given your previous experience with fever, it is essential to consider whether there might be an underlying infection or inflammation that needs to be addressed.

Since your pain is intermittent and not persistent, it may suggest a less severe issue, but it is still important to monitor your symptoms. If you experience any additional symptoms, such as fever, shortness of breath, or significant changes in your overall health, it would be prudent to seek medical attention promptly.
In terms of management, here are some steps you can take:
1. Posture Correction: Continue to be mindful of your posture, especially when sitting for prolonged periods. Ergonomic adjustments to your workspace can help reduce strain on your back and ribcage.

2. Physical Therapy: Engaging in physical therapy can help strengthen the muscles around your ribcage and improve flexibility, which may alleviate pain.

3. Pain Management: Over-the-counter anti-inflammatory medications, such as ibuprofen or naproxen, can help reduce pain and inflammation. However, consult with a healthcare provider before starting any new medication.

4. Monitoring Symptoms: Keep a journal of your pain episodes, noting when they occur, their intensity, and any associated activities. This information can be helpful for your healthcare provider in determining the cause of your pain.

5. Consultation with a Healthcare Provider: If your symptoms persist or worsen, consider scheduling an appointment with a family medicine physician or a specialist, such as a rheumatologist or orthopedic doctor, for a thorough evaluation.

In conclusion, while rib pain can stem from various causes, many of them are manageable with appropriate care and lifestyle adjustments. It is essential to remain vigilant about your symptoms and seek medical advice if you have any concerns about your health. Remember, early intervention can often lead to better outcomes and peace of mind.

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