Left Rib Pain: Causes and When to Seek Help - Orthopedics

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Below the left costal margin?


I often lie in a prone position while using my phone, and recently I've experienced slow gastrointestinal motility.
Last night, I had difficulty having a bowel movement and felt nauseous.
After returning to bed in a prone position, I felt movement under my left rib cage; I could press it down with my hand, and it would bounce back, but it resolved after a while.
However, when I woke up in the morning, that area was painful.
Is this normal? If not, which specialist should I see for an examination? Thank you for your response, doctor!

Eric, 20~29 year old female. Ask Date: 2022/07/10

Dr. Shen Boquan reply Orthopedics


Hello, if there is no obvious injury, the most likely cause is overuse leading to inflammation of the soft tissues (such as muscles or tendons).
If you are experiencing slow gastrointestinal motility, it would be advisable to consult a gastroenterologist for an examination.
To reduce irritation, avoid sleeping on your stomach.
If the pain persists, appropriate use of anti-inflammatory and analgesic medications, either orally or topically, should help alleviate the discomfort.
If you are interested in rehabilitation therapy, you may consider seeing a physical medicine and rehabilitation specialist.
Wishing you good health.
Best regards, Shen Baiquan.

Reply Date: 2022/07/10

More Info


Left rib pain can be concerning, especially when it is associated with gastrointestinal symptoms such as constipation and nausea. Based on your description, it seems that your pain may be related to a combination of factors, including your posture and digestive issues.


Possible Causes of Left Rib Pain
1. Muscle Strain: Given that you often lie in a prone position while using your phone, it is possible that you have strained the muscles around your rib cage. This can lead to localized pain, especially if you are pressing down on your ribs or if your posture is poor.

2. Costochondritis: This is an inflammation of the cartilage that connects a rib to the sternum. It can cause sharp pain that may worsen with certain movements or positions, such as lying down.

3. Gastrointestinal Issues: Your symptoms of slow gastrointestinal motility, nausea, and difficulty with bowel movements could be contributing to your rib pain. Sometimes, gas or bloating can create pressure in the abdomen that radiates to the rib area.

4. Referred Pain: Pain from internal organs, such as the stomach or pancreas, can sometimes be felt in the rib area. If you are experiencing digestive issues, it is possible that the discomfort is referred pain from your gastrointestinal tract.

5. Rib Injury: Although you mentioned that you did not experience any trauma, it is still worth considering the possibility of a minor rib injury or inflammation.


When to Seek Help
If the pain persists or worsens, or if you experience additional symptoms such as fever, significant nausea, vomiting, or changes in bowel habits, it would be advisable to seek medical attention. Here are some guidelines on when to see a doctor:
- Persistent Pain: If the pain does not improve with rest or over-the-counter pain relief.

- Severe Symptoms: If you experience severe abdominal pain, fever, or vomiting.

- Breathing Difficulties: If you have trouble breathing or if the pain worsens with deep breaths.

- Changes in Bowel Habits: If you notice significant changes in your bowel habits, such as prolonged constipation or diarrhea.


Which Specialist to See
If you decide to seek medical help, you may want to start with a primary care physician who can evaluate your symptoms and determine if you need to see a specialist. Depending on the findings, you may be referred to:
- Gastroenterologist: If your symptoms are primarily gastrointestinal, a gastroenterologist can help assess and treat digestive issues.

- Orthopedic or Sports Medicine Specialist: If the pain is determined to be musculoskeletal, an orthopedic doctor or a sports medicine specialist can provide treatment options.

- Pulmonologist: If there are concerns about respiratory issues, a pulmonologist may be consulted.


Conclusion
In summary, while occasional rib pain can be normal, especially after certain activities or postures, persistent or severe pain should not be ignored. It is essential to monitor your symptoms and seek medical advice if necessary. Maintaining good posture, taking breaks from prolonged positions, and addressing any gastrointestinal issues may help alleviate your discomfort. Always consult a healthcare professional for personalized advice tailored to your specific situation.

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