Severe Pain Under Right Rib Cage: Causes, Treatment, and Prevention

Severe pain occurs from the right rib area (below the breast) to the right side of the body?

Hello, last night I felt cold and unwell, and my temperature was slightly elevated at 38.5 degrees Celsius.
I did not take any medication, only drank water and wore thick clothing to induce sweating, and after two hours, I felt more comfortable and my fever subsided.
However, this morning I woke up due to severe pain in the right side of my chest (below the breast) extending to the right side of my body.
After eating a piece of bread, I took two painkillers, which provided some relief, but I still felt pain when touching the area or taking a deep breath.
I initially thought it was just temporary discomfort from poor sleeping posture, but after dinner, the severe pain returned.
While resting in bed, I experienced significant pain whether lying on my back or on my right side.
I would like to know what condition these symptoms might indicate, what the cause could be, how to treat it, and how to prevent it in the future.
Is there any relation to the fever I had the previous night? Thank you very much!

Max, 30~39 year old female. Ask Date: 2010/01/30

Dr. Yang Wenda reply Pulmonology

There are many causes of chest pain.
Since you are experiencing symptoms of fever and chills, it is possible that you have a lung infection (such as pneumonia or pleuritis with pleural effusion) or a cold combined with right-sided neuralgia.
A chest X-ray is necessary for diagnosis of a lung infection.
It is recommended that you visit a pulmonology clinic for further evaluation and treatment.
Best wishes!

Reply Date: 2010/01/30

More Info

Severe pain under the right rib cage can be caused by a variety of conditions, and understanding the underlying cause is crucial for effective treatment and prevention. Given your symptoms of fever, chills, and localized pain, there are several potential causes to consider.

Possible Causes
1. Musculoskeletal Issues: One of the most common causes of pain in the rib cage area is musculoskeletal strain. This can occur due to poor sleeping posture, heavy lifting, or sudden movements that strain the muscles or ligaments around the ribs. If you experienced discomfort after sleeping in an awkward position, this could be a contributing factor.

2. Costochondritis: This is an inflammation of the cartilage that connects a rib to the sternum. It can cause sharp pain that worsens with movement or deep breathing. Costochondritis is often benign but can be quite painful.

3. Pulmonary Issues: Conditions such as pneumonia, pleuritis (inflammation of the lining of the lungs), or even a pulmonary embolism can cause pain in the rib area, especially if it is accompanied by fever and difficulty breathing. Given your recent fever, it is important to rule out any respiratory infections.

4. Gallbladder Problems: Pain under the right rib cage can also be related to gallbladder issues, such as gallstones or cholecystitis (inflammation of the gallbladder). This pain is often accompanied by nausea or changes in digestion.

5. Liver Conditions: Liver inflammation (hepatitis) or other liver diseases can also manifest as pain in the right upper quadrant, particularly if there is associated fever or malaise.

6. Gastrointestinal Issues: Conditions such as gastritis, peptic ulcers, or even pancreatitis can cause referred pain to the rib cage area.

Treatment Options
1. Pain Management: Over-the-counter pain relievers such as ibuprofen or acetaminophen can help alleviate pain and reduce inflammation. However, it is important to follow the recommended dosages and consult a healthcare provider if pain persists.

2. Rest and Ice: If the pain is musculoskeletal, resting the affected area and applying ice can help reduce inflammation and provide relief.

3. Physical Therapy: If the pain is due to musculoskeletal strain, physical therapy may be beneficial to strengthen the surrounding muscles and improve posture.

4. Medical Evaluation: Given the presence of fever and severe pain, it is advisable to seek medical attention. A healthcare provider may perform a physical examination and order imaging studies (like an X-ray or ultrasound) to rule out serious conditions such as pneumonia or gallbladder disease.

5. Antibiotics: If an infection is suspected, such as pneumonia or a gallbladder infection, antibiotics may be necessary.

Prevention
1. Proper Posture: Maintaining good posture while sleeping and sitting can help prevent musculoskeletal pain. Consider using supportive pillows and mattresses.

2. Regular Exercise: Engaging in regular physical activity can strengthen the muscles around the rib cage and improve overall body mechanics.

3. Avoiding Heavy Lifting: Be cautious when lifting heavy objects, and use proper techniques to avoid strain.

4. Healthy Diet: A balanced diet can help prevent gastrointestinal issues that may lead to referred pain in the rib area.

5. Regular Check-ups: Regular medical check-ups can help monitor any underlying health conditions that may contribute to pain.

Conclusion
Your symptoms warrant further investigation, especially considering the fever and the severity of the pain. It is important to consult with a healthcare professional who can provide a thorough evaluation and appropriate treatment plan. Early diagnosis and intervention can lead to better outcomes and prevent complications.

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