Pain in the ribs or under the ribs often forces people to seek help from doctors of various specialties, since it imitates angina pectoris, pleural pain, and the consequences of injury. But often pain in the ribs is a consequence of problems with the spine.
Doctors at the Osteomed Clinic in St. Petersburg very often observe in their practice patients with pain in the ribs or intercostal neuralgia. Along with the pain syndrome, other manifestations are also identified in patients, which require detailed consideration and exclusion of other pathologies. To do this, you need to make an appointment with an experienced specialist and undergo a full examination.
Causes of rib pain
Pain on the left or right under the ribs can have a different nature, as well as the reasons that cause it. It can be strong and almost imperceptible, aching or sharp, occurring at certain moments or continuous. In almost every case, the cause of pain may be a disease that develops in the chest area.
At CELT you can get advice from a specialist algologist.
- Initial consultation – 4,000
- Initial consultation with the head of the Pain Clinic - 4,500
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Chest injuries
Chest injuries usually include fractures or bruises of the ribs. Fractures are characterized by ruptures of bone tissue and cartilaginous joints of one or more ribs. Depending on the injury, pain symptoms may be constant, aching, or acute and intense.
Bruises are characterized by mild pain, which is accompanied by swelling and the appearance of a hematoma in the area of injury. As a rule, pain symptoms disappear after seven to ten days. Fractures require mandatory diagnosis in order to exclude the possibility of injury to the soft tissues of the lung or other internal organs. Depending on the side of the injury, the pain can be localized on the right or left under the ribs or between them. Its intensity and duration depend on how severe the injury was.
Intercostal neuralgia
Pain between the ribs along the nerves can occur due to the following diseases:
- osteochondrosis of the thoracic spine;
- vertebral protrusion;
- intervertebral hernia.
Attacks in the form of shooting pain, similar to an electric shock, occur due to pinched or irritated nerve roots, and their appearance can be triggered by the following factors:
- hypothermia;
- penetration of infection;
- exercise stress;
- getting a back injury.
The pain becomes stronger with strong inhalations/exhalations or attempts to change body position.
Costochondritis
Costochondritis (or, as it is also called, Tietze's syndrome) is a disease in which thickening of the cartilage tissue of the ribs occurs, leading to their pain. Pain is not localized in one place and can spread to the entire sternum. They can be quite strong and appear brighter with sudden movements, deep inhalations/exhalations or coughing. Pain may be accompanied by:
- local edema;
- an increase in temperature in the area of the pathological process.
It appears suddenly and in its manifestations is comparable to an angina attack.
Angina pectoris
Angina is characterized by constant, pressing pain behind the sternum and sometimes between the ribs. It is localized in the retrosternal region and can spread to the left side of the neck, left arm and left side of the chest and may be accompanied by:
- heart rhythm disturbances;
- feeling of fear.
Other reasons
In addition, pain in the ribs can occur with the following diseases:
- malignant neoplasms (in particular, osteosarcoma of the ribs) are characterized by dull pain at the beginning of the disease, which becomes more and more pronounced as it develops;
- fibromyalgia - pain occurs when trying to raise your arms or turn your torso;
- pleurisy - pain symptoms manifest themselves with coughing and deep inhalations/exhalations;
- herpes zoster - characterized by intense pain under the ribs in the right or left side, which is accompanied by itching or burning.
Another reason is hypertonicity of the pectoral muscles, which occurs as a result of intense physical activity. The pain in this case increases and is localized in the intercostal space.
More about fibromyalgia
Diagnosis of the pathological condition
With osteochondrosis, pain in the ribs is periodic, sometimes worsening - usually in the evening and at night, and after a night's rest it subsides. Since the thoracic part of the spine is its most sedentary part, the pain is not as pronounced as with degenerative changes in other areas. It can intensify when breathing, coughing, sighing, but still the vagueness of its manifestations makes patients suspect that they have completely different diseases.
Therefore, it is very important to conduct a thorough differential diagnosis with other pathologies using various types of research:
- X-ray of the chest and lungs, heart, spine - in several projections;
- Computed tomography or nuclear magnetic resonance scanning of the mediastinal organs and the entire chest, including spinal structures;
- Electrocardiography;
- Electromyography;
- Echocardiography;
- Examination of the vital capacity of the lungs, listening to breathing, sputum analysis and other techniques to identify respiratory pathologies;
- Dopplerography of mediastinal vessels;
- General and biochemical tests, etc.
Step by step, in a clinical setting, it is necessary to exclude the most life-threatening conditions, while simultaneously alleviating the patient’s condition with symptomatic means.
Diagnosis of rib pain
If you are suffering from rib pain, contact the CELT Pain Clinic. We employ doctors of various specialties who will use the entire arsenal of diagnostic and treatment capabilities of our multidisciplinary clinic to solve your problems. Since there are many reasons that cause pain in the ribs, it is very important to correctly diagnose. This is the only way to correctly diagnose and prescribe treatment.
If you experience pain, contact one of our specialists:
- therapist;
- neurologist;
- traumatologist;
- pulmonologist;
- cardiologist.
Diagnosis in our Pain Clinic, in addition to examination by a doctor and medical history, may include:
- laboratory research methods;
- cardiography;
- computed tomography;
- magnetic resonance imaging.
Girdle pain in the abdomen and back
Synchronous pain in the back and abdomen is a dangerous symptom, as it occurs rarely. Pain in the abdomen and back at the same time can indicate diseases of the digestive system, for example, with a peptic ulcer, it appears after eating and is accompanied by nausea and vomiting. Unbearable pain in the abdomen and back is observed during exacerbation of pancreatitis; pain can spread to the area of the shoulder blades or heart.
Inflammation of the appendix can occur suddenly; the pathological process is indicated by symptoms such as nausea, a slight increase in temperature, diarrhea and pain that simultaneously appears in the abdomen and back. The danger of appendicitis is that when the appendix ruptures, peritonitis can occur, so only surgical treatment is performed.
Simultaneous pain in the back and abdomen in women is observed with gynecological diseases:
- ectopic pregnancy;
- development of fibroids;
- endometrial proliferation;
- twisting of the legs of a cyst or fibroids;
- spontaneous termination of pregnancy.
Pain syndrome is also observed in women after childbirth. The localization of pain in the back and abdomen is explained by the fact that during labor the muscles experience severe strain.
Patients seeking help at the Yusupov Hospital can be confident that specialists will accurately determine the cause of the pain syndrome and select the most effective and safe methods to eliminate the problem.
Treatment for rib pain
Treatment of rib pain is primarily aimed at eliminating the original cause that caused it. In case of severe pain, symptomatic therapy is used. It involves the use of painkillers and anti-inflammatory drugs. If we are talking about diseases for which thermal procedures are indicated, ointments with a warming effect are used, if the pain occurs due to muscle spasms - antispasmodics.
Physiotherapeutic procedures, massage and manual therapy can relieve pain in the ribs due to osteochondrosis and hypertonicity of the pectoral muscles. After the pain goes away, the patient may be prescribed physical therapy.
In case of chest injuries, the specialists of the CELT Pain Clinic will recommend a state of rest, in which not only the injured area, but also the patient as a whole should remain. This way, healing will be much faster. Can use a chest bandage that prevents sudden movements and deep inhalations and exhalations.
By contacting the CELT Pain Clinic, you can count on professional treatment that is sure to be successful!
Make an appointment through the application or by calling +7 +7 We work every day:
- Monday—Friday: 8.00—20.00
- Saturday: 8.00–18.00
- Sunday is a day off
The nearest metro and MCC stations to the clinic:
- Highway of Enthusiasts or Perovo
- Partisan
- Enthusiast Highway
Driving directions
Treatment of pain under the ribs
As a rule, in case of severe pain, the doctor uses various painkillers - they can be taken in the form of tablets or administered parenterally. Unbearable pain, which can also occur with intercostal neuralgia, is relieved by novocaine blockade in the area of compression of the nerve roots.
Each identified pathology has its own specific means for treatment. In vertebrology, chest pain caused by thoracic or cervicothoracic osteochondrosis has its own treatment features:
- Drug treatment includes analgesics, anti-inflammatory drugs, muscle relaxants, mild diuretics, drugs to improve peripheral circulation, chondroprotectors, vitamin and mineral complexes;
- Manual therapy, therapeutic exercises, physiotherapy act directly on the causative factor of the pathology, helping to release muscle-joint blocks, strengthen and develop the muscles around the spine, improve blood supply and trophism of the thoracic spine;
- Other types of treatment include prescribing rest during the acute period, a diet with a predominance of proteins, dairy products, vegetables, fruits with the exclusion of grapes, sorrel, coffee, carbonated drinks, sweets, and fatty foods from the diet. In addition, patients can use acupuncture, stone therapy and other methods in complex treatment.
Causes of pain under the ribs on both sides
The occurrence of unpleasant sensations under the ribs causes a lot of anxiety. Most often, the pain is aching and tends to radiate to the shoulder, back and other parts of the body. The clinic corresponds to various diseases of the gastrointestinal tract, spleen, liver, pancreas, gallbladder and its ducts.
If it hurts on the left side and radiates slightly to the right, then the cause is an enlarged spleen. And changes in size can be caused by diseases such as hemolytic anemia, acute infectious pathologies, autoimmune disorders, and septic conditions.
Discomfort or a burning sensation in the hypochondrium on both sides are signs that appear against the background of acute and chronic pathologies. The only difference is the severity, since in the acute course of the pathological process the pain syndrome is stronger.
Unpleasant sensations under the ribs have causes:
- Injury to the spleen, liver or other organs of the hepatobiliary tract.
- Formation of retroperitoneal hematoma.
- Gastrological type of myocardial infarction - there is pain on both sides of the ribs, and it hurts to breathe.
- Pathologies of the respiratory and urinary system.
- Osteochondrosis.
- Neurological disorders, etc.
The symptoms that accompany the pain syndrome will be of great help in the diagnostic process - cough, tightness in the chest, fever, increased body temperature, nausea, digestive dysfunction, etc.
High-quality treatment for pain in the back and under the ribs
Specialists at the Yusupov Hospital prescribe comprehensive treatment to eliminate the girdle pain under the ribs and in the back, as well as possible disorders. For some diseases, the patient needs emergency care, which specialists from the Yusupov Multidisciplinary Hospital are ready to provide. Round-the-clock operation of clinics allows diagnosis and hospitalization immediately after treatment.
Medicines are used to treat pain and its causes. Experts draw the attention of patients to the fact that painkillers and medications to relieve spasms have a temporary effect, in addition, they can complicate diagnosis. To eliminate pain, medications in the form of ointments, injections and tablets can be used.
If the patient’s health and life are in danger, surgeons at the Yusupov Hospital can perform surgical intervention. With this method of treatment, experts prefer minimally invasive techniques, after which recovery occurs faster.
Shingles in the back can appear due to insufficient physical activity; rheumatologists recommend leading an active lifestyle, observing personal hygiene rules, and also paying attention to the psychological state to prevent diseases. The Yusupov Hospital employs specialists who develop nutrition programs taking into account the client’s taste preferences.
At the Yusupov Hospital you can receive a wide range of medical services. Specialists pay attention to each patient and accompany him during the treatment process and make the necessary adjustments. If you are concerned about pain in the back area, do not delay visiting a specialist. An appointment with a general practitioner and other specialists can be made by calling the Yusupov Hospital.
Ways to identify the causes of girdle pain
Modern diagnostic methods make it possible to determine the cause of pain localized in the back and under the ribs. When patients who have experienced back pain come to the Yusupov Hospital, the existing symptoms are studied, after which an examination is prescribed.
The main diagnostic measures for back pain are:
- urine and blood tests. The Yusupov Hospital has its own laboratory, so the results are delivered to the attending physician in the shortest possible time;
- Ultrasound of internal organs to detect pathological changes;
- examination of substances discharged from the lungs to exclude diseases of the respiratory system;
- X-ray of the upper limbs and lungs;
- gastroscopy.
Patients may be referred for additional consultation to other specialists at the Yusupov Hospital, a cardiologist, a neurologist, or a rheumatologist. Self-medication for back pain can provoke serious consequences, since without special equipment and knowledge it is impossible to accurately identify the cause of the disease and its manifestations.
Diagnostics
During a physical examination, the doctor determines areas of hyperesthesia and performs superficial and deep palpation of the epigastric zone. The variety of causes of pain in the upper abdomen requires the gastroenterologist to use a whole range of laboratory and instrumental methods. The most informative tests for diagnosis are:
- Ultrasound of the abdominal cavity.
A simple and non-invasive method that detects signs of inflammatory processes, ulcerative defects and neoplasms in the epigastrium. Using ultrasound, the doctor evaluates the anatomical and functional features of the gastrointestinal tract, confirms or excludes typical diseases (calculous cholecystitis, pancreatitis, hernia). - X-ray methods.
A survey radiograph is not very informative, so radiography with oral contrast is used for examination. The study is necessary to detect ulcerative defects, pyloric stenosis, and diaphragmatic hernia. Using this method, the motor function of the gastrointestinal tract is assessed. - EFGDS.
The most informative method that allows you to visualize inflammatory and erosive changes in the walls of the esophagus, stomach and duodenum. EGD with biopsy is used for the differential diagnosis of ulcers, benign and malignant neoplasms of the gastric zone. - Laboratory methods
. The standard complex includes clinical blood and urine tests, coprogram, and glucose level measurement. To identify gastritis and peptic ulcers, a study of gastric juice and a rapid urease test for H. pylori are informative. To exclude chronic bleeding from the gastrointestinal tract, the Gregersen reaction is performed. - Additional Research
. To confirm the diagnosis of hyperacid gastritis, intragastric pH-metry is required. The functional abilities of the stomach are assessed using electrogastrography and radionuclide scintigraphy. A CT scan is performed for detailed visualization of the abdominal organs.
In case of sharp pain reminiscent of the symptoms of an “acute abdomen”, the patient must be examined by a surgeon. If extra-abdominal processes are suspected, consultations with specialized specialists are prescribed: cardiologist, pulmonologist, neurologist. Patients with suspected psychogenic causes of epigastric pain should be examined by a psychiatrist.
Gastroscopy
Treatment
Help before diagnosis
If epigastric pain suddenly appears, you should not take painkillers before visiting a doctor, so as not to blur the clinical picture. If a chronic gastrointestinal disease is diagnosed, to reduce pain it is necessary to adhere to dietary recommendations and avoid provoking factors. In case of food poisoning, you need to rinse your stomach and use sorbents.
Conservative therapy
Treatment begins with non-drug measures: diet therapy, normalization of the daily routine and abandonment of bad habits, elimination of risk factors for the underlying disease. Medicines are selected only after a full diagnosis and identification of the root cause of the pain syndrome. The main groups of medications that are prescribed for pain in the upper abdomen:
- Painkillers
. In the absence of medicinal gastropathy, medications from the group of non-steroidal anti-inflammatory drugs are used to relieve pain. They are supplemented with antispasmodics and prokinetics, which normalize gastrointestinal motility and eliminate discomfort. - Enzymes.
Preparations of gastric juice and digestive enzymes are used for pain caused by malabsorption and maldigestion. Their long-term use improves a person’s well-being and eliminates symptoms of nutritional deficiency. - Antisecretory agents
. Drugs that reduce the acidity of gastric secretions quickly eliminate pain caused by hyperacidity. They promote the healing of defects in the gastric mucosa. - Antibiotics
. Specific three- and four-component regimens with antibacterial drugs are indicated for the eradication of H. pylori. Antibiotics are recommended for bacterial pneumonia and pleurisy, exacerbation of cholecystitis.
