Pain in left rib cage and back

Chronic costochondritis (chest wall syndrome)

Costochondritis is an inflammation of the cartilage that connects a rib to the breastbone. Pain caused by costochondritis may mimic that of a heart attack or other heart conditions.

Rarity: Uncommon

Top Symptoms: rib pain, chest pain, chest pain that is worse when breathing, rib pain when moving, pain when pressing on the chest

Urgency: Phone call or in-person visit

Viral pneumonia

Viral pneumonia, also called "viral walking pneumonia," is an infection of the lung tissue with influenza ("flu") or other viruses.

These viruses spread through the air when an infected person coughs or sneezes.

Those with weakened immune systems are most susceptible, such as young children, the elderly, and anyone receiving chemotherapy or organ transplant medications.

Symptoms may be mild at first. Most common are cough showing mucus or blood; high fever with shaking chills; shortness of breath; headache; fatigue; and sharp chest pain on deep breathing or coughing.

Medical care is needed right away. If not treated, viral pneumonia can lead to respiratory and organ failure.

Diagnosis is made through chest x-ray. A blood draw or nasal swab may be done for further testing.

Antibiotics do not work against viruses and will not help viral pneumonia. Treatment involves antiviral drugs, corticosteroids, oxygen, pain/fever reducers such as ibuprofen, and fluids. IV (intravenous) fluids may be needed to prevent dehydration.

Prevention consists of flu shots as well as frequent and thorough handwashing.

Rarity: Uncommon

Top Symptoms: fatigue, headache, cough, shortness of breath, loss of appetite

Urgency: Primary care doctor

Rib bruise or fracture

Broken or bruised ribs are usually caused by a fall or a blow to the chest, although occasionally this can happen due to severe coughing. With a broken rib, the pain is worse when bending and twisting the body.

You can safely treat this condition on your own. Breathing will be painful, but it is important to avoid taking shallow breaths or not coughing to avoid the pain as this can raise your risk of developing a chest infection. You can look after yourself by taking over-the-counter pain medication, applying an ice pack to the chest, resting periodically (especially if your work involves a lot of physical labor), and holding a pillow against the chest if you needs to cough.

Rarity: Uncommon

Top Symptoms: rib pain that gets worse when breathing, coughing, sneezing, or laughing, rib pain from an injury, sports injury, rib pain on one side, injury from a common fall

Symptoms that always occur with rib bruise or fracture: rib pain from an injury

Urgency: Primary care doctor

Normal occurence of chest pain

Sometimes chest pain is not a sign of a heart attack. The following symptoms are usually typical of more benign conditions:

If the pain is brief, like a short shock, and subsides right away, it is most likely from an injury such as a broken rib or pulled muscle in the chest.

Sharp pain in the chest that improves with exercise is probably from acid reflux or a similar condition, and will be eased with antacids.

A small, sharp pain anywhere in the chest that actually feels worse on breathing is probably from a lung inflammation such as pneumonia or asthma.

An actual heart attack involves intense, radiating chest pain that lasts for several minutes; worsens with activity; and is accompanied by nausea, shortness of breath, dizziness, and pain in the arms, back, or jaw. Take the patient to the emergency room or call 9-1-1.

If there is any question as to whether the symptoms are serious or not, a medical provider should be seen as soon as possible.

Rarity: Common

Top Symptoms: chest pain, rib pain

Symptoms that always occur with normal occurrence of chest pain: chest pain

Symptoms that never occur with normal occurrence of chest pain: being severely ill, shortness of breath, fainting, severe chest pain, crushing chest pain, excessive sweating, nausea or vomiting

Urgency: Phone call or in-person visit

Chest bruise

A bruise is the damage of the blood vessels that return blood to the heart (the capillaries and veins), which causes pooling of the blood. This explains the blue/purple color of most bruises. Bruises of the chest are common, given how exposed this area of the body is.

You can treat this at home with rest (exercise as tolerated) and ice (10-20 minutes at a time).

Rarity: Common

Top Symptoms: rib pain, constant rib pain, rib pain from an injury, recent chest injury, bruised chest area

Symptoms that always occur with chest bruise: rib pain from an injury, recent chest injury, constant rib pain

Urgency: Self-treatment

Bronchitis

Bronchitis is an inflammation of the bronchial tubes, the tiny airways in the lungs.

Acute bronchitis, or "chest cold," comes on suddenly and is caused by the same virus that causes the flu or the common cold. Chronic lasts at least three months and recurs over two years. It is caused by cigarette smoking and/or exposure to other pollutants.

Other risk factors are weakened immune system and gastric reflux (heartburn.)

Symptoms include cough with clear, greenish, or yellowish mucus; fatigue; mild headache; body aches; shortness of breath; low-grade fever; chest discomfort.

Acute bronchitis can lead to pneumonia. Chronic bronchitis is a form of chronic obstructive pulmonary disease (COPD) and requires medical treatment.

Diagnosis is made with chest x-ray and sputum test.

Acute bronchitis lasts 7 to 10 days and needs good supportive care – rest, fluids, and over-the-counter pain relievers. Antibiotics do not work against viral illness.

Chronic bronchitis is treated with lifestyle changes – especially smoking cessation – and an inhaler or other lung medication.

Flu shots, frequent handwashing, and not smoking are the best prevention.

Bacterial pneumonia

Bacterial pneumonia is an infection of the lungs caused by one of several different bacteria, often Streptococcus pneumoniae. Pneumonia is often contracted in hospitals or nursing homes.

Symptoms include fatigue, fever, chills, painful and difficult breathing, and cough that brings up mucus. Elderly patients may have low body temperature and confusion.

Pneumonia can be a medical emergency for very young children or those over age 65, as well as anyone with a weakened immune system or a chronic heart or lung condition.

Complications may include organ failure and respiratory failure. Take the patient to the emergency room or call 9-1-1.

Diagnosis is made through blood tests and chest x-ray.

With bacterial pneumonia, the treatment is antibiotics. Be sure to finish all the medication, even if you start to feel better. Hospitalization may be necessary for higher-risk cases.

Some types of bacterial pneumonia can be prevented through vaccination. Flu shots help, too, by preventing another illness from taking hold. Keep the immune system healthy through good diet and sleep habits, not smoking, and frequent handwashing.

Rarity: Common

Top Symptoms: fatigue, cough, headache, loss of appetite, shortness of breath

Symptoms that always occur with bacterial pneumonia: cough

Urgency: In-person visit

Atypical chest pain

Atypical chest pain describes the situation when someone's chest pain is unlikely to be related to heart or lung disease. There are many other possible causes that could explain chest pain, like sore chest wall muscles or psychological factors like stress and anxiety.

It looks like your chest pain is atypical, however further testing might be needed. Therefore, you should schedule an appointment within two days with your primary care physician who can coordinate these further tests. These will likely include a stress EKG (electrocardiogram), which is a readout of the heart's electrical activity during exercise.

Rarity: Common

Top Symptoms: chest pain, shortness of breath

Symptoms that always occur with atypical chest pain: chest pain

Symptoms that never occur with atypical chest pain: fever

Urgency: Primary care doctor

Acute costochondritis (chest wall syndrome)

Acute costochondritis is also called anterior chest wall syndrome. It is an inflammation of the flexible cartilage that connects each rib to the breastbone.

Costochondritis is caused by excessive coughing or by straining the upper body, as with weightlifting. It is a common occurrence and is seen in children, teenagers, and adults.

Symptoms include a sudden, sharp, aching pain anywhere in the chest wall, especially near the breastbone where it connects to the ribs. The pain gets worse with deep breathing or with almost any movement.

Any sort of chest pain should be seen by a medical provider, especially if the person is over 35 and/or has had any cardiopulmonary symptoms. Heart attack symptoms can be mistaken for costochondritis in some cases.

Diagnosis is made through physical examination. X-rays or CT scans may be done to rule out any other causes for the pain.

Treatment involves rest along with over-the-counter, nonsteroidal anti-inflammatory drugs. Injection of corticosteroid medication to ease pain and inflammation is occasionally done.

Questions your doctor may ask about rib pain

• Do you have a cough?
• Any fever today or during the last week?
• What makes your chest pain hurt more?
• How would you explain why your chest hurts?

Self-diagnose with our free Buoy Assistant if you answer yes on any of these questions.

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