Pain in lower right side under ribs

Medically Reviewed By Megan Soliman, MD

— Written By Healthgrades Editorial Staff

Updated on January 27, 2022

Rib cage pain may feel like a sharp, dull, aching, or stabbing pain around the chest area, along the sides, or in the back. Pain under the rib cage may come on suddenly, such as after an injury. Rib cage pain that develops over time may indicate an underlying medical condition. Rib cage pain can be due to issues or injuries affecting the rib cage itself, such as a fractured rib or a strained muscle. Pain felt under the rib cage may be from one of the internal organs that the rib cage protects.

This article looks at rib cage pain in more detail, including causes, what you can do for rib cage pain, and when to call your doctor.

What is rib cage pain?

Pain under the rib cage can result from problems with the rib cage itself or with organs in the chest or abdomen. It can feel sharp, dull, aching, or stabbing.

The type of pain you experience and where you feel the pain are important clues for finding the cause.

Types of pain include:

• Acute pain: This comes on suddenly. It may be due to an injury to the ribs.
• Chronic pain: This lasts for weeks or months and may be a symptom of an underlying medical condition, such as osteoporosis.
• Referred pain: This starts in one area then travels to another area where you actually feel the pain.

Other symptoms may occur along with rib cage pain. Pain is never normal, but it is not always serious. Sometimes, pain in your rib cage requires treatment.

What causes pain from structures of the rib cage?

The rib cage consists of 12 ribs on each side. Of these, 10 attach to the spine in the back and the breastbone in the front. The bottom two are floating ribs. They have attachments in the back but not in the front.

This system of bones supports your skeleton and protects your internal organs, including the heart and lungs. Ribs play a critical role in breathing.

Injury or inflammation affecting the rib cage can result in pain. However, pain can also occur without injury.

Rib cage pain can stem from various parts of your rib cage, such as the:

• connective tissue between the ribs and the breastbone (costochondral cartilage)
• membrane that lines the inside of the chest (pleura)
• muscles between the ribs (intercostal muscles)
• nerves of the chest wall

The sections below discuss conditions that cause pain related to rib cage parts.

Costochondritis

Costochondritis refers to inflammation of the cartilage that attaches a rib to your breastbone. The cause may be an injury, a viral infection, or something unknown. The pain may be acute and sharp, and taking a deep breath can make the pain worse.

If a viral infection is the cause, you may have a fever and cough. Taking nonsteroidal anti-inflammatory drugs can help relieve the pain.

Muscle sprains or strains

Sprains and strains of intercostal musclescan cause sharp or dull rib cage pain. There may be an obvious stretching and tearing injury.

Sometimes, the injury is not obvious, only the pain. The pain may worsen when you cough or take a deep breath. It may also be painful to press over the injured area.

Resting the muscle, icing the area, and taking over-the-counter pain relievers can help.

Pleurisy

Pleurisy refers to inflammation of the lining inside your rib cage and over the surface of your lung. The pain may be worse when taking a deep breath.

Fluid can build up inside the pleural linings. This can collapse the lung and cause difficulty breathing.

Treatment depends on the cause and severity of the pain.

Shingles

Shingles is a viral infection that causes acute, sharp, and stabbing nerve pain. Before the pain starts, you may have a fever, headache, chills, or nausea.

Shingles usually cause a blister-like rash on one side of the rib cage where the pain appears. The rash usually forms a line across the chest. Sometimes, the pain can become chronic, lasting for months. Shingles can also affect other areas of the body.

Antiviral medications can treat the infection to help shorten it and reduce its severity.

What causes referred rib cage pain?

Rib cage pain may start in one area but travel to an area nearby where you actually feel the pain. This is known as referred pain. For instance, a disease or disorder in your abdomen can cause referred pain under your rib cage.

The sections below list some abdominal organs and conditions that affect them that may refer pain to the rib cage.

Gallbladder

Gallbladder disease, or gallstones, causes pain in the right upper abdomen. The pain may be sharp and acute and may radiate to the back or under the ribs. The pain may develop after you eat a fatty meal.

Other symptoms may include clay colored stools, jaundice, and fever.

Surgery is often necessary for symptomatic gallstones.

Liver

Liver diseases, including liver cancer and liver infection, can cause pain in the right upper abdomen. The pain may be dull and chronic. You may feel the pain under your right ribs.

Other symptoms may include:

• nausea
• jaundice
• fatigue
• dark urine
• swollen feet and ankles
• bruising
• weight loss

Treating liver disease depends on the underlying cause.

Lungs

Pulmonary embolism (PE) can cause chest pain or pain that feels as though it is in the lungs. The pain can be sharp, and it may occur with breathing or deep breathing.

Other symptoms may include rapid breathing, shortness of breath, difficulty breathing, and coughing up blood.

A PE is an emergency that requires immediate medical care. Treatment involves taking medications to dissolve the clot or limit its growth. Sometimes, a procedure to remove the clot is necessary.

Pancreas 

Inflammation of the pancreas, or pancreatitis, causes acute and sharp pain in the left upper part of the belly that you may feel under the left ribs. The pain will likely be constant.

Other symptoms may include nausea, vomiting, and fever. 

Pancreatitis usually requires treatment in a hospital.

Pancreatic cancer causes pain that is dull and chronic. There may also be nausea, jaundice, and weight loss.

Pancreatic cancer treatment involves destroying or removing cancer cells and undergoing therapies to help with general health and managing the symptoms.

Other conditions

Gastrointestinal conditions can cause pain that feels as though it is in the rib cage. These include:

• gas
• heartburn
• gastroesophageal reflux disease (GERD)

Chest pain can also be a symptom of a potentially life threatening condition, such as a heart attack. It is important to promptly report any acute or unexplainable rib cage pain to your doctor.

What can you do for rib cage pain?

To manage rib cage pain at home, your doctor may recommend the following:

• Rest: Take a break from any activities that trigger or worsen your rib cage pain.
• Ice: Apply an ice pack to the painful area for short periods to relieve rib cage pain and inflammation.
• Heat: Sometimes, heat feels better to relieve pain than cold. If this is true for you, apply a heating pad or hot water bottle instead of ice packs for short periods.
• Over-the-counter pain relievers: Take acetaminophen (Tylenol) or ibuprofen (Advil, Motrin) to ease rib cage pain. Ibuprofen is the better choice if inflammation accompanies the pain.

Other rib cage pain treatments will vary depending on the underlying cause. Getting a proper diagnosis will inform your treatment plan.

When to call a doctor

Contact your doctor immediately if you have severe or chronic rib cage pain, especially if the pain occurs with movement or breathing.

Always call your doctor if you have rib cage pain with:

• cough
• fever
• jaundice
• nausea
• rash
• shortness of breath
• vomiting

Seek immediate medical care if you have severe rib cage pain with persistent nausea and vomiting. Go to the emergency room if you have rib cage pain with chest pain or difficulty breathing.

Summary

Pain in the rib cage has several potential causes, including injuries to nearby structures and conditions such as pleurisy and shingles.

If you are concerned about rib cage pain, speak with a doctor. They can examine you and provide an accurate diagnosis.

What organ is on the right side below the ribs?

When should I be worried about right side pain?