What Causes Severe Left-sided Pain Under Rib Cage?

Posted on Sat, 31 Jan 2015

Medically reviewed by Ask A Doctor - 24x7 Medical Review Team

Sat, 31 Jan 2015 Answered on

Wed, 18 Feb 2015 Last reviewed on

Question : Fell on left side of back one week ago. Lower left rib hurt some at the time but quickly got better. Two days later pain was severe, took ibuprofen and it helped. Very severe pain now when I sneeze or cough in same area. Gradually eases off after a while. Still taking ibuprofen. Doesn't appear to be any swelling or discoloration.

Pain is excruciating when I sneeze. Any way to avoid or reduce severity of pain during sneeze or coughing? Pain is in lower left rear back at bottom of rib cage. After sneeze or cough pain has subsided it has burning sensation for 30 to 45 minutes. Is slightly sensitive to touch but not bad. I have been taking 600 mg of Advil a couple of time a day which seems to have best effect.

Answered by Dr. Dr. Naveen Kumar Sharma (27 minutes later)

Brief Answer:
You might have a rib fracture

Detailed Answer:
Hello,
I have studied you case and I think you might be having rib fracture. This pain is very severe and increases after coughing and sneezing. I would suggest you a chest x ray to confirm the diagnosis. If there is any fracture than you will need following.
1. Avoid smoking, constipation.
2. Hot water fomentation
3. Volini gel local application
4. Tablet Diclofenac daily three times.
This pain is going to stay for three to six weeks. You should avoid any binder. I hope this answer will be useful for you. Let me know if there is any other followup questions.
Thanks

Above answer was peer-reviewed by : Dr. Ashwin Bhandari

Follow up: Dr. Dr. Naveen Kumar Sharma (6 hours later)

Not sure what you mean by "avoid any binder". Does that mean avoid wrapping elastic bandage around body as a support? Or does that refer to a chemical binder or medicine that might interfere with suggested medication.

Also if purpose of x-ray is to confirm rib fracture and treatment for rib fracture is basically same as suggested is there really any reason for x-ray? I had rather avoid x-ray unless you think it is absolutely necessary or think there may be other complications.
Is Diclofenac an OTC medication? Will 600mg of Advil serve the same purpose or does Diclofenac have some properties that will reduce time needed to heal?

There is no noticeable blood in urine or gastrointestinal problems at this time. Only problem is pain in lower left back when coughing, sneezing and sometime laughing.

Answered by Dr. Dr. Naveen Kumar Sharma (8 hours later)

Brief Answer:
Binder means elastic bandage

Detailed Answer:
Hello,
1. Rib binder means elastic bandage, they are of no use and only increases pain.
2. X ray will tell us how bad is the fracture and accordingly we can expect recovery.
3. Diclofenac is OTC and better than advil.
4. If cough is more than better to take cough syrup because any movement will increase time of healing.
Thanks

Above answer was peer-reviewed by : Dr. Yogesh D