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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Does Pain In The Rib Cage On The Right Side Indicate?

About a week ago I sneezed and hit the floor when a pain jolted through my right side in my kidney area. The pain has moved more towards my side right under my rib cage. It hurts horribly when I sneeze or cough. It s uncomfortable to lay on my right side but only a little painful to do so. It hurts to run or make sudden movements and is tender to the touch. Any ideas on what it could be?
Wed, 22 Nov 2017
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Ayurveda Specialist,  's  Response
**
Thanks for contacting with your health concern

1. since the symptoms are there for 1 week thus I do recommend following symptomwise approach:

i. In absence of injury, pain could be a pleural pathology. [ask for chest X-ray to exclude pleuritis, pleural effusion since pain increases on sneezing/ coughing]

ii. As the pain is on the right side, in addition to x-ray, ask for ultrasonography of HBR [hepatobiliary region] for Amoebic liver abscess and Cholecystitis.

iii. Consult a chest specialist who will go for systemic examination and if any chest signs are present will ask for imaging scans of chest with Hb%, WBC, ESR and then will provide proper management [as they can ask more detailed questions on associated symptoms]

iv. since symptoms are still persisting and as chest pain is related to the chest wall, the following should be the symptomwise approach:

i .Think of fracture rib, new or old.
ii. Think of costochondritis, very common anteriorly
iii. Think of muscle sprain

. If by adopting
- hot water fomentation
- rest with minimal movements
- chest strapping
- intercostal nerve block
- taking an analgesic, anti-inflammatory enzymes, and muscle relaxant, the pain goes away continue with the same, however, if the pain is not relieved ask for Hb%, WBC, ESR & X-ray Chest

PS. Although most of the times, pain may be the result of minor injury or postural changes, however sometimes there may be an underlying medical condition/situation which needs appropriate treatment.
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What Does Pain In The Rib Cage On The Right Side Indicate?

** Thanks for contacting with your health concern 1. since the symptoms are there for 1 week thus I do recommend following symptomwise approach: i. In absence of injury, pain could be a pleural pathology. [ask for chest X-ray to exclude pleuritis, pleural effusion since pain increases on sneezing/ coughing] ii. As the pain is on the right side, in addition to x-ray, ask for ultrasonography of HBR [hepatobiliary region] for Amoebic liver abscess and Cholecystitis. iii. Consult a chest specialist who will go for systemic examination and if any chest signs are present will ask for imaging scans of chest with Hb%, WBC, ESR and then will provide proper management [as they can ask more detailed questions on associated symptoms] iv. since symptoms are still persisting and as chest pain is related to the chest wall, the following should be the symptomwise approach: i .Think of fracture rib, new or old. ii. Think of costochondritis, very common anteriorly iii. Think of muscle sprain . If by adopting - hot water fomentation - rest with minimal movements - chest strapping - intercostal nerve block - taking an analgesic, anti-inflammatory enzymes, and muscle relaxant, the pain goes away continue with the same, however, if the pain is not relieved ask for Hb%, WBC, ESR & X-ray Chest PS. Although most of the times, pain may be the result of minor injury or postural changes, however sometimes there may be an underlying medical condition/situation which needs appropriate treatment.