Back pain under the ribs - as a symptom of disease

Back pain under the ribs can be a symptom of various diseases. It is very difficult for a non-specialist to understand such a variety of diseases, so a hand-made diagnosis often does not coincide with the one made by a qualified doctor. Moreover, in order to make a final diagnosis, doctors usually do not limit themselves to finding out the symptom, and prescribe additional studies.

What does the localization of the pain tell us

We, however, without sufficient knowledge and capabilities, can only guess what pain under the ribs in the back may be associated with. The exact localization of the pain will tell us.

Right-sided pain

When pain appears in the right side of the back under the rib, it is necessary to remember what organs a person has in this area. To the right of the spinal column we have: the right lung, the corresponding part of the diaphragm, the liver (its right part), gallbladder, some part of the stomach, the head of the pancreas, one of the two kidneys. In the absence of thickening in the muscles and ligaments of the back, traumatic foci, episodes of increased load on the back (spine and muscles), as well as diseases of the spine can be suspected that the cause of pain is a disease of internal organs (one of the above).

Pain on the right side of the back under the rib is characteristic of liver diseases. However, it should be understood that this organ is poorly innervated and begins to hurt only in severe damage. Pain syndrome of varying intensity is characteristic of the inflammatory process in the liver (hepatitis), cirrhosis, fatty degeneration of the organ (fatty hepatosis is rarely accompanied by unexpressed pain in the right subcostal region), tumor processes in the organ. Pain on the right side under the ribs is associated not with damage to hepatocytes (liver cells, its parenchyma), but with the transition of the pathological process to the capsule of the organ, where sensitive receptors are located.

In severe liver disease, there are also more characteristic symptoms: changes in blood composition, increased bilirubin in the blood and tissues of the patient (jaundice), circulatory disorders, symptoms of intoxication of the body. Pain is constant, but can be intensified by pressing on the liver area.

Next to the liver is the gallbladder with its ducts. In case of stagnation in the organ, concretions (stones) may form, which are pushed into the bile ducts by bile juice. This process is accompanied by severe pain in the right subcostal area in the front, but it can also go to the back. The pains are not constant. They subside when the stone is discharged outside (into the intestine).

Gallstone disease is often accompanied by inflammation of the gallbladder, which can also have an infectious character. In this case, the pain will also be localized on the right side closer to the lumbar region, but it can also irradiate to the scapula and clavicle. With acute cholecystitis, the pain is severe, penetrating, accompanied by hyperthermia, nausea, vomiting. Sometimes, as in liver disease, the level of bilirubin may increase, which is reflected in the color of the skin and whites of the eyes.

If the disease is chronic, the pain is usually mild and only increases with fatty and fried foods, and vomiting occurs. Patients may also complain of belching and a bitter taste in the mouth that is not associated with bitter foods.

For most pathologies of the pancreas is not characterized by pain under the ribs on the right back, i.e. From the back, because most of the organ, except for its head is located on the left side of the spinal column. Nevertheless, inflammation of the pancreas begins from here, i.e. From the place of entrance to the duodenum, where the bile ducts come out. Inflammation of the organ is accompanied by unexpressed or acute pain of the corresponding localization. If only the head of the pancreas is inflamed, then the pain will be localized mainly on the right. In acute inflammation, the pain is severe, almost as in appendicitis, but its focus is located slightly higher. For chronic inflammation is characterized by low pain, which appears with errors in nutrition and subsides after the pancreas gets a chance to rest.

For pancreatitis is more characterized by shingling pain under the ribs and in the back closer to the lumbar region (after all, the size of the gland is not small, in an adult the length of the organ varies within 15-22 cm). At the same time, patients complain of pain on the left side in the back and abdomen more often than the right-sided symptom, probably because most of the pancreas is located on the left side, and we feel the reflected pain.

Other symptoms are considered: heaviness in the stomach after eating after 1.5-2 hours, weakness, deterioration of appetite, skin discoloration (it becomes pale or yellowish), pancreatic diarrhea (stool disorder with painful spasms), hyperhidrosis, sometimes vomiting.

If the pain of chronic pancreatitis is constant, it is possible to suspect oncology, i.e. Pancreatic cancer, which usually develops in the head of the organ in people with hereditary predisposition.

The ducts of the pancreas and gallbladder exit into that part of the intestine which is commonly called the 12-peritoneum. Its walls are not usually not damaged by acid, as in the stomach, but in some pathologies there is a throwing of gastric juice into the intestine, the mucosa of which is not designed for such an aggressive impact. Alkalis in the composition of bile and pancreatic juice should quench acid, but with dysfunction of the liver, gallbladder or pancreas this does not happen, which leads to inflammation of the walls of the initial intestine and the formation of ulcers on it.

The bulb and descending part of the 12-rectum are located on the right side of the spine and border the liver and the right kidney. When these segments are inflamed, there is a nagging pain on the right side of the epigastrium, which often goes to the back, reminiscent of the pain of pancreatitis. With ulcer of the right segments (and they are most often affected) of the duodenum there are unpleasant aching pains, especially in the evenings and at night (hunger pains), which can recoil into the back and even into the arm. The pain is most often localized in the lumbar and thoracic region, subsiding some time after eating.

The stomach, as part of the digestive tract, is located in the area of the passage of the lower ribs, it is not surprising that with diseases of this organ can occur pain in the back under the ribs. More characteristic is still pain in the abdomen from the front (epigastric), but it may well recoil and in the back. Such a symptom is characteristic of gastritis, which often occurs in a chronic form, but can be acute with a strong pain syndrome in the area of localization of inflammation.

When inflammation of the gastric mucosa is also not uncommon: belching, heartburn, nausea, flatulence, heaviness in the abdomen after eating, deterioration of appetite, stool disorders.

Back pain also occurs in the case of ulcerative-erosive lesions of the gastric mucosa, which often extends to the duodenum.

If the ulcer is located in the third of the stomach, which is located on the right side of the spine or extends to the initial parts of the 12-peritoneum, the back pain may also appear on the right side. The pain increases and then subsides. In exacerbation, it has a dagger character, forcing the patient to bend in the lower back. Severe pain appears at the onset of hunger, immediately after eating spicy or hot food or in stressful situations.

Other symptoms of gastric ulcer are: nausea and vomiting (often with blood), belching, heartburn, flatulence, blood may appear in the feces. When the stomach wall is perforated (perforated ulcer), symptoms of peritonitis appear: vomiting, fever, severe aching and sharp pain in the abdomen and back.

The kidneys are a paired organ of the excretory system. One of the kidneys is located on the right side and the other on the left. In inflammatory kidney disease, back pain is one of the most characteristic symptoms. If only the right kidney is affected, then the pain will have a right-sided localization. With bilateral kidney damage, pain will be felt in both the right and left side of the back. The intensity of pain will depend on the severity of the pathological process.

Other symptoms of pyelonephritis (glomerulonephritis) are: fever (in the acute course of the disease), swelling of the face and limbs, frequent urination. Urine becomes cloudy and dark. As a consequence of poor filtration and intoxication of the body, nausea, vomiting, headaches, general weakness, dizziness appear.

As a result of stagnation in the kidneys, as well as in the gallbladder, concretions may form, which are periodically washed into the ureter with the flow of urine. Kidney stone disease is characterized by renal colic, accompanying the advancement of a urinary stone or sand. Pain on the right side occurs if the stone comes out of the right kidney. Bilateral colic is rare.

Pain in renal stone disease is sharp, attack-like, may irradiate to the groin and abdomen. The localization of pain as the stone advances is constantly changing. It occurs in the area of the lower ribs of the back, moving to the lumbosacral region.

Kidney stone disease is also characterized by cloudy urine, but frequent urges to urinate do not always end positively. Often there is a retention of urine in the body and as a consequence swelling.

Unlike pyelonephritis, the pain symptom of kidney stones can be treated well with antispasmodics. Heat treatments also relieves pain.

Pain in the right subcostal region with irradiation to the back, lower back, anus may be one of the symptoms of acute appendicitis (inflammation of the cecum). In this case, the most severe pain patients usually experience in the pelvic area in the front, but the sensations radiating to the back may be similar to renal colic. Other symptoms may also indicate appendicitis: fever, constipation combined with vomiting, diarrhea with blood, hyperhidrosis, chills and others. In this case, pressing on the appendix area is less painful than the moment when the hand is abruptly removed.

The similarity of appendicitis symptoms with renal colic sometimes causes serious complications. Relieving the pain with antispasmodics, the patient only complicates the diagnosis of appendicitis, and delay in this case may cost him his life. When an inflamed appendix ruptures, its contents spill into the abdominal cavity, causing inflammation of the peritoneum (peritonitis), a potentially very life-threatening condition.

In the above diseases, back pain under the ribs usually occurs in the lumbar and lower thoracic region, although in some cases it may irradiate to the upper back. If the pain is localized under the ribs in the area of the shoulder blades, you can suspect diseases of the lower respiratory system (bronchitis, pneumonia, pleurisy).

In bronchitis, pain in the back under the ribs usually occurs during coughing. In this case, it is difficult to say in which part of the back it is felt more strongly. With pneumonia and bronchopneumonia, the localization of pain indicates which part of the respiratory system is affected by the disease. With a right-sided lesion, the back in the area of the shoulder blades and slightly below will hurt on the right. The pain will also increase with coughing. Often back pain with this pathology is the only symptom, which complicates the diagnosis and treatment of this dangerous disease.

Back pain under the ribs when breathing in can have different causes. Displacement of the bones of the chest and movements of the anterior wall of the abdominal cavity can increase the pressure on the diseased organ, resulting in (or increasing) pain. Because of the displacement of the bones, it is at such times often announces itself intercostal neuralgia, pain in which, especially in the middle parts of the chest below the mammary glands, resembles attacks of angina pectoris. But this does not appear characteristic of heart disease symptoms: increased sweating, a sense of shortness of breath, a feeling of compression in the chest, shortness of breath, nausea. Breathing problems are explained only by the fact that with a deep breath the pain increases (becomes sharp, dagger-like), so the person tries to breathe shallowly, because of which the air may still be insufficient.

Neuralgia, despite the severe pain, is not particularly life-threatening, unlike cardiovascular diseases and pleurisy. The latter is an inflammatory pathology and most often acts as a complication of infectious diseases of the respiratory system (inflammation of the lungs). Both in dry and effusive forms of pleurisy, pain when breathing is one of the characteristic symptoms of the disease, along with shallow frequent breathing. Painful sensations, forcing the patient to take a forced position, also appear when coughing, hiccups, an attempt to bend over in the opposite direction from the focus of the lesion. For example, if the focus of inflammation is localized in the right part of the pleura, then sharp pain in the right side of the back occurs when bending to the left.

Breaking reflected pain in the back under the right lower rib sometimes occurs in women with diseases of the reproductive system, such as uterine abnormalities or inflammation of the endometrium, as well as in dysmenorrhea (painful periods), when abdominal pain can go to the back, but with less intensity. The right-sided character of reflected pain may be evidence of inflammation in the right ovary. The pain in the back is not intense, not having a clear localization, but unpleasant in that it causes anxiety and worry, which only aggravates the situation.

Back pain under the ribs and in the lower back is often complained of by pregnant women. In pregnancy pathology, we are most often talking about right-sided pain. Although often the cause of pain is fatigue of the spine, which in the lumbar region has to take an uncharacteristic previously strong bend as the fetus grows inside the uterus.

Left-sided pain

On the left side of the spine in our body are located: heart, left lung with the left bronchus, left part of the diaphragm, spleen, the main part of the stomach and pancreas, left kidney.

Pain in the left side of the back under the ribs may indicate inflammation of the left kidney or the formation of concretions in it, which, when moving along the ducts, just cause painful sensations, radiating to the back and side. In women, pain of less intensity is noted with inflammation of the left ovary. In severe inflammation, they are interspersed with acute abdominal pain.

Pain in the left side from the back can complain and expectant mothers, especially in late terms. In early terms, a temporary weak pain symptom (right or left) can occur during the penetration of the embryo into the uterus and during the period of placentation, which does not indicate pathology at all. True, such a symptom should not be treated carelessly. Sometimes pains in the subcostal region (right or left) are complained of by women who are subsequently diagnosed with ectopic pregnancy. Other symptoms of this pathology are brown discharge and quite severe abdominal pain down on one side (the localization of pain indicates the location of the embryo).

Approximately the same localization on the left side have pain with pancreatitis. If the inflammation covers not only the head of the pancreas, the pain becomes shingles. Most often they irradiate to the left side of the back, but can also reach the right. In this case, it is very difficult for the patient to determine where exactly it hurts, and what is the nature of the pain. The intensity of pain in chronic pancreatitis is small, but in acute pancreatitis it becomes dagger-like, from the pancreatic area gradually descends into the subcostal region and below, girdling the abdomen and back. In this case, neither antispasmodics nor analgesics do not help to noticeably reduce pain sensations. Other symptoms are considered: nausea, vomiting, stool upset, severe weakness.

Back pain on the left side under the ribs is often felt by patients with stomach pathologies (inflammation or ulcer). In principle, back pain is not characteristic of gastritis, especially at an early stage of the inflammatory process. Usually patients complain of discomfort and pain in the abdomen, belching, nausea, heartburn. Back pain to these symptoms are joined to these symptoms later, with exacerbations of the disease, which has acquired a chronic course. Chronic diseases tend to weaken the body, so a person appears or exacerbates other pathologies. These can be diseases of the kidneys, liver, gallbladder. It is likely that the pains can be associated with these organs, so they can be both left-sided and right-sided (depending on the location of the diseased organ).

But a neglected gastritis (especially with increased acidity of gastric juice) threatens to turn into a gastric ulcer. In this case, the pain becomes much stronger, strictly tied to the intake of food (hunger pains and those that occur when eating spicy food) and the psycho-emotional state of the person. Back pain is localized in the area of the lumbar region, but can irradiate and under the shoulder blades. Their intensity is somewhat lower than abdominal pain. But with the perforation of the ulcer, the pain becomes shingling, cinchal, a person can not find a comfortable position, he has bloody vomiting, body temperature rises.

Gastritis and peptic ulcer are diseases that can not be asymptomatic for a long time, so back pain under the ribs in the absence of symptoms from the GI tract is unlikely to be associated with inflammatory or erosive-ulcerous processes in the digestive system. Most likely, their cause should be sought in the state of the kidneys or spine.

Pain in the upper abdomen under the ribs, irradiating to the back is also characteristic of spleen pathologies. Pain usually occurs when the organ is enlarged, which in turn occurs in spleen injuries, lymphoma, leukemia, hemolytic anemia, infectious mononucleosis, hepatic hypertension, endocarditis, lupus erythematosus and some other pathologies. That is, pain in the back with an enlarged spleen can be a symptom of many diseases, only indirectly related to this organ. And even a rupture of the spleen, which is possible both in a traffic accident and as a result of the enlargement of the organ, and is accompanied by blueing of tissues near the navel, requires a careful study of the causes of what happened.

What can indicate spleen disease, in addition to back and abdominal pain on the left side, which increases with any movement? The appearance of chills, fever, nausea, vomiting can also be symptoms of spleen disease. Sometimes patients notice an unexplained itching on the body.

Pain on the left side under the ribs in the area of the shoulder blades and just below is characteristic of left-sided pneumonia, which is diagnosed less often than right-sided pneumonia, but has a more severe course, problems with therapy and a high risk of complications, as well as left-sided pleurisy and lesions of the diaphragm on the same side. Back pain associated with airway pathology is usually tied to the acts of inhalation and exhalation. The pain increases on inhalation and becomes milder on exhalation.

Back pain under the ribs on the left side may be a symptom of cardiovascular diseases: angina pectoris, ischemic heart disease, myocardial infarction, spinal cord stroke. With myocardial infarction, some patients do not experience chest pain of the usual localization, but complain of back pain. Most often it is pain between the shoulder blades (more often on the left side), which can go to the left shoulder, lower jaw.

Back pain and discomfort that occurs during walking, physical and emotional exertion, and immediately subsides after rest, may be one of the symptoms of developing cardiac ischemia. The pain of angina pectoris and IBS can be easily managed with nitroglycerin.

Aneurysm and dissection of the heart aorta causes pain on the left side in the chest, which may radiates to the groin and occipital area or back.

With spinal cord stroke, pain in the back under the ribs can be called the precursors of this rare but extremely dangerous disease, which often turns out to be a complication of osteochondrosis or herniated discs (sometimes the cause of stroke is a tumor). It is with the exacerbation of the underlying disease and is associated with sharp pain in the back combined with tension in its muscles. If subsequently a person begins to feel weakness and pain in the legs, a decrease in their sensitivity, disorders of defecation and urination, the occurrence of moving limp in combination with back pain - these are already alarming symptoms that require medical attention.

Localization of pain in neurological diseases and pathologies of the spine (osteochondrosis, herniated discs, spondylitis, scoliosis, etc.) indicates the area of the passage of the affected nerve. But it should be taken into account that excitation is able to be transmitted along the nerve fiber. Its compression or inflammation are local irritating factors that increase the sensitivity of the nerve, but the signal of pain will be transmitted from neuron to neuron, so the pain can irradiate to the neck, limbs, perineum, which does not make it possible to determine by eye exactly where the nerve is damaged.

Nature and intensity of pain

Back pain under the ribs can have not only different causes and localization, but also differ in its intensity. It is clear that severe pain always attracts our attention, although it is not often a sign of a dangerous disease.

In neurological diseases, for example, the patient usually feels a lot of pain, because the nerves, the structures responsible for our sensations, are affected. However, neuralgia, as a disease of a compressed nerve, is less dangerous than a stomach ulcer, in which back pain is rarely very intense, or a myocardial infarction, which was manifested by back discomfort.

Neuralgia and diseases of the spine, in which there is often pain under the ribs, which gives into the back, pain is not dangerous in itself, but its complications, so they should not be left to fend for themselves.

Usually it is not the intensity of the pain syndrome that gives us more information about the pathology, but its nature. Considering the types of pain is not always possible to diagnose a specific disease, but you can determine the nature of the course of the disease. Thus, aching pain in the back under the ribs most often indicates a sluggishly ongoing inflammatory process. The same pain can occur in overwork of the back, as a result of fatigue of muscles and spine, during menstruation and pregnancy.

Dull aching pain on the left side of the back under the ribs may be a precursor of myocardial infarction or a consequence of another gradually progressive cardiovascular disease. It also occurs with enlargement of the spleen, chronic diseases of the stomach, kidneys, osteochondrosis on the eve of exacerbation, etc. But with relapses of any pathologies, the pain usually changes its character.

So, sharp pain in the back under the ribs can be the result of neuralgia or osteochondrosis (appears when moving, from it and intensifies), and the consequence of exacerbation of all sorts of diseases of internal organs of inflammatory nature, the passage of stones in the kidney or bile ducts, acute heart attack, exacerbation of appendicitis, perforation of gastric ulcer.

Sharp pain in the back under the right ribs is more characteristic of acute cholecystitis and gallstone disease, and with cirrhosis of the liver and hepatitis, the patient is tormented by a dull aching pain that occurs with physical exertion. In hepatic colic on the background of latent cholelithiasis, the pain again acquires a sharp stabbing character.

Diagnosis of back pain under the ribs is complicated by the fact that in the same disease pain can have different intensity and character, and the presence of reflected pain does not allow you to accurately determine the location of the diseased organ or structure.