Introduction
Pain in the right costal arch can have various causes and also occur in different ways. A distinction is made between chronic rib pain that lasts longer than six months and acute pain in the region of the costal arch. If the pain lasts longer, the cause should be clarified by a physician, because this region also contains important organs that may be diseased and thus trigger the pain.
Causes
Pain in the right costal arch may be muscular or organic in origin. If muscle tension is present, which has been caused, for example, by sporting exercises, pain may occur when the patient moves again. In addition, a severe cough can also cause a rupture of the muscle fibers between the ribs.
If the cause is organic, the pain on the right side of the costal arch can be caused by the liver, gall bladder or colon located there. If the pain is possibly caused by the gallbladder, it may be an inflammation of the gallbladder or gallstones. The pain may then radiate into the right shoulder.
Typically, other symptoms occur, such as the yellowish coloration of the skin (icterus), a discoloration of the stool, and nausea with vomiting may occur. Colicky pain is characteristic, especially after fatty food. Furthermore, even a large meal can lead to pain in the area of the right ribs.
The stomach is very full and especially additional strenuous activities, but also lying down, can cause the filled stomach to press on the diaphragm which is located on top. This is supplied by numerous nerves and is therefore very sensitive. Another cause can be pleurisy, which can vary greatly in the duration of the disease.
In medical terminology, it is called pleuritis and usually develops as a result of pneumonia. In addition to an increased accumulation of fluid in the pleural gap (pleural effusion), unpleasant pain also occurs in the lung membrane, which is very well supplied by nerves. Last but not least, the right kidney behind the peritoneum can also cause pain in this area.
Typically, the pain in the case of a renal pelvic inflammation tends to occur on the back, but it can nevertheless radiate to the front edge of the ribs and thus initially lead to a different suspected diagnosis. As the largest abdominal organ, the liver lies against the ribs from below and can be palpated below the costal arch. Deep inhalation causes the liver to move downwards from the diaphragm, which is why it protrudes a few centimeters below the costal arch.
In various liver diseases, such as inflammation of the liver (hepatitis) of a fatty liver due to alcohol consumption, the liver swells up so much that it can be palpated without difficulty in the right abdomen without any aids. Pain is mainly caused by the stretching of the organ capsule, the pressure on the diaphragm and the pressure on the ribs from inside. How to recognize a hepatitis disease is explained in our article Inflammation of the liver.
Back pain that originates in the spine can radiate to the closely adjacent ribs. Each thoracic vertebra is in contact with the corresponding ribs on both sides via a joint. It is not uncommon for this joint to be tilted, blocked or dislocated due to incorrect movements.
The muscles of the back can also be responsible for pain in the costal arch. Lying down for a long time, incorrect loading or seemingly unprovoked blockades can cause the muscles to tense and pull. Strong pain in the posterior costal arch can consequently occur during movement, while sitting and lying down or even through deep breathing. In our article Back Pain – Optimal Recognition and Treatment you will learn how you can effectively treat this back pain.
