Pain under the ribs is a very common, but initially not threatening problem. The pain can be attributed to a variety of causes. Only in the rarest cases are there serious organic diseases behind it.
Pain under the ribs can be direct or transmitted pain. If the pain is unbearably severe or does not improve within a short period of time, a doctor must clarify the exact cause. The clinical pictures which are behind the doubt should be clarified in the following.
The causes
The 12 ribs extend from the spine as a curved bone towards the sternum. They cover externally the entire thorax and parts of the upper abdominal area. Between the individual ribs lie various muscle strands that play a role as respiratory muscles, among other things.
There are also blood vessels and small so-called “intercostal nerves” under each rib. All these structures are predestined for injuries, tension and pain due to their superficial position and constant movements in the thorax. Rib fractures are a common injury that leads to movement-related pain.
Severe contusions of the ribs can also be painful. The muscles can also be affected. Tension in the small muscles between the ribs is the most common cause of stabbing rib pain, especially when breathing.
Sports activities, monotonous sitting, cold air and jerky movements promote tension. More rarely but often very painful is an involvement of the nerves under the ribs, the intercostal nerves. Intercostal neuralgia is not a rare condition.
It is a constriction of the nerve between the muscles and ribs. Again, movements caused by breathing are very painful. Projections of other organs can also be responsible for pain under the ribs.
In the thorax itself, the lungs, heart and thymus can cause pain of this kind. For example, heart attacks and angina pectoris are often described as pain of the ribs. Inflammation of the pericardium also triggers pain.
In the lung, only the lung membrane is sensitive to pain. If this is injured or affected, for example by inflammation, pain occurs under the ribs. Under unfavorable circumstances, injuries to the ribs can also puncture and injure the pulmonary pleura immediately below.
More rarely, upper abdominal organs also project pain onto the ribs. The diaphragm, stomach, esophagus, liver and gallbladder are often affected. If these organs are injured or enlarged, pain may affect the lower costal arch. A rare cause is the “HELLP syndrome” of pregnancy. This organic damage must be urgently clarified by a doctor.
