If you experience sudden or intermittent pain under your left rib cage or breast, especially after eating or while seated, you will need to understand the possible causes in order to properly relieve the pain. This pain can be associated with organs such as the pancreas, kidneys, and gastrointestinal tract. Movements like bending or activities like eating certain foods might worsen this discomfort.
In this article, we'll explore a comprehensive list of potential causes, helping you identify when such pain warrants immediate attention.
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Causes of Pain Under or Around Left Rib Cage
There are several reasons why you may experience pain under or around the left rib cage, as this area contains various vital organs and can also be a site for referred pain.
The rib cage provides vital protection for the lungs and heart, encasing them in a bony shield.There are 24 ribs in total, 12 on each side of the body.
Emergency Causes
The following are emergency causes of pain under the left rib cage:
Heart Attack
A heart attack occurs when blood flow to the heart is blocked, leading to damage or death of heart muscle tissue. This can cause severe chest pain that may radiate to the left side, including under the left rib cage. The pain may also be accompanied by other symptoms like:
- Shortness of breath
- Sweating
- Pain in the jaw, neck, or back
- Pain in one or both arms or shoulders
Ruptured Spleen
An enlarged or ruptured spleen can result from trauma or certain medical conditions. Due to its location in the upper left abdomen, near the ribs, the spleen can cause sharp pain under the left rib cage. In severe cases of spleen rupture, there may be signs of internal bleeding, such as light-headedness and a rapid heart rate.
Kidney Infection
A kidney infection, also known as pyelonephritis, is a bacterial infection of the kidneys. This can cause sharp, intense pain in the back and sides of the abdomen, potentially extending to the left rib cage area due to the involvement of the left kidney.
Other symptoms may include:
- Fever
- Chills
- Nausea and vomiting
- Painful urination
Pericarditis
Pericarditis is inflammation of the pericardium, the sac surrounding the heart. Due to the pericardium's proximity to this area, pericarditis can cause chest pain that radiates to the left side, including under the left rib cage. The pain is typically sharp and worsens with deep breathing or lying flat.
Other symptoms of pericarditis may include:
- Fever
- Weakness
- Trouble breathing
- Coughing
Splenomegaly
Splenomegaly is an enlargement of the spleen, which can occur due to various underlying conditions such as infections, liver diseases, blood disorders, or certain cancers. This enlargement can lead to discomfort or fullness in the left upper abdomen, including under the left rib cage, as the spleen is located in this area. If the spleen becomes significantly enlarged, it can cause pressure on surrounding structures, leading to pain and tenderness, especially with deep breathing or movement.
Pleurisy
Pleurisy is inflammation of the lining surrounding the lungs (pleura). This condition can cause sharp chest pain, particularly during breathing, that may be felt under or around the left rib cage due to the location of the affected pleura. Pleurisy pain is often worse with coughing or sneezing and may be relieved by holding the breath.
Other pleurisy symptoms may include:
- Shortness of breath
- Rapid breathing
- Coughing
Pancreatitis
Pancreatitis is inflammation of the pancreas, often caused by gallstones or excessive alcohol consumption. Symptoms of pancreatitis include severe pain in the upper abdomen, nausea, and vomiting. Severe cases may require a few days in the hospital for intravenous (IV) fluids, pain medication, and nutritional support.
Pulmonary Embolism
A pulmonary embolism occurs when a blood clot (usually from the leg or pelvis) travels to the lungs and blocks one or more pulmonary arteries. This can result in symptoms such as:
- Sudden shortness of breath
- Chest pain
- Coughing
- Coughing up blood
- Very low blood pressure
The pain associated with a pulmonary embolism can be sharp and may be felt under or around the left rib cage due to the proximity of the affected lung area.
Pneumonia
Pneumonia is an infection of the lungs, typically caused by bacteria, viruses, or fungi. This infection leads to inflammation and fluid buildup in the lung tissue, resulting in symptoms such as cough, fever, chest pain, and difficulty breathing.
The inflammation and fluid accumulation can cause pain under or around the left rib cage due to irritation of the pleura and localized lung tissue involvement, especially if the infection affects the lower lobes of the left lung.
Shingles
Shingles is a viral infection caused by the varicella-zoster virus, the same virus that causes chickenpox. After a person has had chickenpox, the virus can reactivate years later and cause shingles. This condition manifests as a painful rash with fluid-filled blisters that typically appear in a band or strip following a nerve pathway on one side of the body.
If the shingles rash affects the area around the left rib cage, it can cause sharp, burning, or shooting pain under or around the left rib cage due to inflammation of the nerves in that region. This pain is known as postherpetic neuralgia and can persist even after the rash has healed, requiring specific treatments to manage.
Less-Threatening (But Bothersome) Causes
The following are less-serious causes of pain under the left rib cage.
Kidney Stone
A kidney stone is a solid mass formed in the kidney. It often causes intense flank pain that can radiate to the lower abdomen and groin. If the stone moves downward, it can cause referred pain that can be felt under the left rib cage due to the position of the left kidney.
Symptoms of kidney stones can also include:
- Blood in the urine
- Frequent urination
- Nausea or vomiting
- Fever and chills
- Urine that smells bad
Gastritis
Gastritis is inflammation of the stomach lining, commonly caused by bacterial infection or excessive use of nonsteroidal anti-inflammatory drugs (NSAIDs), such as Advil or Motrin (ibuprofen) and Aleve (naproxen).
Gastritis can also lead to symptoms like pain in the upper part of the belly or abdomen, loss of appetite, and nausea. The resulting abdominal discomfort may also extend to the left side, potentially causing pain around the left rib cage as the stomach is situated in this region.
Stomach Ulcer
A stomach ulcer is a sore or lesion that develops in the lining of the stomach or the first part of the small intestine (duodenum). It can cause a burning or gnawing pain in the upper abdomen, just under the rib cage. Stomach ulcer pain often occurs on an empty stomach or after eating certain foods.
Broken or Bruised Ribs
Broken or bruised ribs can result from trauma or repetitive strain. This can cause sharp pain on and around the left rib cage, especially with movement or deep breathing, as the ribs protect the organs in the chest cavity. Other symptoms may include bruising on the skin, tenderness in the area, pain with movement or rest, and increased pain with coughing or sneezing.
Costochondritis
Costochondritis is inflammation of the cartilage that connects the ribs to the breastbone. This can cause tenderness and pain around the left rib cage, often exacerbated by movement or pressure.
Other symptoms include:
- Sharp pain originating at the front of your chest wall, potentially radiating to your back or stomach
- Experiencing heightened discomfort when deep breathing or coughing
- Tenderness when pressing the area where the rib connects to the breastbone
GERD (Gastroesophageal Reflux Disease)
GERD is a condition in which stomach acid flows back into the esophagus, causing heartburn and chest pain that can possibly radiate to the left side of the rib cage. This pain is often worse after eating or lying down.
Other common symptoms are:
- Feeling like food is stuck behind the breastbone
- Heartburn, or burning pain in the chest
- Nausea after eating a meal
IBS (Irritable Bowel Syndrome)
IBS is a gastrointestinal disorder that can cause abdominal pain, bloating, and changes in bowel habits. Left-sided abdominal pain near the rib cage can occur in IBS, along with other symptoms like diarrhea or constipation.
Other symptoms may include a whitish mucus in the stool and the feeling that you have not completed a bowel movement.
IBD (Inflammatory Bowel Disease)
IBD includes conditions like Crohn's disease and ulcerative colitis and involves chronic inflammation of the digestive tract. Left-sided abdominal pain near the rib cage can be a symptom of IBD if the flare-up occurs in that area.
Other IBD symptoms can include:
- Diarrhea
- Rectal bleeding
- Weight loss
- Anemia
Slipping Rib Syndrome
Slipping rib syndrome occurs when the cartilage connecting the ribs becomes lax or slips out of place. This can cause sharp, intermittent pain under the affected side of the rib cage and worsen by certain movements or pressure.
Other symptoms may include:
- A popping or slipping sensation
- Pain with applied pressure to the area
- Worsened pain with twisting, coughing, and laughing
Describing How Left Rib Pain Feels
Left rib pain can manifest in various ways depending on the underlying cause. It may feel like a sharp, stabbing sensation, especially with movements like breathing deeply, coughing, or twisting. Some may describe it as a dull, achy discomfort that lingers or intensifies over time.
In certain cases, the pain may radiate to the back, abdomen, or shoulder. It's important to note any additional symptoms like difficulty breathing, swelling, or tenderness, as these can provide important clues to the cause of the pain.
Describe your symptoms in detail to your healthcare provider so they can determine a cause and provide appropriate treatment.
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Emergency Left Rib Pain and Related Symptoms
Emergency left rib pain can indicate several serious conditions that require immediate medical attention. If you experience sudden, severe left rib pain along with any of the following symptoms, seek emergency medical care:
- Difficulty breathing or shortness of breath
- Chest pain or pressure
- Nausea or vomiting, especially if accompanied by abdominal pain
- Fever or chills
- Rapid or irregular heartbeat
- Dizziness or light-headedness
- Sweating, particularly cold sweats
- Paleness or clamminess of the skin
These symptoms may indicate a range of potentially life-threatening conditions such as a heart attack, pulmonary embolism, pleurisy, or a ruptured spleen.
Prompt medical evaluation and treatment are crucial to assess the underlying cause and prevent complications. If in doubt, always err on the side of caution and call 911 right away.
Left Rib Pain Treatment Overview
Treating left rib pain depends on its underlying cause.It is important to see your healthcare provider for a diagnosis and for the appropriate treatments. Treatment options vary and could include the following:
Costochondritis
- NSAIDs may help reduce inflammation and pain.
- Gentle exercises and stretches may improve flexibility and reduce pain.
Gastrointestinal Issues
- Antacids, proton pump inhibitors (PPIs), or H2 blockers (histamine 2 antagonists) may be prescribed to reduce stomach acid and relieve symptoms.
- Avoiding trigger foods and eating smaller, more frequent meals can help manage symptoms.
Pleurisy
- NSAIDs or pain-relieving medications may be prescribed to alleviate chest discomfort
- Resting in different positions until you find a comfortable one
Rib Fracture or Bruise
- Rest, ice packs, and pain relievers can help manage pain while the rib heals.
- Deep-breathing exercises can prevent complications like pneumonia.
Cardiovascular Issues Such as a Heart Attack or Pulmonary Embolism
- Immediate evaluation and treatment are crucial for heart-related conditions.
- Depending on the diagnosis, medications like blood thinners or clot-dissolving agents may be prescribed.
Hospitalization and Rehabilitation
Hospitalization for pain under the left rib is required when there is a need for immediate medical attention, diagnostic clarification, pain management, monitoring of complications, or specialized interventions based on the severity and suspected cause of the pain.
Emergencies such as a heart attack, pulmonary embolism, pneumonia, ruptured spleen, or other severe trauma require hospitalization until the person is stable for discharge.
In some cases, you may be able to take care of yourself at home. If that is the case, your healthcare provider may recommend some of the following (depending on your diagnosis):
- Rest
- Over-the-counter pain medications
- Prescription pain relief
- Heating pad to the affected area
- A special diet
Testing to Confirm Diagnosis
Diagnostic tests for left rib pain would depend on the suspected cause of the pain. Here are some common diagnostic tests that may be performed:
Physical Examination
A thorough physical examination by a healthcare provider can provide valuable information about the location, severity, and nature of the pain. Palpation (examining by touch) of the rib cage, abdomen, and surrounding areas can help identify tenderness, swelling, or abnormalities.
Imaging Studies
- X-rays
- Computed tomography (CT) scan
- Magnetic resonance imaging (MRI)
Blood Tests
- Compete blood count (CBC)
- Inflammatory Markers: Tests like C-reactive protein (CRP) and erythrocyte sedimentation rate (ESR) can indicate inflammation in the body, which may be related to the pain
Ultrasound
Ultrasound imaging can evaluate the abdominal organs, helping diagnose conditions like gallstones, liver disease, or spleen enlargement that may cause referred pain to the rib area.
Endoscope
If gastrointestinal issues are suspected, such as gastritis, GERD, or peptic ulcers, an endoscopy may be performed to visualize the esophagus, stomach, and upper digestive tract for abnormalities.
Summary
Understanding the potential causes of pain under or around the left rib cage is crucial for prompt diagnosis and appropriate treatment.Whether the pain is related to emergency conditions like a heart attack or pulmonary embolism, or less-threatening causes such as gastritis or costochondritis, seeking medical attention and following a treatment plan tailored to your diagnosis is paramount.
Talk with your healthcare provider for an accurate diagnosis and a personalized care approach.
