Pain Under Right Rib Cage

Pain under rib cage is one of the manifestations of a large number of associated diseases.

Rib cage is mainly composed of 12 ribs on either side of the chest and encloses different chest structures such as hearts, lungs and trachea. It is also composed of twelve thoracic vertebrae and sternum which is a T-shaped bone.

Thus, pain can be due to pathology within these structures. There are many other reasons of this pain as well and it can radiate to the ribs from different other organs. Blunt force injury to the chest is another cause of pain in the chest. Ribs fracture or cracks development in them may also make a person to suffer from rib cage pain.

Rib cage functions to provide shelter to the sensitive organs of the body such as heart and lungs. It also allows the lungs to expand during the process of inspiration.  So this is the most important skeletal organ of our body. Any pathology in it should need to be addressed immediately and effectively.

pain under rib cage

Causes of Pain Under Right Rib Cage

Pain under the right rib cage has a large number of reasons. The pain here can be localized or generalized involving the whole rib cage. The causal agents for right-sided rib cage pain comprise:

  • Costochondritis – Costal Cartilage Inflammation

It is the most common cause of pain under the rib cage. Pain can be on the left or the right side depending on the site of inflammation. Along with pain in the chest breathing also becomes painful. This condition can be due to infection or trauma to the costal cartilages. Even it can be due to severe sort of coughing that puts strain on the ribs and resulting into the inflammatory condition of the cartilages.

  • Trauma To Ribs or its Cartilages

Fall, crush injuries or accidents particularly of motor vehicle can lead to pain and injury in the chest. If injury has occurred to the right sided ribs, then pain will be at this side. There may also be different other symptoms along with pain in the rib cage depending on the severity or impact of the injury.

The pain also arises due to repetitive trauma or movement as seen in certain sports such as rowing or golf etc. Pain due to injury can be accompanied by difficult breathing. Fractures of the ribs are also one of the main causes of pain. Displaced fractures may lead to more complications and more severe pain. A chest X-ray helps to find out the fractures.

  • Strain on the Intercostal Muscles

Ribs are connected with each other via different muscles groups’ names as intercostal muscles. The main function of these is in the respiration. They contract when we take breath in and relax when we breathe out. The rib cage moves accordingly. The pain arises when muscles of that side is affected due to inflammation or infection or due to some other causes. Speedy torso twisting can also produce a strain on the intercostal muscle. The strain may then turn out to produce a painful respiration and discomfort.

  • Stones in the Gall Bladder

Gallbladder is an organ small in size and shape like a pear. It is present underneath the liver. It accumulates and liberates bile which is a digestive juice. This organ is known to be affected by stones. And if stones are formed into it, it leads to pain at that side. The site where gall bladder lies is mainly the right side of the cage.

Thus cholecystitis, an inflammation of the gallbladder and gallstones are two most common causes behind pain under the right side of the rib cage. Pain in case of Cholecystitis also occurs in the right upper quadrant of the abdomen.

  • Liver Injury

An injury or infection of any sort to the liver may also produce pain under the right side of the rib. Pain is accompanied by different other manifestations depending on the diseases or intensity of the injury. Hepatic carcinoma may also produce severe kind of the pain under the rib cage of the right side.

  • Peptic or Duodenal Ulcer

Peptic or duodenal ulcer may also cause pain in the right side of the rib cage. It is basically a condition of high gastric acid secretion which destroys the normal protective mucosa of the stomach and duodenum. As a result, the pain and the burning sensations are felt in the right side of the abdomen.

  • Crohn’s Disease

A person affected with Crohn’s disease may also likely to experience Pain under the right rib cage.  This is the inflammatory condition of large intestine lining. Other symptoms of this inflammatory bowel disease include diarrhoea, abdominal discomfort or flatulence.

Pain Under Right Rib Cage Under Special Circumstances

There are some situations when pain under the right rib cage is experiences. These include:

  1. During Pregnancy

Pain arises during pregnancy as hormonal changes lead to laxity of the ligaments which become slightly sore. It also occurs as the size of the uterus increases. In addition, the increase in size of the breast may also cause pain in the ribs during pregnancy. The additional weight drags the shoulders forward and down, and places strain on the upper back, neck, and often results in pain around the rib cage.

  1. During Running

It is the most common type of condition seen among people. It is also known as stitches. Pain is felt like a sharp type of pain. There is yet no known study regarding exact cause of the pain but it is believed to be due to certain factors such as over hydration, inconsistent breathing patterns or dehydration, etc.

Associated Symptoms

The severity of the pain under the right rib cage can be mild to severe in nature. It frequently radiate to the different side of the body such as the back both upper and lower. The pain can occur for a few minutes or can be continuous depending on the nature of pain and its cause. The symptoms along with pain include sneezing, difficult breathing, fever, coughing or pain in any other area of the body such as abdomen.


The pain under the right rib cage should always be needed to diagnose properly. For it a doctor will ask you to undergo certain examinations and tests. These include:

  • Chest X ray
  • Blood Tests
  • MRI
  • Certain Biochemical Tests
  • Endoscopic retrograde cholangiopancreatography (ERCP)
  • Complete urine examination
  • Stool test
  • Blood Cultures
  • Liver Biopsy

Treatment for Pain under Rib cage

There is no particular treatment to treat the pain under tight rib cage.  The main treatment is the correction of the underlying root. Most of the conditions especially of inflammatory nature are easily cured by the use of non steroidal anti inflammatory drugs. Over-the-counter pain killers can also be taken in case of pain of mild nature.

Need of Surgery

Surgery is required in case of gallstones, rib fracture or in a condition of flail chest. So surgery is compulsory to remove the stones from the gall bladder or to correct the fractures. This way pain under the rib cage can be alleviated.

Treatment for Liver Diseases and Cancer

In case of hepatitis and liver injury, usually supportive treatment is given. While in case of some fulminant disease of the liver, liver transplantation is recommended. This will restore liver function as well as relieve pain under the right rib cage.


Published by Dr. Jackie Te RN, MD under Pain Management.
Article was last reviewed on January 12th, 2022.

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