Understanding Pain on the Left Side Behind the Ribs
Experiencing pain on the left side behind your ribs can be alarming. However, in many cases, it is not a cause for serious concern. There are various minor musculoskeletal and digestive issues that can lead to pain in this area. But sometimes, it could signal an underlying medical condition requiring treatment. Knowing the possible causes and when to see a doctor is important.
What Organs Are on the Left Side Behind the Ribs?
The ribs protect several vital organs located on the left side of the body behind your ribcage. These include:
- Left lung - Taking up most of the space in the chest cavity behind the ribs.
- Heart - The bulk of the heart is positioned slightly left of the breastbone.
- Stomach - The stomach sits just below the ribs on the upper left side of the abdomen.
- Spleen - This organ is tucked up under the ribcage on the left side.
- Left kidney - The left kidney is situated towards the back on the left side of the body behind the ribs.
- Left adrenal gland - This endocrine gland lies above the left kidney.
Problems affecting any of these organs can potentially cause pain behind the left ribs. The specific location and nature of the pain provides clues as to which organ is involved.
Common Causes of Pain on the Left Side Behind Ribs
There are many possible reasons for pain behind the left ribs, including:
- Gas and digestive issues - Gas, indigestion, stomach cramps, constipation, or diarrhea can all cause temporary pain under the left ribs.
- Muscle strain - Overuse injuries like muscle strains of the intercostal muscles between the ribs or back muscle spasms can cause soreness.
- Poor posture - Slouching and bad posture stresses the back and rib muscles leading to achiness.
- Costochondritis - Inflammation where the ribs join the breastbone causing localized chest pain.
- Heartburn - Acid reflux can produce burning pain under and behind the ribs.
- Pancreatitis - Inflammation of the pancreas triggers pain in the upper left abdomen that may radiate to the back.
Less common but more serious possible causes include:
- Heart attack - Cardiac chest pain from a heart attack may radiate to the left side and back.
- Pleurisy - Inflammation of the pleura lining around the lungs leads to sharp chest pain when breathing.
- Pneumonia - A lung infection causes chest pain that worsens with deep breaths and coughs.
- Kidney stones - Sharp pain under the ribs on one side signals a kidney stone.
- Enlarged spleen - An abnormally enlarged spleen puts pressure on nearby organs.
When to See a Doctor
Make an appointment with your doctor if you have any of the following:
- Severe, sudden, sharp pain behind the ribs
- Pain not relieved by over-the-counter medications
- Pain that persists for more than a week
- Difficulty breathing or pain with breathing
- Tenderness over the ribs
- Unexplained weight loss, fever, or chills
- Associated symptoms like chest tightness, shoulder and jaw pain, nausea, or lightheadedness
Seek prompt emergency care for:
- Sudden, crushing chest pain
- Severe pain that radiates down the arm or to the neck and back
- Pain accompanied by profuse sweating or difficulty breathing
- Coughing up blood
These red flag symptoms indicate a possibly serious medical problem requiring immediate treatment.
Musculoskeletal Causes of Pain on the Left Side Behind Ribs
Issues with muscles, bones, and connective tissues account for many cases of pain on the left side under and behind the ribs. Typical causes include:
Muscle Strains and Spasms
The muscles between the ribs and those supporting the back work hard with breathing, posture, and trunk movements throughout the day. Overuse, poor posture, injury, or simply sleeping in an awkward position can strain or spasm these muscles. This produces sore, tender spots and spasms.
Muscle pain tends to feel worse when stretching, twisting, bending, or taking deep breaths. Applying heat, massage, and over-the-counter pain medication provides relief. Resting the muscles for a few days aids healing.
Costochondritis
Costochondritis causes inflammation where the upper ribs attach to the breastbone or sternum. It produces localized chest pain and tenderness. The pain may resemble a cardiac issue but has a more clearly defined area of discomfort. It is often triggered by traumatic injury, respiratory infections, or arthritis.
Anti-inflammatory medications, hot/cold therapy, and avoiding aggravating movements helps costochondritis. Steroid injections can relieve stubborn cases unresponsive to other measures.
Poor Posture
Slouching, hunching over a desk, improper bending, and other poor postural habits add extra stress and tension to the upper back and ribcage. This slowly provokes aching, soreness, and even muscle spasms over time. Practicing good upright posture and taking regular stretch breaks prevent pain.
Fibromyalgia
Widespread chronic muscle pain occurring at specific tender points around the body is the hallmark of fibromyalgia. The region around the left ribs may be one area of discomfort. Treating fibromyalgia requires medications, lifestyle changes, stress reduction, and physical therapy.
Gastrointestinal Origins of Pain Behind the Left Ribs
Abdominal and digestive disturbances often manifest as pain under the left ribs. Possible gastrointestinal causes include:
Gas and Bloating
Excess gas and bloating puts pressure on the organs under the diaphragm, causing referral pain that is felt behind the ribs. Gas pain may feel sharp and stabbing initially, then turn into a dull ache. Moving around and passing gas provides relief. Dietary changes reducing gas production treat the root cause.
Stomach Ulcers
Ulcers occur when the protective lining of the stomach erodes due to bacterial infection or excessive acid production. The pain is described as gnawing or burning, usually worse when empty stomach and improved by eating. Ulcers require antibiotics and medications reducing stomach acid to promote healing.
Gastritis
Gastritis refers to inflammation of the stomach lining frequently due to a bacterial infection. Symptoms include burning stomach pain, nausea, and loss of appetite. Treatment involves antibiotics, antacids, and medications decreasing acid production.
Constipation
Difficult, infrequent bowel movements lead to bloating and cramping pain. The backed up stool puts pressure on other organs like the stomach and spleen causing referred pain under the ribs. Drinking more fluids, adding fiber to your diet, exercise, and over-the-counter laxatives treat constipation.
Irritable Bowel Syndrome
IBS causes recurrent abdominal pain related to bowel disturbances. The pain occurs in the lower abdomen but can also be felt under the left ribs. IBS is managed through diet changes, stress reduction, medication for diarrhea/constipation, and drugs modulating gut pain perception.
Cardiac Causes of Pain Behind the Left Ribs
Because the heart resides right under the left ribs, cardiac problems often produce pain in this area. However, the discomfort may radiate to other parts of the body as well. Common heart-related causes include:
Angina
When blood flow to the heart is temporarily disrupted, it causes chest pain termed angina. It may feel like pressure, tightness, or aching under the left ribs and spread to the shoulders, arms, neck, or jaw. Angina signifies underlying heart disease and requires prompt medical evaluation.
Heart Attack
A heart attack occurs when a blocked cardiac artery cuts off oxygen to an area of heart muscle, causing tissue damage. The classic heart attack symptom is crushing, excruciating chest pain under the ribs that radiates down the arm. However, milder pain in other areas like the upper back can also happen.
Pericarditis
Inflammation of the pericardium surrounding the heart produces sharp, stabbing chest pain that changes with position and breathing. The region under the left ribs is particularly tender. Pain relievers and anti-inflammatory medications are used for treatment.
Aortic Dissection
A tear in the aorta’s inner lining causes blood to surge through and split its layers apart. Severe tearing chest and back pain described as ripping or shearing results. An aortic dissection is a life-threatening emergency requiring immediate surgery.
Other Serious Causes of Left-Sided Rib Pain
Some potentially severe conditions originating from other body systems and organs can also generate pain behind the ribs on the left side. These include:
Pneumonia
An infection and inflammation of the lung tissue produces a sharp, stabbing chest pain with coughing or deep breaths. Fever, chills, fatigue and shortness of breath accompany pneumonia. Antibiotics tailored to the specific bacteria are used to treat it.
Pleurisy
The pleura are the lubricated membranes surrounding the lungs allowing smooth expansion with breathing. Pleurisy occurs when this delicate lining becomes inflamed, causing a sharp, knifelike pain worsening with inhales and coughs. Pain medication and anti-inflammatories help relieve discomfort until it resolves.
Pancreatitis
Inflammation of the pancreas, frequently from gallstones blocking a duct, results in severe abdominal pain radiating to the back. Nausea, vomiting, fever and elevated enzymes reflecting pancreatic damage occur also. Pain control, IV fluids, and rest to avoid stimulating the pancreas are the treatment basics.
Kidney Stones
Sharp, cramping left flank pain signals a kidney stone in the ureter triggering spasms as it tries to pass down into the bladder. The pain may radiate around to the side, back, groin, and abdomen. Pain control and hydration facilitate stone passage, while some cases require surgery.
Enlarged Spleen
An abnormally enlarged spleen presses on the stomach and diaphragm, causing pain under the left ribs. It enlarges reactively due to liver disease, infections, cancer, or blood disorders. Treating the underlying condition may resolve spleen enlargement. Otherwise, surgery to remove the spleen is warranted.
When Pain on the Left Side is Serious
While left rib pain often arises from minor musculoskeletal or gastrointestinal causes, certain red flag symptoms warrant prompt medical evaluation for potentially serious conditions. Seek emergency care for:
- Sudden, severe chest pain
- Rib pain with difficulty breathing
- Coughing up blood
- Passing out or feeling faint
- Radiating pain down the arm, shoulder, neck or jaw
- Associated symptoms like sweating, nausea, vomiting, or back pain
Preexisting history of heart disease, lung disorders, cancers, spleen issues, kidney disease, and aneurysm also place you at higher risk if new rib pain develops.
Left rib pain involving these urgent signs indicates problems like a heart attack, pulmonary embolism, pneumonia, aortic dissection, pancreatitis, or splenic rupture. Waiting to get medical attention could have devastating consequences, so call 911 or go to an emergency room right away.
Diagnosing the Cause of Pain Behind Left Ribs
To pinpoint the origin of pain behind your left ribs, the doctor will begin with a detailed history and physical exam. Diagnostic testing guides further evaluation of concerning symptoms.
Medical History
Your doctor will ask questions to characterize your pain, including:
- Exact location of the pain
- Quality - sharp, dull, burning, aching
- Severity
- Duration
- What makes it worse or better
- Associated symptoms
- Past medical issues
- Recent physical activities
- Dietary changes
- New medications
Physical Exam
A focused exam assesses the ribs, chest, abdomen, back, and flank. Your doctor will check for:
- Pain or tenderness when palpating the chest and ribcage
- Redness, swelling or bruising over the ribs
- Point tenderness suggestive of costochondritis
- Rapid or irregular heart rate
- Lung sounds revealing decreased air movement or rubbing during breathing
- Abdominal bloating, masses, fluid, or enlarged organs
Diagnostic Tests
Tests that may be ordered include:
- Blood tests - Signs of infection, elevated cardiac enzymes, kidney dysfunction
- Urinalysis - Detects blood or bacteria signaling UTI, stones
- Stool test - Checks for blood suggesting ulcer or inflammation
- Chest x-ray - Views lung infections, rib fractures, enlarged heart
- CT chest scan - Further evaluates lungs, ribs, heart, and spleen
- Abdominal ultrasound - Checks abdominal organs like spleen, kidneys, pancreas
- Electrocardiogram - Records heart's electrical activity
With an accurate diagnosis, appropriate treatment can be initiated to resolve your left rib cage pain.
Treating Pain Behind the Left Ribs
Treatment depends on the diagnosed cause of your left rib pain. Some general treatment options include:
- Pain relievers - Over-the-counter NSAIDs or prescription narcotics relieve discomfort.
- Heat/ice - Applying heat packs or cold compresses alleviates muscular pain and inflammation.
- Rest - Avoiding activities aggravating the pain allows healing.
- Postural correction - Improving posture lessens muscle strain.
- Physical therapy - Stretches and exercises strengthen and stabilize the structures around the ribs.
Additional targeted treatment options address the specific causative condition such as:
- Antibiotics for pneumonia and infectious gastritis
- Steroids and other anti-inflammatories for costochondritis or pleuritis
- Antacids and acid-reducing agents for ulcers
- Laxatives and high fiber diet for constipation
- Diuretics to eliminate kidney stones
- Surgery to repair aortic dissection or enlarged spleen
See your doctor promptly if pain persists longer than 1-2 weeks for proper diagnosis and treatment. Be sure to follow up to ensure adequate resolution of your rib pain.
When to Seek Medical Care
Make an appointment with your doctor for any of the following:
- Unexplained left rib pain lasting over a week
FAQs
What organs are located behind the left ribs?
Key organs protected by the left ribs include the heart, left lung, stomach, spleen, left kidney, and left adrenal gland. Problems with any of these organs can potentially cause pain behind the left ribs.
When should I see a doctor for left rib pain?
See your doctor if the pain is severe, persistent, gets worse, or is accompanied by breathing issues, chest tightness, sweating, lightheadedness or other concerning symptoms. Call 911 for sudden, crushing chest pain.
What tests help diagnose left rib pain?
The doctor may order blood tests, urinalysis, chest x-ray, CT scan, abdominal ultrasound, EKG, and other tests based on your symptoms to pinpoint the cause of left rib pain.
Can gas cause pain under the left ribs?
Yes, excess gas putting pressure on the stomach, spleen and diaphragm can refer pain that is felt behind the left ribs. Gas pain usually comes and goes. Moving around and passing gas brings relief.
Is back pain normal with rib injuries?
It's common to feel pain in the back below the ribs with rib fractures and muscle strains since the muscles around the ribcage extend into the upper back area. See a doctor to assess the injury.
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