The rib pain on the left side


Rib pain on the left side is an uncomfortable but in most cases harmless symptom. The anatomy of the left rib cage does not differ from the right side, only the organs underneath and thus the organic causes of the rib pain vary.
The pain can be constant and dull, but also shooting, stabbing and acute. Superficial injuries to the chest are particularly painful during breathing, as this leads to a displacement of the ribs. Often, however, there are also more serious organic causes that are mistakenly perceived as superficial pain in the ribs.

The possible causes

In most cases, harmless external chest discomfort is responsible for the pain in the ribs. In addition to the rib bones, the cartilaginous parts of the rib, the so-called "intercostal nerves", as well as the superficial sheet of the pleura can be affected. The ribs can be bruised or broken from an injury, which can lead to stabbing rib pain. Entrapment or irritation of the intercostal nerves can suddenly lead to unpleasant stabbing chest pain, which is misinterpreted as heartache.
Deeper injuries to the chest, on the other hand, can lead to painful damage to the pleura, known as the “pleura”. However, this can also be inflamed as part of pneumonia and cause rib pain on the left side.

On the other hand, diseases of the chest organs or the upper abdominal organs are less common behind the left-sided rib pain. The main thing to think about is the heart. If the heart is insufficiently supplied with oxygen, sudden stabbing pains can occur on the left side, which in many cases even radiate into the left arm or jaw.
Changes in the upper abdominal organs can also project pain onto the left ribs. This can result from increased pressure on the diaphragm due to enlargement of the spleen or liver.

For more information, also read: Chest pain.

Rib pain from coughing

Uncomfortable rib pain when coughing is a common symptom. The pain occurs when you inhale deeply and can even make breathing difficult.

Breath-dependent rib pain suggests a problem with the ribs, the rib muscles, the intercostal nerves or the outer pleura. The jerky exhalation when coughing puts a lot of strain on the structures of the chest. The ribs drop suddenly, the muscles tighten, and the lungs contract. Injured ribs can be stabbing pain, broken ribs can even shift due to coughing and pinch other structures.
The pleura also experiences displacement and friction from coughing, which can cause severe pain if there is inflammation.

Find out more about the topic here: Rib pain when coughing.

Rib pain under the left breast

The localization of the pain on the left under the chest leads to the assumption that the heart is affected and that there is even a heart attack. However, a disease of the ribs or the structures of the chest is much more likely and harmless. In young people in particular, stabbing pain on the left under the chest is often temporary. Movement and breathing dependent pain also speaks against a disease of the heart.

Below the left chest, the pain can also originate from the upper abdomen and indicate increased pressure on the diaphragm.

Chest pain? Read more about this here.

The accompanying symptoms

The accompanying symptoms depend on the underlying condition and can vary widely.

Superficial injuries to the chest can be accompanied by other typical signs of injury such as swelling, reddening, visible deformities and a bruise. In severe cases, the pain also causes restricted breathing, resulting in shortness of breath.
An inflammation of the pleura, on the other hand, can be accompanied by general symptoms such as fever, fatigue, cough and shortness of breath. If there are diseases of the chest or abdominal organs as the cause of the pain in the ribs, other symptoms such as increased heart rate, decreased blood pressure, fever, cold sweat and numerous other accompanying symptoms can occur.

The diagnosis

The diagnosis is first made on the basis of a detailed anamnesis (recording of the medical history) and a physical examination. Here, the complaints and accompanying symptoms are precisely recorded, which already provides important information about the underlying diagnosis.

The severity of the symptoms influences the sequence of the diagnostic procedure. Severe rib pain on the left side can indicate a heart attack, which is why this should first be ruled out with the help of an EKG and laboratory tests. Injuries to the ribs can then be diagnosed on an X-ray.
If there are indications of an organic cause of the disease, the organs can be better visualized with the help of further blood tests and radiological procedures. For this purpose, a CT examination can be carried out, which provides a significantly higher resolution and diagnostic accuracy than the X-ray image.

The treatment

Treatment varies widely with the underlying condition. A distinction must be made between symptomatic and causal therapy.

Symptomatic therapy includes pain relief, which is necessary in many cases for left rib pain. If breathing is impaired by the pain and sleep is disturbed, the pain should be relieved with medication. For this purpose, drugs from the group of NSAIDs such as ibuprofen, indomethacin or diclofenac are recommended.

A causal therapy for injuries to the ribs is usually not carried out. The ribs heal by themselves and should be spared during this period. Diseases of the left thoracic and abdominal organs require very individual therapy, ranging from antibiotics to surgical therapies

The duration

The duration of the pain can vary widely. Injuries to the chest and ribs can be persistent and cause pain for a few weeks. A broken rib can cause discomfort for up to 4-6 weeks.

Rib pain emanating from internal organs often lasts as long as its therapy. With the response to the drug therapy or after the operation, the pain subsides within a short time. The duration of the pain is therefore dependent on the start of therapy and the therapy response.


The prognosis for rib pain is usually good. Superficial pain subside by itself within a few weeks and is therefore considered to have healed.

Potential diseases of the organs as a cause of left-sided rib pain also have a good prognosis. On the other hand, there are potential heart diseases that can lead to complications and even death. They are only rarely the cause of rib pain.

Also read the article: Prognosis after a heart attack.

The rib pain in pregnancy

Pregnancy can also be the result of rib pain on the left side. In the course of pregnancy, the child grows up to the upper abdomen and displaces surrounding organs. These changes can be felt in many areas of the body and cause discomfort.

In the upper abdomen, the uterus can put pressure on the spleen and the diaphragm above it. The lower costal arch can also experience pressure from the inside, which can cause stabbing pain in the ribs. The pain is poorly relieved during pregnancy, but it subsides immediately after the pregnancy ends.

You can find more information on this topic at: Rib pain during pregnancy.

Can this also be an indication of a heart attack?

In most cases, superficial chest disease is behind the pain in the ribs. However, in some cases, acute stabbing pain in the ribs on the left side can also indicate a heart attack. This leads to an occlusion of a coronary artery, which means that the heart muscle is supplied with too little oxygen and can die. This causes severe pain in the chest, as well as in the left arm, back or jaw. In addition, panic, fear and shortness of breath often occur.

Mostly it is a highly acute event that should be treated immediately in the hospital.

Find out more about the topic here: Signs of a heart attack.