Pain in the right costal arch - that's behind it

introduction

Pain in the right costal arch can have different causes and also occur in different ways. Finally, a distinction is made between chronic rib pain that lasts longer than six months and acute pain in the area of ​​the costal arch. In the case of persistent pain, the cause should be clarified by a doctor, because this region also contains important organs that may be diseased and thus trigger the pain.

causes

Pain in the costal arch right can muscular or organic cause be. Is there a Muscle tension before that for example during sporting exercises caused pain when you move again. It can also be caused by a strong cough Torn muscle fiber between the ribs come.

At organic causes The pain on the right side of the costal arch can be caused by lying there Liver, gall bladder or the large intestine caused. If the pain is from the gallbladder, it could be a Inflammation of the gallbladder or also around Gallstones act. The complaints can then radiate into the right shoulder. Typically, there are other symptoms like that yellowish discoloration of the skin (Jaundice), one Discoloration of the stool and it can too Nausea with vomiting come. Are characteristic Colic-like painthat especially too after high-fat food occur.

Furthermore, a extensive meal to pain in the right area Ribs to lead. Of the Stomach is very full and especially additional strenuous activities, but also that Lie down, can lead to the the full stomach presses on the diaphragm above it. This is through numerous annoy supplied and is therefore very sensitive.

Another cause can be the pleurisy which can be very different in the duration of the illness. It is called in medical terminology pleurisy denotes and arises mostly as a result of pneumonia (pneumonia). In addition to a increased fluid accumulation in the pleural space (pleural effusion) finally also occur uncomfortable pain in the lung membrane which is very well supplied by nerves.

Last but not least, the right kidney behind the peritoneum Cause pain in this area. Typically the pain occurs in the case of kidney inflammation more on the back on, but they can Radiate to the front edge of the rib and thus initially lead to a different suspected diagnosis.

Involvement of the liver

The liver, as the largest abdominal organ, lies against the ribs from below and can be palpated below the costal arch. By inhaling deeply, the liver is pushed down from the diaphragm, which is why it protrudes a few centimeters below the costal arch. With various diseases of the liver, such as liver inflammation (hepatitis) a fatty liver caused by alcohol consumption, the liver swells in such a way that it can easily be felt in the right stomach without aids.

Pain is mainly caused by the stretching of the organ capsule, the pressure on the diaphragm and the pressure on the ribs from within.

You can find out how to recognize hepatitis in our article Inflammation of the liver.

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In order to be able to treat successfully in orthopedics, a thorough examination, diagnosis and a medical history are required.
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The aim of any treatment is treatment without surgery.

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For more information about myself, see Lumedis - Orthopedists.

Back pain as a cause

Back pain that arises in the spine can radiate to the closely spaced ribs.

Each thoracic vertebra is in contact on both sides with the corresponding ribs via a joint. It is not uncommon for this joint to jam, block or dislocate due to incorrect movements.
The muscles of the back can also be responsible for pain in the costal arch.

Lying down for long periods, incorrect exercise or seemingly unfounded blockages can cramp and pull the muscles. When moving, sitting and lying down, or even through deep breathing, severe pain in the posterior costal arch can occur.

You can also find out how you can effectively treat this back pain in our article Back pain - recognize and treat optimally.

Anatomy of the right costal arch

Figure pains costal arch right: internal organs from the front

Right costal arch pain

  1. Sternum - sternum
  2. Rib 5 - Costa V
  3. Rib 6 - Costa VI
  4. Rib 7 - Costa VII
  5. Rib 8 - Costa VIIi
  6. Rib 9 - Costa IX
  7. Rib 10 - Costa X
  8. Colon - Intestinum crassum
  9. Right lung - Pulmodexter
  10. Pericardium - Pericardium
  11. Right costal arch -
    Arcus costalis dexter
  12. Liver - Hepar
  13. Galena - Vesica biliaris
  14. Stomach - Guest
  15. Pancreas -
    Pancreas
    The costal cartilages of the 7th - 10th rib
    merge into the costal arch.

You can find an overview of all Dr-Gumpert images at: medical illustrations

Symptoms

nausea

If nausea and possibly vomiting occur in addition to the pain in the costal arch, this can be an indication of typical diseases.

On the right side is the gallbladder, which can cause the symptoms mentioned in the case of inflammation, gallstones or rupture. The liver can also be the cause of nausea and pain in the rib area.

In addition to an enlargement, the HELLP syndrome, preeclampsia or a more severe gestosis come into consideration, especially in the context of an advanced pregnancy. But gastrointestinal diseases can also be present, especially if diarrhea occurs. In all cases, a doctor should clarify the situation so that more serious complications can be avoided.

Read more on this topic at: Pain in the ribs during pregnancy

Localization pain

Pain on the right front costal arch

Potential causes of pain in the costal arch that occur on the right front are muscular causes, such as tension, or caused by the lungs, liver and gallbladder or organs of the gastrointestinal tract.
With a detailed questioning and subsequent physical examination, most superficial complaints of the ribs, muscles or nerves can be differentiated from organic causes.

With bruised or broken ribs, there is often a shock, blow or fall on the chest. The pain can be provoked and intensified in a targeted manner by external pressure or by breathing deeply.
Muscle complaints can also be recognized in this way. On the one hand, there may be injuries and tears in the shoulder, chest, back or respiratory muscles, but also tension, cramping and sore muscles after particular exertion can lead to the pain.

Stinging, breath-dependent pain can also result in injuries to the pleura (med .: Pleura) to lead. In rare cases, an injury to the ribs or a stab in the chest can cause minor injuries to the pleura, which can even cause the lungs to collapse. When inhaling, this can lead to sharp pain. Highly acute pain that is not influenced by inhalation can originate in the liver or gallbladder.

The liver, the largest organ in the upper abdomen, is located directly below the lower right-hand rib cage. In the course of many diseases, it can swell and press on surrounding structures, for example the ribs.

Inflammation of the gallbladder can also be particularly painful. Her colicky pain in the right anterior costal arch often occurs after eating.

Read more about this at: Gallbladder pain

Pain in the right back of the costal arch

Pain that occurs in the back of the costal arch and extends to the spine, in most cases, has its origin in bones, muscles or nerves. The spine can also be a trigger.

Each thoracic vertebra is in direct contact with a rib through a joint on each side. These joints can become dislocated, blocked or dislocated due to muscle spasms or incorrect rotational movements.

There are also large muscles on the back of the rib cage that trigger movements in the thoracic spine and shoulder blade. The shoulder blade rests laterally on the upper ribs and is moved and fixed by various muscle groups.

If there is tension in the back, shoulder or armpit, movement-dependent pain in the back of the costal arch can occur.

You can find out how to relieve this tension in our article Tension.

Pain in the costal arch on the top right

The costal arch extends up to the base of the neck and the collarbone, laterally up to the armpit and at the back to the transition to the cervical vertebrae and neck. This area is home to many muscular structures that are involved in moving the spine, chest, shoulder, and upper arm. The armpit in particular is muscular on several sides and is susceptible to

  • Strains,
  • aching
  • and tension in individual muscles.

In particular, the large pectoral muscles that "Pectoralis muscles", Are often painfully overexerted after intensive strength training. Likewise, lymph nodes on the side in the armpit or in front below the collarbone can cause pain in the ribs.
The lymph nodes in this area can often swell painfully during a viral infection. The pain can be provoked by external pressure.

Please also read: Lymph node pain

The neck and the cervical vertebrae are a fragile skeleton of the important structures of the neck. With tension, bruises and strains, the pain in this area can radiate into the upper costal arch.

Read more about this at: Chest pain from tension

Pain in the lower right costal arch

The lower costal arch covers the upper abdominal cavity and the upper abdominal organs located therein. The large abdominal muscles that cover the rest of the abdomen and are also prone to overexertion and strains, for example in sports, end here.

The liver, gall bladder and parts of the stomach and small intestine are located under the right costal arch. The liver can be painful and enlarged as part of various diseases.
As an important metabolic organ that is responsible for detoxification, it is burdened with many pollutants.
In addition to the typical hepatitis viruses, toxins such as alcohol, certain drugs, fat and harmful metabolic products of the body can also damage the liver in the long or short term. The liver can swell and put pressure on the diaphragm, abdominal organs, and costal arch.

The gallbladder is also a very common cause of pain in the right and lower costal arches. A common clinical picture is gallbladder inflammation as a result of gall congestion caused by blocking gallstones. Even with light pressure on the costal arch and the right abdominal wall, there is considerable pain.

You can find out how to recognize gallbladder inflammation in our article Diagnosis of inflammation of the gallbladder.

Right costal arch pain during pregnancy

As part of the physical changes during pregnancy, pain in the right costal arch can also occur. The abdominal muscles attach to the ribs and are very stretched and stressed during pregnancy. This enormous pull on the muscles can cause pain.

Furthermore, the increase in size of the child can also be the cause of the symptoms. The organs are pressed tightly together and also pushed upwards by the growing abdominal circumference. This can cause irritation to the liver and the well-innervated diaphragm, which can be painful. But kicks the baby in this area can be very uncomfortable for a short time.

Another possibility is the so-called HELLP syndrome, which can occur during pregnancy and is a problem for the liver. It is a serious gestosis that is associated with an increase in liver values, an increase in the size of the liver and a decrease in the number of blood platelets. In addition to high blood pressure, there is also protein excretion in the urine. The enlargement of the liver as part of this condition can cause pain. In the case of HELLP syndrome, the pregnant woman should be closely monitored and an early termination of the pregnancy is often sought by requiring a caesarean section.

Read more on this topic at: Costal arch pain during pregnancy

Rib pain on inhalation

Breathing is a muscle-controlled process in which, in addition to the diaphragm, so-called auxiliary breathing muscles, which are located in the area of ​​the chest, can also play a role.
These muscles can be pulled, torn or tense, but they can also be painful as a result of strength training as a result of incorrect loading. It is not uncommon for bronchitis to cause sore muscles in the auxiliary respiratory muscles after a long cough. When coughing, the otherwise weak muscles between the ribs cause forced exhalation through spontaneous tension.

When inhaling, there is also a movement of the chest and a displacement of the organs of the chest and upper abdomen. In the case of existing painful complaints, inflammations or injuries, inhalation can aggravate and provoke the pain. In the case of a broken rib, for example, breathing in can be so painful as the edges of the broken rib move that it becomes difficult to breathe.

Read more about this at: Pain in a broken rib

Rib pain after coughing

Rib pain after coughing can have various reasons. On the one hand, the pain can be caused by a broken rib that was caused, for example, by direct trauma. Then the pain is aggravated by the cough.

On the other hand, coughing itself can damage the ribs or the surrounding muscles. When coughing, the ribs move with the exhalation. There is a lot of power and high speed behind the coughing process. Many muscles attached to the ribs are involved in this. Strong coughing can lead to muscle tension or cause a blockage in the ribs. This is a blocked costal vertebral joint. Stinging pain typically occurs, which radiates along the costal arch to the front and is aggravated again by the shock when coughing.

Read more on the subject at: Pain in the costal arch from coughing

Pain in the left costal arch

In the left upper abdomen under the left costal arch are the spleen, parts of the large intestine, the head of the pancreas and, behind the peritoneum, the left kidney. In addition to muscular tension, bruised ribs or broken ribs, diseases in these organs can cause pain below the ribs.

In the spleen, a painful enlargement or even a ruptured spleen may be responsible for the pain. Inflammation of the pancreas or even a tumor in the head of the pancreas can also cause painful symptoms. Stomach problems and diseases of the colon can be painful and radiate to the ribs. If there is pain in the left upper abdomen, a heart attack should always be considered. The pain emanating from the heart can also affect the ribs. In addition, nausea and malaise occur, which can then suggest that the symptoms are caused by the stomach or intestines.

Read more on this topic at: Pain in the left costal arch

Figure ribs

Illustration of the skeleton of the rib cage from the front and thoracic vertebrae with rib from above

I-XII ribs 1-12 -
Costa I-XII
(I-VII) True ribs -
Costae verae
(VIII-X) false ribs -
Costae spuriae
(XI-XII) rudimentary ribs -
Cost. fluctuantes

  1. Rib head - Caput costae
  2. Rib neck - Collun costae
  3. Rib humps -
    Tuberculum costae
  4. Rib body - Corpus costae
  5. Rib head joint -
    Articulatio capitis costae
  6. Sternum - sternum
  7. Vertebral bodies -
    Corpus vertebrae
  8. Costal cartilage -
    Cartilago costalis
  9. Rib-sternum joint -
    (Sternocostal joint)
  10. Rib-vertebral body joint -
    (= Point 5.)

You can find an overview of all Dr-Gumpert images at: medical illustrations

Diagnosis

Since the pain can be very diffuse and several causes can be considered in the area, the doctor must first take a precise anamnesis of the occurrence and type of pain. This is followed by a detailed physical examination, which usually includes eavesdropping with a stethoscope, tapping, and palpation. Here the doctor can receive initial information about an organ problem.

Since several organs in the area of ​​the costal arch can be the cause of pain, an imaging procedure will always be necessary to make a reliable diagnosis. In most cases, an X-ray of the lungs is arranged and magnetic resonance imaging is suitable for imaging the organs located in the upper abdomen such as the liver, gall bladders, stomach and intestines. It represents soft tissue particularly well so that changes such as enlargement or inflammation can be detected very easily.

Read more on the topic: Chest x-ray (chest x-ray)

therapy

The therapy depends on the underlying disease. Liver disease can often very good medication can be set. Also Diseases of the stomach and intestines can very well treated with medication become. However, there is one Inflammation of the gallbladder with gallstones before, it is often necessary to remove the gallbladder. Be likewise Surgically removed gallstonesif they do not resolve on their own after a while and cause complications.