Back pain under ribs: pain in the right, left upper quadrant

They can occur even for those who are trying to take care of their health, not to mention those with risk factors. Therefore, these patients are frequent visitors to the doctor's appointment. And among the complaints often is the pain under the ribs from behind the back. Why do I get this symptom, you can learn only after a thorough examination.

pain in back and ribs


If it hurts in the back under the ribs, it causes legitimate concerns. Discomfort in the left or right side are a reflection of the changes in various body systems. And sometimes they become quite serious. Therefore, the tactics to be appropriate.

Most patients know: if back pain under the ribs or in the other part is connected with the spine. And many cases are proof. The pain is often a symptom of the pathology of the axial skeleton:

  • Degenerative disc disease.
  • Intervertebral hernia.
  • Spondylosis.
  • Of spondylolisthesis.
  • Of spinal stenosis.
  • Injuries (bruises, fractures).
  • Tumors.

Of particular concern in patients and causes acute girdle pain under the ribs, which delivers the greatest suffering and significantly limits physical activity. But it may be associated not only with diseases of the spine. Intercostal neuralgia, herpes zoster – frequent causes of such symptoms. In addition, in the upper quadrant are the internal organs, the destruction of which often causes pain, which is given in the back. Such conditions include:

  • Cardiovascular pathology.
  • Diseases of the respiratory system.
  • Problems of the digestive system.
  • Kidney disease and urinary tract.

Thus, pain under the ribs is a frequent phenomenon, which requires careful and differentiated approach. In fact back problems can occur in many, but not all of it is connected with the spine.

Find out why it hurts on the left under the ribs, only the results of a medical examination and additional examination. To not waste time and quickly determine the cause, should be treated in a medical facility.


Pain in the left or right upper quadrant on the back – fairly common symptom. In many cases they are the main complaint from patients. So, back pains have the following features:

  • Acute or obtuse.
  • Stabbing, aching, throbbing, shooting, drawing.
  • Appear suddenly or develop gradually.
  • Local or common.
  • Located on one or both sides (shingles).
  • Localized in the lumbar region, the chest, in the middle of the spine, between the shoulder blades, pain in the abdomen, right or left side.
  • Which are distributed in the feet and hands, the neck, the area of the pelvis.
  • Aggravated by movements of the trunk and limbs, back pain with deep breaths, coughing, sneezing.

That is the pain under the ribs can have different colors, each patient is their own. And only an individual approach will achieve success in the diagnosis of any case. But besides pain in the left or right upper quadrant, there will be other symptoms that will help you to make an accurate conclusion. Knowing them, we can assume this or that problem even without the intervention of a doctor. But the exact cause of the pain will only install specialist.

If back pain left side under ribs, the first doctor to identify the symptoms. This will give the opportunity to form a complete clinical picture of the likely pathology.

Diseases of the spine

Pathology of the axial skeleton is the most common cause of pain localized behind. They can give in any part of the body, including hypochondria. A source of pathological impulses becomes a muscle spasm or compression of nerve roots. If the lesion is in the lumbar region, back pain can acquire the following character:

  • Lumbago – acute lumbago.
  • Lumbalgia – aching and deep.
  • Sciatica – which give in the leg.

As a rule, uncomfortable sensations when twisting and leaning while standing or sitting, or while walking, t.. Zn. in cases when there is a load on the axial skeleton. If the affected thoracic spine, the pain under the ribs on the left provoked deep breath, chest pain when you cough, sneeze or laugh. In addition, there are other characteristic symptoms:

  • Numbness, tingling, burning, "crawling".
  • Reduced sensitivity.
  • Change in tendon reflexes.
  • Fatigue in the legs, a feeling of weakness.

On the back side of the lesion is determined by muscle spasm and pain points. You can notice the flattening of physiological curvatures or the pathological. Movement in the back is severely restricted.

Pathology of the spine in most cases leads to restriction of physical activity, which adversely affects household and professional activities.

Intercostal neuralgia

Pain under ribs can be caused by intercostal neuralgia. This is the banal colds and in more serious cases: inflammation, trauma, neoplastic processes. If the nerve is affected on both sides, unpleasant sensations in the direction of have surrounding the character, both right and left. Because the source is located in between the ribs, and the symptoms will have local character:

  • Pain in this area.
  • The increase in sensitivity.
  • Numbness, tingling, "crawling".

Typically, the visual changes on the skin and the pain increases during motion in the thorax: breathing, coughing, sneezing. So patients try to breathe shallowly and avoid unnecessary bends torso.


Pain under ribs on the left often appear herpes. It is a viral disease that affects the nerve ganglia and fibers of the intercostal. The symptoms are similar to neuralgia, but there are characteristic changes on the skin: vesicles filled with clear fluid (vesicles) located on a red background. Unlike the previous pathology, and flank pain with herpes will have a permanent nature, they are quite pronounced and bring more suffering to the patients. At the stage of healing you may experience itching in between the ribs.

Shingles refers to infectious diseases, so it requires proper treatment and care.

Cardiovascular disease

Cardiovascular disease

If it hurts on the left under the ribs, it is necessary to exclude cardiovascular pathology. It is impossible to forget about such conditions as ischemic heart disease, pericarditis or myocarditis. If the pain is felt behind the breastbone (in the middle) and extends to the left shoulder girdle, arm and back pain between the shoulder blades, you should think about angina or myocardial infarction. When the lesion (necrosis) areas of the heart muscle may disturb the hypochondrium and upper abdomen. Then the pain becomes prolonged and can not be removed nitroglycerin. With the following features:

  • Heart palpitations.
  • The pressure change.
  • Shortness of breath.
  • Alarm.
  • Sweating.

A heart attack is the most serious pathology of the cardiovascular system, which requires emergency treatment. Otherwise, there is a large number of acute and chronic complications, including life-threatening.

Diseases of the respiratory system

Pain left side under ribs can occur due to respiratory pathology. Usually, we are talking about lower lobe pneumonia or pleurisy. In these cases, they often provoked by a deep breath or cough, and with bilateral lesion of the acquire surrounding the character. Besides pain in upper quadrant, there will be other symptoms:

  • Dry or wet cough.
  • The appearance of sputum (mucous, purulent).
  • Shortness of breath.
  • Fever.
  • General malaise.

Pleurisy is characterized by a decrease in pain lying on the affected side. Objective examination marked dullness of percussion sound over the area of inflammation, easing breathing and the appearance of pathological noise: wheezes, friction of the pleural layers.

In the area of edges is the edge pleurisy of leaf, which is affected in diseases of the respiratory system, including pneumonia.

Problems of the digestive system

Pain under the ribs is a common symptom of diseases of the gastrointestinal tract. Can affect various organs of the digestive system. In the left upper quadrant is the pancreas. Therefore, if back pain under ribs you can think about pancreatitis. During exacerbation of the disease these sensations will become stronger and will be combined with other symptoms:

  • Nausea.
  • Vomiting.
  • Loss of appetite.
  • The indulgence of the chair.
  • Flatulence.

Palpation of the right hypochondrium will be local tenderness, and in some cases may increase body temperature. Characteristic changes in the stool: increased bowel movements, oily sheen.

The right side can be disturbed in case of cholecystitis. Then the pain under the ribs often radiates to the back, under the shoulder blade or in the neck. And the patient feels bitter taste in the mouth, nausea, loose stools. Gastric ulcer, on the contrary, most often characterized by constipation, pain located in the upper middle abdomen (epigastrium) or a bit to the side in pyloroduodenal zone. Sometimes the pain is felt in the back, in the region of the thoracic spine.

Kidney disease and urinary tract

The kidney is in the retroperitoneum, so when it is the inflammation of the pain is felt under the ribs and lower back. This is especially noticeable in glomerulonephritis. The urinary tract also affected due to stones, which can injure and disrupt the dynamics. And the most frequent symptoms of this pathology are:

  • Cramps when urinating.
  • Change the color and the number of detachable urine.
  • The increase in temperature.
  • General weakness.

If impaired renal function, you may encounter such symptoms as swelling of the face and increased blood pressure. And identified changes lead to organ failure, when growing the symptoms of urinary intoxication.

Renal disease for a long time can occur latent or with scarce symptoms, but in the end will lead to failure.


Given the wide variety of causes that lead to pain, particular importance is differential diagnosis pathology and diseases of the internal organs. In this process plays a role not only clinical examination, but is important to pursue additional methods. They include instrumental and laboratory tools, which helps the doctor to make an accurate conclusion. If you suspect a spinal lesion, the following activities:

  • The x-rays.
  • Sonography.
  • Magnetic resonance imaging.
  • CT.

And to exclude or confirm disorders of the internal organs require advanced diagnostics, which will include methods appropriate to the affected system. Be sure to conduct analysis of blood determination of total and biochemical parameters, take samples of urine. Tools include the following:

  • ECG.
  • A chest x-ray.
  • Ultrasound of the heart, abdominal organs, kidneys.
  • A gastroscopy.

After further diagnostics the patient is required inspection of specialized professionals. And only then it becomes clear, why it hurts on the left under the ribs. And on the basis of the obtained results formed a therapeutic program that each disease has its own characteristics.