Pain Under Left Rib Cage

What Can Cause Pain Under the Left Ribs?

Pain under the left rib cage can arise from any organ in the left upper abdomen or chest, spine, or the left ribs themselves. In otherwise healthy people, spleen irritation and gas built in the colon are main causes of pain under the lower left ribs. Pain can be also psychological, for example from neurotic heart, but physical causes have to be excluded first.

Spleen Irritation

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During or after running, walking or other physical activities, irritation of the spleen capsule can cause side pain under the lower left ribs. Pain usually goes away after some rest.

Gas in the Colon – Splenic Flexure Syndrome

Gas trapped in the bend of the colon lying near the spleen (splenic flexure) can cause pain in the left upper abdomen or in the left lower chest. Other symptoms and signs of the so called splenic flexure syndrome include:

  • Distension of the upper abdomen, which can be tender to touch or not.
  • Drum-like sound when tapping upper abdomen with the hand
  • Pain in the upper left abdomen when bending or twisting the upper body. Pain is also often triggered by sitting down and relieved by standing up.
  • Constipation, diarrhea, abdominal cramps or excessive gas may be present in persons diagnosed with irritable bowel syndrome (IBS) .

Some people try to get rid of trapped gas by leaning over the back of a chair, or fence. It is important you find a cause of trapped gas, which may be:

Costochondritis

Sharp or dull, gnawing pain near the breastbone, affected by deep breathing, cough or moving the upper body may be due to costochondritis (costosternal syndrome). Costochondritis is an inflammation of cartilages that connect the ribs with the breastbone. The exact cause is not always clear, but trauma, fibromyalgia or infection can be included.

Costochondritis may be confused with heart attack. Pain from costochondritis is localized in small area on one or both sidesof the breastbone, and is tender to touch, while pain from heart attack or angina pectoris comes from under the breastbone and is not tender to touch.

Doctor can suspect costochondritis from symptoms and signs found during physical examination; costochondritis is not shown on X-ray of the chest.

Costochondritis usually heals on its own in a week or two. Rest and anti-inflammatory drugs, like aspirin or ibuprofen can help.

Pinched Nerve in the Thoracic Spine

Bulging or herniated disc, osteoporosis, rheumatoid arthritis or spondylitis can result in pinched nerve(s) in the neck or chest part of the spine (from C7 to Th8), which innervate the muscles and skin of the chest wall. Pain, burning, numbness or tingling, usually only on one side of the chest, can be affected by different body positions. Diagnosis is made by CT of the chest spine.

Broken Rib

Broken or fractured rib(s) on the left side causes pain during deep breathing and moving of the upper body. The main cause is trauma. Diagnosis is made by chest X-ray, but still some fractures can be missed since a broken rib may be only a crack in the rib, which does not necessary fall apart in two pieces. Elastic wraps to “immobilize” the chest are not used anymore. Simple cracks heal in a month or two, complicated fractures require surgery. Painkillers are recommended to enable deep breathing without pain.

Herpes Zoster (Shingles)

Shingles is an inflammation of one of the spinal nerves due to reactivation of infection with Herpes zoster (varicella) virus. Burning pain extending as a stripe from the back toward the breastbone, and itchy rash that often appears some days after pain has started, are main symptoms. Shingles heal on its own in few weeks. Painkillers may be needed.

Pleuritis, Pneumonia, Pneumothorax, Lung Cancer…

Inflammation of the lung membrane (pleuritis) on the left side can cause stabbing pain around the lower ribs. Pain is usually affected by deep breath and cough. Pneumonia(bacterial, viral or caused by mycoplasma or other microbes) affecting the left lung can cause cough, left side chest pain and fever.

Pneumothorax is a collapse of the lung (usually on one side only) due to a break in the lung membrane. Pneumothorax may be caused by trauma or can be spontaneous – the later usually affects young skinny males. Vague, not necessary sharp pains around the chest and back, affected by breathing and body movements, are typical. Diagnosis is made by X-ray; treatment is with surgery.

Other lung causes of pain under the left ribs:

  • Tuberculosis or other lung infection
  • Lung cancer
  • Pleural effusion
  • Lung infarct
  • Mesothelioma

Heart Attack and Angina Pectoris

Heart attack causes a sudden pain of various intensity behind the breastbone or slightly to the left. Angina pectoris, is a chronic pain, caused by various heart disorders, and usually triggered by physical effort or stress. Check other heart disorders.

Pancreatitis and Pancreatic Cancer

Pancreatitis or pancreatic cancer may cause pain in the middle or left upper abdomen. Diagnosis is with CT and blood tests.

Spleen Disorders and Enlarged Spleen

Liver disease, systemic lupus erythematosus (SLE), spleen rupture, spleen infarct, infectious mononucleosis, malaria or other infections, lymphoma, leukemia, sickle cell anemia and other blood disorders, or certain (rare) genetic metabolic disorders can cause pain in the spleen.

Other Disorders Causing Pain Under the Left Rib Cage

Other possible causes of pain under the left rib cage include:

  • Stretched or torn muscle or muscle spasm in the chest or abdominal wall
  • Chest or abdominal trauma
  • Gastric ulcer
  • Kidney diseases, including urinary stones in the kidney or left ureter
  • Pericarditis – an inflammation of the heart sac
  • Aneurysm or dissection of abdominal aorta
  • Henoch Schönlein purpura, inflammation of arteries affecting various organs

Related Articles:

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  • Marco Freeman

    I am starting to become really worried, 5 days ago i drank and smoked quite a bit of ciggarrettes, then I went to sleep, and when i woke up is when i felt this incredibly sharp pain in my left rib cage, I thought nothing of it at first but after 5 days went by and the pain hasn`t even decreased in the slighest, i`m starting to worry it`s something serious, I went to the doctor he checked my blood pressure, and my breathing and said everything was fine and it was likely a pulled muscle, but how can i pull my muscle in my sleep? and is it a coincidence i feel this pain after drinking and smoking a lot of cigarettes the night before? also the pain also seems to be the worst right when I wake up, but i feel it through-out the day and breathing in gives me intense sharp pains, should I get xrays on my chest at this point? any help would be appreciated.

  • tracy

    Hi I have been having bad pain just below my rib cage on the left hand side.
    And also it is very tender to touch and hurts when I breath and move about.
    I have tramadol for my lower back pain but it’s not touching the pain by my ribs.
    Any help would be much appreciated xx

  • JC McGee

    Hello. I am a 43 yof who has had a pain just below the ribcage on my left side but more towards the back. I does hurt more to the touch and a little more if I take a deep breath almost like there’s not enough room in that area once I inhale the lungs. It doesn’t feel like a muscular problem but a lot like an organ that’s inflamed or swollen or something else along those lines. I just don’t know which organ it could be. Thank you for your help.

  • Kelli

    Hi, I have constant pain under the lower part of my rib cage. I had blood work, ultra sound, and urine test. All came back clear. I’m going to the bathroom regularly and passing gas normal. I was also given a shot of pain medication and it didn’t seem to help. Any suggestions? Thank you!

  • Hi Tracy. The question at this point is whether the problem is on the surface or internal. There are several organs that lie in this area like the stomach, spleen, kidneys, portion of the small and large. The pancreas and gallbladder can also cause pain in this region. It is advisable that you follow up with your doctor at this point or get a referral to a specialist in internal medicine if necessary. Pain on its own is difficult to diagnose. You have not mentioned any other symptoms or a possible diagnosis. Hopefully you have been seeing a doctor and not treating yourself.

  • Hi JC. It could be the stomach, spleen or left kidney. Really difficult to say for sure without other symptoms being present. Disease of all three organs could increase pain when taking a deep breath as the diaphragm flattens and pushes down on it. Urinary symptoms would obviously indicate a kidney problem while digestive symptoms are more likely due to a stomach problem. You will have to follow up with a doctor.

  • Hi Kelli. Pain under the rib cage may not only be due to the kidneys. Assuming that you are talking about the left side, the stomach, spleen and portion of the colon lie here. Furthermore the surrounding organs like the gallbladder, pancreas and small bowel may also cause symptoms in this region. There is also the possibility that this is not emanating from the abdomen but from the chest or even the chest wall. Pain on its own with no other symptoms is difficult to diagnose. You should follow up with your doctor and maybe see a gastroenterologist as well if you notice any digestive symptoms.

  • Cherie

    I have had pain below my left rib cage since November 2014. It moves around to the side, or sometimes the lower back, all on the left side. Had MRI came out normal. It can be a dull ache or sharp pain. It is pretty constant. I have gurd and obesity. Doctor says it is because of my weight. Can you help? My doctor is blowing it off, but the pain is chronic.

  • Jennifer

    I am experiencing left side pain under my ribs toward the back. Yesterday I was experiencing a sharp, cramp like pain in my lower abdomen as well that wouldn’t go away no matter what I did. That pain has lessened but im still experiencing some pain in that area along with the pain under my ribs. I’m also experiencing indigestion. Is this stomach related or something else?

  • Monquie hurt a lot

    I have been dealing with a sharp stabbing pain just under my left rib cage, the pain usually occurs when I move my body a certain way and breathe lightly or heavily, it also increases when I’m laying down or walking. It seems to have made me quite tired, I’m very sluggish, I seem to still have an appitite, but am devolving a slight fever, I was also have had irregular bowel movements with myself having constipation, I do not know if this is related. I haven’t been to the doctors yet and I was just wondering if it was something minor or serious? Do you have any answers?

  • Monquie hurt a lot

    I have been dealing with a sharp stabbing pain just under my left rib cage, the pain usually occurs when I move my body a certain way and breathe lightly or heavily, it also increases when I’m laying down or walking. It seems to have made me quite tired, I’m very sluggish, I seem to still have an appitite, but am devolving a slight fever, I was also have had irregular bowel movements with myself having constipation, I do not know if this is related. I haven’t been to the doctors yet and I was just wondering if it was something minor or serious? Do you have any answers?

  • JC McGee

    Hello. Well, I wanted to touch base with you and tell you what my doctor found as I did end up going to the er as I couldn’t endure the pain any longer. It was kidney failure due to a mass (tumor) that closed off my uterers and was forcing my urine back up into my kidneys. The tumor is being diagnosed as Lymphoma and is the size of a man’s fist. It has also encompassed my aortic valve that circulates blood down through the legs and the vein that circulates the blood out of the legs. The biopsy was extremely painful so for those of you who may be having this particular procedure done, they’re lying to you when they say “you’ll feel a little poke then some pressure”.
    I now have 2 nephrostomy tubes (one for each kidney) coming out of my back with a bag attached to each one to collect my urine. I now get to empty these bags every couple of hours and log what was drained. I only get about 4 hours of sleep at a time now as it is very difficult to get comfortable and I have to drain the bags anyhow.
    At any rate, I felt as though I should inform you of the results after seeing the doctor as I inquired to you initially before seeing the doctor. Funny thing, two weeks ago I didn’t have one doctor, now I have five.
    Thank you for your insight into my particular situation, I truly appreciate it. Have a great day!!

  • Hi Cherie. Obesity can cause many symptoms with no significant underlying problem. It is mainly associated with the strain on the musculoskeletal system due to the excess weight. If there are no other significant symptoms and additional tests like an endoscopy and so is clear then the only solution may be to look again at the weight issue. Of course numerous conditions can cause this type of pain and may be not just due to the weight issue. In the region you are experiencing the pain it could be due to gastritis, peptic ulcers, a hiatal hernia and so on. It may also be associated with the spleen or kidney that lies in this region as well as portions of the colon that lie here. Pain on its own is difficult to diagnose when no other symptoms indicate a possible cause. It may be a good idea to consult with a gastroenterologist.

  • Hi Jennifer. It could be the stomach but since it is also occurring much lower in the abdomen the colon would be a more likely organ that is affected. Really difficult to say for sure because you are only experiencing pain with no other symptoms like diarrhea or flatulence. It could also be a kidney problem because the kidney lies higher up and the ureter leads from it all the way down the flanks to the bladder. If it is the kidney then there should be some urinary symptoms. It is best to speak to your doctor about this as further tests may be required.

  • Hi Monique. The symptoms you describe can occur with a number of different conditions. It may be arising from the digestive system or even the kidney and urinary tract. It is difficult to say with any certainty. The fact that you are experiencing symptoms like persistent/recurrent pain, a fever and fatigue needs to be investigated by a medical professional. We cannot say with any certainty whether this is serious or not but you should be seeing a doctor at this point.

  • Hi JC. Thank you for updating us. It will be very helpful to all our readers. Glad we could have been of some assistance. Hope you are keeping well and best wishes to your continued recovery.

  • nicole

    I’ve had a constant sharp pain in my left side for two days now, I’ve gone to the doctor for it three weeks ago but he didn’t wait for the urine sample to come back and gave me amoxicillin for an assumed kidney infection. After I finished the treatment the pain came back, and the ER said they couldn’t find anything wrong (infection or otherwise) and gave me two Tylenol and sent me on my way. The pain never goes away and is worse when I lay or walk. Any insight as to what I should do would be appreciated.

  • melissa

    hi I have been having pain on my left side right under the lift rib cage for a couple years on and off,but now the last week I have been having pain constantly.Hurts in certain position to breath and move.Also in the same area I would double over to the point of not being able to move it felt like my insides were rolling,i couldent even move.i think I might have blood in bowl dark black not all of it just some.

  • Hi Nicole. The results of the urine test is very important and you don’t mention what it was. Ideally you should go back to the doctor who first tested you and prescribed the antibiotics. It will allow him to follow up on his initial suspicions and confirm or rule out possible causes. This may require further diagnostic investigation. You don’t mention any urinary symptoms so while it could be a kidney infection there may also be other possibilities. As you can see from the article above, there are many possible causes apart from kidney problems, such as stomach and spleen disorders. The only way to know for sure is to follow up with you doctor. The ER is just there to stabilize a patient and exclude potentially life-threatening condition. Your family doctor should be overseeing your condition in the long term.

  • Hi Melissa. Pain in this region could be due to the stomach, spleen or kidney among other organs as is mentioned in the article. Digestive tract problems are more likely given the possible blood in the stool. Gastritis, peptic ulcers and a hiatal hernia are some of the conditions that need to be considered, and it is possible that there is more than one condition affecting you. Pain with movement and breathing does point more towards a hiatal hernia. Of course these conditions can only be confirmed once further tests are done. The gallbladder and pancreas can also not be ruled out as the possible origin of the problem. A doctor will need to assess you further.

  • Angieelle

    Hi so im not sure what i have but this started about 3 days ago but it started getting worse as of today but i get full really quickly (i got full with on banana for breakfast) then i get pain under my left ribs,also now at the same time i just started getting chest pain on the same side near my heart this lasted for quite a few minutes but i was laying down and the two pervious days weren’t as bad i just felt a sharp pain while laying down for 3 seconds or so and now i feel hungry again but as soon as something enters my stomach i feel so full and starts over again the pain comes when I’m laying down mostly after a snack but the full and lower rib pain kinda stays either way for minutes and I’ve been loosing weight but thats because of my diet I’ve been on so I’ve been restricting calories too. (to many actually but I’m working on that)

  • Sheikh

    Hi, I am 28 year old male, have been experiencing mild pain under left(extreme) rib cage for over last few months, previously during day time I almost didn’t feel it, but during sleep I would wake up off mild pain if I had been sleeping on the left side. I don’t have any stomach problems, constipation etc. Now I can feel the dull pain sometimes in the daytime also. Please suggest… Worried!!

  • Shannon Mazzone

    Hi Doctors,

    MY daughter is 14 turning 15 soon and she has been complaining about a stabbing pain under her left rib? It used to come and go 4-5 times a day but latley (this week) she hasn’t been sleeping because it’s not going away. The pain is there all the time but becomes stonger when she breaths in.. she is normally a tough girl but this has got her in tears at times. Do ypu have an idea what it could be and do I need to take her to hospital? Or do I let her wait till tomorrow for the doctors? Thankyou

  • Hi Sheikh. You may not be aware of the underlying stomach problems that you could have. You should consult with a gastroenterologist who can do further investigations like an upper GI endoscopy. However, it may not be the stomach either. There are so many organs in the part of the abdomen that it is difficult to say for sure. Pain on its own is difficult to identify especially when there are no accompanying symptoms.

  • Chelsey

    OK so I’ve been having really bad pains under my left rib cage I’m really tired having bad migraines and I get really dizzy and my vision blacks out help?

  • Heather

    I am 34 years old. A couple of months ago I started doing the Atkins diet. I am still doing low carbs but I find myself on the weekends eating whatever I want. Recently after eating I get a dull pain in my left rib cage area. Usually it will last for an hour or two and then go away. Its not every time I eat but seems to be getting more frequent. What could this be?

  • Hi Heather. There are many organs in any given quadrant of the abdominal cavity and it is difficult to isolate a cause on pain alone. Other symptoms could give a clue to the possible cause of the pain. You may be looking at a host of possible conditions from a stomach problem to kidney conditions. It is advisable that you see a doctor who can then undertake further tests based on his/her findings of a clinical examination. Take note of any additional symptoms like if the pain starts after eating, your urine patterns have changed and so on.

  • Jordon Simonetti

    Hello, my names Jordon. Ive been experiencing a sharp pain in my left rib cage under my pectorial for the past year and it gets worse when i inhale deeply or exhale deeply when it starts up.. BUT it isnt constant or consistent, it comes and goes randomly and only happens for about 5-10 minutes.. Any ideas???

  • Uttam Shrestha

    i am having the same problem. it hurts when you inhale or exhale deeply, there is sharp jolt of pain in the left rib cage. i have to use computer most of the time, so my sitting posture may not be right; most of the time my backbone is bent, i wonder it might be the cause of it, and it is also not consistent like u said, it comes and goes randomly.

  • Dan

    I have occasional dull pain under the lower middle left rib cage area. Mainly bothers me most when I am driving my car for more than 2 or more hours. I have to keep moving and stretching to help it feel better. Any ideas?

  • Criss Mabbit

    Hello, female, 18. When I lay flat on my back then bend up. A inch down from my rage cage hurts on my left side in the front in one area. I have lost and gained weight. Its only been two day but I would like to know if I should go to the doctors or if is just gas pain. Please help.

  • Bright74

    About a week ago, I got a sharp pain in my upper mid back, just to the left of my spine, after putting a large heavy pan on a high shelf. I had the back pain for about 3 days, but excedrin would always take the pain away. I used heat and ice which always helped as well The pain has now moved from my back to just under my left rib cage., more to the left. It is the same kind of pain I had in my back. Excedrin takes the pain away every time. I have no rash or other ailments. Thinking it was a stretched or pinched nerve, but now, I am not sure. I am a 60 year old female. Thanks,

  • Danny Lou

    Hi. I don’t know if you are still answering comments, but I thought it was worth a shot, and thank you in advance for any help or advice!

    Anyways, for the past 3 months or so, I’ve been have a weird sensation in my left quadrant of my chest and abdomen. I have a tender spot on my ribs, where my top left abdominal muscle sits, and sometimes the pain radiates to my back, there is a tender spot there as well. I would also describe it as a feeling of pressure or fullness in my lower left abdomen, possibly my spleen. Overall, I feel healthy, but these few changes in my body have been nagging at me, and they do sometimes seem to get better, but the symptoms always come back. During this same period of time, there was a week or two where my hands felt like they had nerve damage, it would take extra effort to grab certain things, and sometimes my fingers would seize up randomly. That symptom got better after I rubbed ointment on my arms and wrists, but my hands still don’t feel 100%, it still feels like some nerves or tendons are messed up.

    The symptoms are worse when i sit down, and the area around my belly button also feels sensitive. My diet and sleep schedule are normal, no nausea or fatigue, my athletic performance is still the same. I went to the doctor for a physical and an x-ray, both came back normal. Any advice?

  • Fifteen-year-old girl

    I have been sick with a fever for around 3-5 days now and the first day I woke up without a fever I felt a sharp pain under my heart, under the left rib cage. Recently I haven’t eaten much since I’ve been sick. I have tried reading about it and I think it might have something to do with me having some air trapped in that area. It has been more than 24 hours and the sharp pain is still there. I can barely move and the positions I know of that don’t hurt are a few sitting positins and laying on my back. I’m also having a bit of a problem breathing deeply, it hurts too much. I have experienced this pain before but it has never been this bad and it hasn’t lasted this long. The pain sort of feels like I’m being stabbed or as if there is a needle stinging me.

  • theiaoakes

    Hi, Dx with gallstones, but atypical pain sharp stabbing constantly under left rib not right, which is tender under, sometimes going around back ribs. Digestion poor and no appetite for 3 months, nausea, giddiness, severe bloating, tightness of diaphragm. CT scan normal other than small Hiatal hernia and a diverticulum. Bloods Ok other than low Vit D and sl raised GGT/ white cells. Endoscopy normal. Having the gallbladder out but no Dr could tell me what the left pain is caused by – could it be gallbladder to blame, h hernia or something else? Is it advisable to get 2nd opinion before the surgery?

  • Kathryn Clark

    My dad 86 was stepping down a shallow step and felt 2 pops and pain under his left rib now he cannot pick his left foot up to walk without the same pain. It only happened last night. He is in no pain when sitting and van lift his leg in this position with no problems

  • Sherry Crane

    I have been having severe pain for a week in left side in ribs and under left breast . Sometimes the pain is so severe it feels as if someone is stabbing me. I also hurt in left kidney area. And I can’t get much sleep because I sleep on left side and the pain gets so bad I get in recliner and lean back to get any sleep. Don’t have Gallbladder, appendix and have had complete hysterectomy

  • Hi Kathryn. Given his age, it would be best that he speaks to a doctor as soon as possible. While this may not seem serious, it could be a problem that may worsen over time and lead to complications. This does seem to be more musculoskeletal but the only way to know for sure is to have the necessary diagnostic investigations that his doctor will advise.

  • HI Sherry. There are many possible causes for pain in this area as you can see from the article above. This could be your kidney but there is also the possibility of cardiac (heart problems), a hiatal hernia and so on. The only way to know for sure is to see a doctor and you will possibly need to undergo further diagnostic investigation to confirm the underlying cause. Speak to your doctor and he/she will advise you accordingly.