Pain under the lowest rib

When you feel pain on the outside of your chest, it may be due to heart disease or coronary heart disease, or it may be due to excessive exercise that causes muscle strain, or it may be gastroesophageal reflux caused by stomach disease. You can go to the hospital for an examination to rule out the possibility of stomach disease, and then receive symptomatic treatment. It is recommended to eat more vegetables and fruits, drink more boiled water, and avoid doing some high-risk actions.

Causes

1. Costochondritis

It is common in young and middle-aged people, and the cause is still unclear.

2. Intercostal neuralgia

It is a group of symptoms that refers to the damage of the thoracic nerve roots due to various reasons, such as thoracic vertebra degeneration, thoracic vertebra tuberculosis, thoracic vertebra injury, thoracic vertebrae dura mater, tumors, ankylosing spondylitis and other diseases or rib, mediastinum, pleural lesions, which cause compression and stimulation of the intercostal nerves and an inflammatory reaction.

Clinical manifestations

1. Costochondritis

It manifests as thickening of the costal cartilage accompanied by pain, which mostly occurs in the 2nd to 4th costal cartilage on one side, and occasionally in the costal arch or other parts of the costal cartilage. The local area is sometimes slightly raised, with no abnormal skin color, and there is pain. The pain may worsen during activity and sometimes there is tenderness. The course of the disease may vary from several days to several months, and the symptoms may be mild or severe and may recur.

2. Intercostal neuralgia

Band-like pain in the chest, between the ribs or in the abdomen.

examine

Perform chest fluoroscopy, costoclavicular compression test, etc. as appropriate.

If the flank pain is mainly in the right flank, it is often related to liver and gallbladder diseases. Testing liver function indicators can determine whether it is various types of hepatitis. Testing the viral indicators of hepatitis A, B, C, D, and E in the serum can help diagnose and type hepatitis. B-ultrasound examination, CT and MRI can be used as the basis for the diagnosis of diseases such as cirrhosis, hepatobiliary stones, acute and chronic cholecystitis, and fatty liver. Indicators such as blood lipids and plasma proteins in blood biochemistry can also be used as auxiliary diagnostic indicators for diagnosing fatty liver and cirrhosis. Testing of indicators such as fetoprotein and alkaline phosphatase in the blood can be used as a reference for preliminary screening of intrahepatic tumors.

diagnosis

Diagnosis is based on medical history, clinical manifestations, and examination.

Differential Diagnosis

1. Rib tenderness

In cirrhosis of the liver, portal vein pressure increases. When it exceeds 200 mm of water column, the return blood from the normal digestive organs and spleen to the heart is blocked through the liver, resulting in the establishment of portal-systemic collateral circulation between many parts of the portal vein system and the vena cava. Due to portal hypertension caused by cirrhosis, the normal portal vein is blocked, and blood enters the vena cava system through the anastomosis between the two. Since the veins at the anastomosis are small, the increased blood flow will cause varicose veins. Once ruptured, it can cause heavy bleeding, such as vomiting blood, blood in the stool, and varicose veins can be seen around the navel, etc.

2. Rib pain

If the thoracic vertebrae on the back corresponding to the ribs are slightly displaced, the costal nerves may be stuck or adhered, causing pain. There is muscle damage at the painful point, which produces sterile inflammation and stimulates the costal nerves, causing pain.

treat

Treatment should identify the primary lesion and adopt appropriate treatment methods.

Acupuncture is generally used, and some people also advocate the use of electroacupuncture, acupoint injection, cupping, etc. There are also people who use magnetic needles to stimulate the ear acupoints, which also has a good analgesic effect. In recent years, there has been a trend towards simplification in acupoint selection, and often satisfactory therapeutic effects can be achieved by selecting only one acupoint.