Pain under the left rib cage can mean anything from a ruptured spleen, to heart trouble, to just needing to have a good fart. The ribs are a veritable collection of bone, muscle, and organs, most of which are fairly important for living and other useful functions.
Consequently, pain from the rib cage tends to cause alarm, especially if it comes on suddenly. However, pain can mean different things depending on location and other associated symptoms.
The Primary Causes of Pain under the Left Rib Cage
1. Broken Rib
The rib bones can break in response to injury, usually something like a car crash or other type of collision or blunt force trauma. The most apparent sign of a broken rib is intense pain in the area, especially when moving or bending. Pain under the left rib cage when breathing is also not uncommon, but again, it will depend on where specifically the broken rib is located.
There may also be signs of bruising around the injury site. In the worst case scenario, a section of the rib cage can fully break and detach from the chest wall.
This results in a medical emergency known as “flail chest” and presents with painful, labored breathing, as well as something called “paradoxical breathing,” where the chest can appear to move opposite to the normal patterns of inhalation/exhalation.
2. Spleen Damage
The spleen is used to filter red blood cells and hangs in the upper part of the abdomen. An enlarged or ruptured spleen can cause sudden or chronic pain under the left rib cage that ends up migrating towards the back and/or shoulders.
An enlarged spleen is usually due to specific types of infection or inherited conditions that affect the organ’s function. An enlarged spleen does not necessarily present with pain and in some cases will simply come with a feeling of “fullness” despite not eating or only eating a small amount (the spleen is pressing on the stomach). You may also experience anemia, fatigue, and begin to bleed more easily.
A ruptured spleen is much more dramatic and can present with sudden, intense pain under the upper left rib cage as well as potential pain in the left shoulder and confusion or lightheadedness. Since the spleen is filled with blood at any given time, a rupture will likely lead to signs of bruising as blood begins to pool under the skin.
The spleen can rupture in response to trauma or when an enlarged spleen is left untreated for a prolonged period. Due to the organ’s positioning, the spleen is in the perfect spot to get poked by a broken rib and can sometimes rupture as a result of an untreated rib injury.
3. Heartburn/Acid Reflux
On the less-scary side of the spectrum, pain under the left rib cage can also be from heartburn. Heartburn, also known as acid reflux, is when excess stomach acid is produced or some of the stomach acid splashes back up the esophagus. This can create a sharp pain under the left rib cage that seems to be coming from the heart, hence the name “heartburn”.
The pain under the left rib cage will come after eating in most cases, especially if the meal was highly acidic or spicy. A bloating sensation is not uncommon, either.
An ulcer is when a sore develops in the lining of the stomach or small intestine and are caused by long-term NSAID use, chronic excess of stomach acid, or infection by H. pylori bacteria.
The irritation of a stomach ulcer can cause a dull pain under the left rib cage, reduced appetite (due to pain), acid reflux or heartburn, nausea and vomiting, gastritis (stomach inflammation), and unintended weight loss. In rare cases, untreated stomach ulcers can lead to a persistent, sharp pain and begin to bleed into the digestive tract.
5. Indigestion or Irritable Bowel Syndrome
IBS can result in intestinal or bowel irritation in response to digestion that will produce sharp pains under the left rib cage along with intestinal cramps, diarrhea, or constipation, especially after large meals. Even without IBS, large meals can still produce pain under the ribs.
Basically, when you eat a lot of food, your digestive system slows in order to accommodate it all properly. This leads to the trapping and buildup of gasses and pressure, resulting in pain.
A kidney stone is a calcium deposit that can form under various conditions. If a stone migrates to the urinary passage it may get lodged in place due to its size. This results a sharp pain under the left or right rib (depends which kidney) that is located near the small of the back.
Kidney stones are spectacularly painful and if suspected they should be brought to a doctor’s attention as soon as possible.
7. Lung Problems
If something is wrong with your lungs, such as inflammation, infection, fluid buildup, or a puncture, you will likely experience a pain under the rib cage that worsens when breathing or coughing. Generally speaking, if your pain seems connected to lung function or comes with difficulty breathing, you should get it checked out ASAP.
8. Heart Attack
The heart is located under the left rib, so the pain from a heart attack will be felt there as well. A heart attack is when something has impaired blood flow to the heart and part of the organ begins to starve and die from lack of oxygen.
The symptoms of a heart attack can emerge more gradually than most people realize and take the form of tightness or squeezing pain in the chest that can radiate to the left arm, jaw, back, or abdomen, along with shortness of breath, excessive sweating, nausea/vomiting, dizziness, or weakness.
There may also be something called “Levine’s sign”, which is where the chest pain can be localized (focused) by clenching the first over the breastbone (sternum).
9. Angina Pectoris
Angina pectoris can often cause pain under the rib cage and especially under the rib cage on the left side of the body. Angina is caused by a lack of blood flow to the heart muscle.
The lack of blood flow is often caused by an obstruction in the coronary arteries. The pain that comes with angina is usually a feeling of pressure, squeezing, and tightness in the chest. While angina pectoris pain focuses on the chest, it’s not unusual to also feel pain in the shoulder, neck, jaw and arms (especially in the left arm).
Costochondritis is an infection of the breastbone that can cause chest pain on the left side of the body. In this case, the pain is a sharp and aching pressure. This pain worsens with deep breaths and coughs. The pain can often be felt on the left side of the breastbone, but it may spread to the rib area as well.
There is no clear cause of costochondritis, but issues like injury, arthritis, tumors, joint infection and physical strain do appear to be connected to the condition. Viral respiratory infections and recent upper-chest surgeries also appear to have a strong connection to costochondritis.
Pancreatitis is the inflammation of the pancreas that can be caused by active digestive enzymes within the organ. This inflammation can cause pain, which tends to be achy and can become sharp and pointed when pressure is applied to the pancreatic region.
The pancreas is located behind the stomach in the upper abdomen; therefore, pancreatitis pain is focused on an area that includes the lower left side of the ribs.
Pericarditis is a fairly serious condition where the membrane that surrounds your heart (called the pericardium) becomes inflamed or irritated. This inflammation can lead to the swelling of the pericardium.
Pericarditis’s main symptom is chest pain in the heart’s general location- under the left rib cage. This chest pain tends to build over a period of time until it becomes sharp and painful. During the sharp and painful phase, it isn’t uncommon for people to mistake the pain for a heart attack.
How to Diagnose Pain under the Left Rib Cage
Diagnosing pain under the left rib cage is not incredibly complicated but may require multiple steps for a full medical diagnosis. As you can see by the list of possible pain under left rib cage causes, there are more than a few that require a doctor’s visit right away.
Your doctor will take into account your personal medical history and ask a series of questions in an attempt to rule in and rule out certain medical conditions. This will usually be followed by a physical exam. Depending on your doctor’s suspicions, imaging tests like X-rays and MRIs may be ordered, as well as urine or blood analysis. Some conditions may require specialized diagnostic tools such as an endoscopy or biopsy of tissues.
How to Treat Pain under the Left Rib Cage
The above conditions and ailments all have wildly different treatment approaches and are not an exhaustive lift of causes for pain under the left ribs. Possible approaches can be anything from antibiotics to diet changes to emergency surgery depending on the underlying cause.
The best treatment, therefore, is to be aware of the signs your body is sending you and to speak to your doctor.
To generalize, if the pain under your ribs is connected to eating, then you are more likely to have a digestive issue. Under other circumstances, especially if you have breathing difficulties or suffered blunt force to the chest in the past few days, then you should get checked out as soon as possible.
Surgery is often a last-ditch effort to resolve the issue of pain under the left side of ribs, as many of the causes do not require an invasive form of treatment. That being said, some cardiac conditions such as a heart attack or angina may require it. If a broken rib happens to puncture an organ like the pancreas or lungs, surgery may be required to help repair the rib in addition to the organ it has damaged.
Some of the causes of pain under the left rib cage may be treated with medication. Antibiotics may be used to get rid of infections and inflammations that may be causing the pain. In many cases, pain medications and anti-inflammatories may also be used to manage pain as the condition causing the pain is healing.
3. Dietary and Lifestyle Changes
Dietary and lifestyle changes may help to eliminate some of the digestive issues that may be causing the pain.
Heartburn and indigestion may be relieved by adopting a diet geared toward lowering acid reflux is a good idea. Try eating less acidic foods like non-citrus fruits (bananas, melons, avocados) and leafy green vegetables, as well as those that are easy to digest. This will help reduce levels of acid in the stomach.
4. Natural Remedies
A few natural remedies may be able to help you take care of pain under the left rib cage. Natural herbs like arnica could potentially reduce pain and inflammation when used as an ointment placed directly on the left rib cage area and chest.
Other natural methods include the use of cold and hot compresses to help relieve inflammation, relax sore muscles, and help promote circulation in the area, which can help encourage healing.
When to See a Doctor
Whenever there is physical pain or discomfort, the question of when to seek medical attention arises. If you find that you are experiencing this pain under the left rib cage once every few months, it might be a good idea to talk to the doctor about it on your next visit. However, there is no rush.
If the pain seems to be slowly building, it is a good idea to get it checked out right away, as it may indicate the start of an issue that can be treated quickly to prevent further damage. If the pain is sharp, sudden, or a combination of the two, seek medical attention as soon as possible.
Don’t Let Pain under the Left Rib Cage Go Too Long!
Chest pain of any sort should be closely monitored. If it develops under the rib cage on the left side of your body, you definitely should not ignore it. It could be a minor discomfort or a condition that is relatively easy to treat like acid reflux.But it could also be the symptom of the more severe pericarditis, broken ribs, or pulmonary edema.
The good news is, pain symptoms are a great early warning system. So, if your condition is serious, you will hopefully receive treatment for the cause of your left rib cage pain before it worsens.
“10 Common Causes of Pain under Left Rib Cage,” NLDA; https://www.nlda.org/a/pain-under-left-rib-cage/, last accessed September 26, 2017.
“Pain under Left Rib Cage,” Patient Help, November 20, 2013; http://www.patienthelp.org/diseases-conditions/pain-under-left-rib-cage.html, last September 26, 2017.
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