The causes of pain under the right rib cage range from inflamed costal cartilage, fractures, or cracked ribs due to an injury, to referred pain from organs located on the right side of the rib cage or the right upper quadrant of the abdomen. The following write-up provides information on some of the probable causes of pain below the right rib cage.

The human rib cage comprises twelve pairs of ribs, twelve thoracic vertebrae and a T-shaped bone called sternum. Rib cage pain occurs when any of these structures get damaged. More often than not, pain in and around the ribs is caused due to blunt force trauma to the chest. The ribs can get fractured or develop cracks if a person receives a hard blow to the chest. Pain could be experienced if a person suffers from a soft tissue injury. Injury to the muscles, intercostal muscles, and the ligaments that support the rib cage are likely to cause pain. Pain may also be accompanied by swelling and bruising, and the injured area may be sore to touch. Sometimes, pain may be felt at a location that is different from the site of injury. At times, pain may be referred from the liver or the gallbladder to the rib cage.

Causative Factors
Pain under the right rib cage could be caused due to a wide range of reasons. Pain may be localized to the right side of the thoracic cavity if a person suffers from an injury around this region. The contributory factors for right-sided rib cage pain include:

Rib Injuries
Damage to the rib cage usually occurs in motor vehicle accidents, crush injuries, or falls. Blunt trauma to the rib cage could occur when a person receives a blow to the chest. In case of a crush injury, the intensity of pain would vary, depending on the impact or the force with which an object lands on the rib cage. Rib injuries could also occur due to repetitive movements involved in sports such as golf or rowing. People who have low bone density are susceptible to rib fractures or injuries. If a person suffers from a rib injury, he/she is likely to experience pain at the site of injury. Pain may also be felt with movement or while taking deep breaths. Complications could arise if a person suffers from a displaced rib fracture, wherein a segment of the rib moves from its place and causes damage to the surrounding organs.

Rib fractures can be diagnosed with the help of an X-ray examination. The treatment usually involves the use of painkillers, non-steroidal anti-inflammatory drugs, or nerve block injections. The patient needs to take rest and avoid indulging in any activity that may worsen his/her condition. Surgery may be required in severe cases.

Inflammation of Costal Cartilage
The term 'costal cartilage' refers to bands of hyaline cartilage that directly attach the ends of the true ribs (first seven pairs of the ribs) to the sternum (breastbone). One of the most common causes of pain under right rib cage is costochondritis, which refers to the inflammation of the costal cartilage. While trauma to the chest or repetitive strain injuries are likely to cause this condition, at times the costal cartilages could get inflamed due to violent coughing that may occur due to respiratory infections caused by a virus.

The common symptoms of costochondritis include chest pain and painful breathing. The use of painkillers and non-steroidal anti-inflammatory drugs may be recommended for alleviating the symptoms. In severe cases, doctors may prescribe steroids.

Intercostal Strain
There are various groups of muscles that are located between the ribs. These are called intercostal muscles. These muscles play a vital role in the process of respiration. When we inhale, these muscles contract, thereby expanding the rib cage. On the other hand, the rib cage drops when the intercostal muscles relax. The movement of the rib cage brings about a change in the pressure within the chest cavity, which helps to draw in air in or push it out.

If the intercostal muscles on the right side are affected, the affected individual is likely to experience pain under the right rib cage. Rapid twisting of the torso can cause an intercostal muscle strain, which in turn, may cause painful breathing and soreness. While the patient should take ample rest, use of painkillers and non-steroidal anti-inflammatory drugs may also be recommended.

Gallstones
Gallbladder is a small pear-shaped sac that is located beneath the liver. It stores and releases a digestive juice called bile. Bile mainly consists of bile salts, bilirubin, and cholesterol. Stone-like deposits could form in the gallbladder if the amount of bilirubin or cholesterol increases. These deposits are referred to as gallstones. Gallstones can block the flow of bile, thereby affecting the process of digestion in an adverse manner. These can also cause cholecystitis, which refers to inflammation of the gallbladder.

Cholecystitis is characterized by pain in the right upper quadrant of the abdomen. Pain may even be referred to the right rib cage. People affected by digestive ailments such as irritable bowel syndrome or excessive buildup of gas could also experience pain on the right side, under the ribs.

If a person has suffered from a rib injury, it would be best to consult a doctor at the earliest. An X-ray examination can help to diagnose the extent of damage caused by the injury. Taking ample rest is important as that would speed up the process of healing. Drug therapy can help to alleviate pain, but surgery may be required in case of a displaced rib fracture or multiple fractures. Treatment options would vary if pain is referred from the organs located in the abdominal cavity.

Disclaimer: The information provided in this article is solely for educating the reader. It is not intended to be a substitute for the advice of a medical expert.