Pain Under Left Rib Cage

Reviewed By: Pramod Kerkar, MD, FFARCSI

The rib cage supports and protects vital organs in the thoracic cavity, chest and in the abdominal region. The area around the thoracic cavity or the rib cage is a common location for pain due to various reasons. This area is also more prone to injuries and can have varying degrees of discomfort.

Pain Under Left Rib Cage

Causes Of Pain Under Left Rib Cage

As there are various causes that can lead to pain under left rib cage, it is necessary to understand and differentiate them. The severity of the pain or discomfort, other associated symptoms and any underlying existing medical condition can help in identifying the exact cause of pain under left rib cage.

Abdominal Causes For Pain Under Left Rib Cage

The rib cage on the left covers a wide area of the abdomen and various related conditions can cause pain under the rib cage. Some of these causes include

  • Gas in colon (Splenic Flexure Syndrome) – Excessive amount of gas formed and trapped in the colon can cause pain in the upper left side of the abdomen and this area is felt below the left rib cage. Pain and discomfort under left rib cage may be experienced after consumption of food. There may be associated symptoms like distended stomach, indigestion and relief after passage of gas.
  • Spleen Irritation – Sometimes, the spleen, located under the left rib cage, can get irritated due to physical activities like running or walking or due to spleen rupture. This too may cause pain under left rib cage and may also be associated with pain in left shoulder. Under normal circumstances the pain subsides after rest and stopping of physical activity. In cases of spleen rupture, immediate evaluation is required.
  • Acid Reflux – Over consumption of foods or drinks causing hyperacidity, can cause acid to regurgitate into the food pipe located under the rib cage. This may cause pain under the left rib side and may be associated with burning sensation and abdominal bloating.
  • Gastritis and Gastric ulcer – Sometimes, long standing acid reflux or irritation of the stomach lining can cause gastritis or even ulcers in the stomach. This can cause sharp pain under the left rib cage; especially after consumption of food. It may extend to the left shoulder or under the breastbone.
  • Other Causes – Other gastrointestinal causes that lead to gas formation, irritation of organs and pain under left rib cage include, irritable bowel syndrome, food intolerances, trauma, post surgical adhesions, pancreatitis and pancreatic cancer.

Musculoskeletal Causes Of Pain Under Left Rib Cage

These include:

    • Costochondritis – The cartilages that join the ribs to the breastbone can get inflamed causing pain and discomfort in the ribs. It could be due to injury, infection or fibromyalgia and can cause severe pain, especially on touching the affected area.
    • Fractured Rib – An injury leading to broken rib on the left side can cause excruciating or sharp pain under the left rib cage and needs immediate medical attention.

Fractured Rib

  • Nerve Irritation – Sometimes a trapped or irritated nerve due to spondylitis, bulging disc or other arthritic conditions and injuries in the neck or upper back can cause pain under the rib cage, depending on the area supplied by the nerve. Certain infections like herpes, causing spinal nerve inflammation may cause pain and burning along the course of nerve extending to the rib cage.

Respiratory Causes Of Pain Under Left Rib Cage

Lungs and surrounding structures of the respiratory system too can be a potential cause of pain and discomfort under left rib cage. Inflammation of the lining of lungs and other structures or infections can cause such pain. These conditions are often accompanied with respiratory symptoms like cough, fever and chest pain, which is usually worsened by coughing.

Some common respiratory conditions that can cause pain under left rib cage include pneumonia, pleurisy, pleural effusion, penumothorax, tuberculosis and lung cancer.

Cardiac Causes Of Pain Under Left Rib Cage

Sudden sharp or stabbing pain in the left rib cage area can also be due to a heart attack or angina pectoris, which may occur in other heart disorders and need immediate medical attention.

Other Causes Of Pain Under Left Rib Cage

Some other causes of pain under left rib cage include, muscle spasm or strained muscle, trauma to the chest cavity or abdomen, disorders or inflammation of the blood vessels; particularly aorta and some kidney disorders like renal or left ureteric stones.

Diagnosis Of Pain Under Left Rib Cage

Any pain arising in the left side or under the left rib cage can be due to minor reasons while some can be a medical emergency. While it is not necessary that every pain is serious, it is worth performing a thorough medical assessment. Any pain under left rib cage needs proper evaluation and clinical examination to detect the exact cause.

Investigations Depend On The Suspected Cause And May Include

  • Laboratory tests to detect infection and related parameters
  • Imaging studies like X-rays, CT scan to detect structural abnormality, injury, fracture, etc, MRI to note structural growth or any specific changes
  • Gastric studies may be ordered to detect gastrointestinal causes.

Treatment Of Pain Under Left Rib Cage

Proper identification of the cause for pain under left rib cage can help in determining the severity of the condition and appropriate treatment can be decided. Treatment depends on the underlying cause and may include

  • Rest, immobility and painkillers helps for musculoskeletal or physical causes of pain under left rib cage like muscle spasm, trauma or fracture.
  • Gastric causes of pain under left rib cage may be treated with medications for hyperacidity, indigestion and proper bowel movement.
  • Respiratory infections causing pain under left rib cage may need more specific treatment like antibiotics or chest tube insertion in more severe cases.
Pramod Kerkar

Written, Edited or Reviewed By:


Pain Assist Inc.

Last Modified On: February 7, 2018

This article does not provide medical advice. See disclaimer

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