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Lower Right Rib Pain – Most Likely Causes

by | Apr 11, 2011 | Health

Do you experience severe, even at times debilitating pain on the lower right side of your rib cage? Have all your ultrasounds and blood tests come back normal, and your doctors either


  1. Can’t seem to figure out what’s wrong
  2. Don’t believe that anything is wrong
  3. Think you are imagining the pain?

Well, you are not alone. There are thousands of people with the same malady, and for the most part their doctors are as equally baffled as yours. Many have endured their pain for years. So take comfort — you are not crazy, nor are you imagining the pain. It is real.

So what’s causing the pain, and what’s the cure?

I have scoured the Internet asking just these questions and have found that, after reading hundreds of cases, the same (successful) diagnoses kept cropping up. I have listed them here in order of likelihood. Please note, I am note a doctor — I am simply compiling the results of my research to help you discuss your pain with your doctor. I recommend that if you suffer from an unidentifiable pain in your lower right ribcage (LRR), that you print this list and take it to your doctor, and ask them to check for each cause.

1. Costochondritis

Doctors often don’t think of costochondritis when a patient complains of lower rib pain. Costochondritis is caused by inflammation of the cartilage joining the rib to your breast plate, and usually causes pain in the breastbone. At times, this pain can mimic a heart attack, although the pain will be confined to a small area, rather than widespread as with a true heart attack. (Note: If you feel any kind of chest pain, don’t try and differentiate between the two — assume it’s a heart attack and call 911 immediately).

Costochondritis can also manifest itself as pain to one side of the ribcage, although this is rarer. Many doctors don’t consider Costochondritis as a potential cause of lower right rib pain for that very reason. Also, Costochondritis can’t be observed on tests, so doctors are often hesitant about providing a diagnosis. In spite of this, Chostochondritis is probably the leading correct diagnosis for those suffering from LRR pain.

Costochondritis is not curable, but it is treatable Here are some prescriptions that doctors have given to patients with LRR pain whom they have diagnosed with Costochondritis. Patients prescribed these treatments have called them “great” and “miraculous”. If diagnosed with Costochondritis, discuss these treatments with your doctor, but on no account place yourself on any medication without their approval.

  • Celebrex
  • Vioxx (no longer available)
  • Anti-inflammatory medications

Note: People with Costochondritis often report that the pain resurfaces or becomes especially severe after times of stress. Since Costochondritis has also been described as a “cramp” of the muscles and cartilage around the ribs, this makes sense. Stress causes your chest to literally “cramp”, causing the pain. To this end,

  • Massage
  • Heat
  • Relaxation

are excellent strategies to try, and do not need a doctor’s approval first.

A more severe form of costochondritis is called Tietze Syndrome, and includes swelling and tenderness.

2. Gallbladder

This one’s tricky. For many people, their LRR pain is caused by a complication with their gallbladder. Then again, there are many people with LRR pain who have had their gallbladder removed already.

Often, gallbladder tests will look normal for people with LRR pain. If this is the case and you still think the problem may be with your gallbladder, request an old fashioned test where the doctors give you dye tabs and a drug IV to make your gallbladder contract. They will then X-ray the gallbladder to see how much dye comes out when your gallbladder contracts. This test can often find existing gallbladder problems even if your ultrasounds come back clean.

An HIDA scan with CCK will also check gallbladder function and may show gallbladder problems even if you don’t have stones.

One patient whose LRR stemmed from their gallbladder found that

  • Drinking two cups of hot water

really helped alleviate the pain. That might be something to try while you wait for your test results to come back.

3. Loose Cartilage

This is especially common among people who have experienced some sort of fall or blow to the chest. Essentially, what happens is that a piece of the cartilage on their ribcage breaks off and just kind of floats around. If it becomes inflamed, it can cause intense LRR pain.

When cartilage breaks off your ribcage, it is called costo-chandral separation (slipped rib syndrome).

A doctor can usually tell if this is your problem by pulling up on your ribcage with one hand and feeling around underneath with the other (no surgery needed). Note that you cannot do this test by yourself.

Surgery is often not an option for this ailment. However, their may be medication to help the pain.

One patient found that taking

  • Two Gas-X pills + a pain pill

really helped alleviate the pain. However, neither the patient nor their doctors knew the reason why it worked — only that it did. Again, never take any kind of prescription medication without your doctor’s approval.

4. Acid Reflux

Many people associate acid reflux with heart burns and throat pain. However, some patients with previous histories of acid reflux who no longer have that but who now have LRR pain have found that by taking medication that blocks stomach acid, their pain almost completely goes away. Some such medication includes:

  • Nexium
  • Lanzoprazol
  • Omniprazol

If acid reflux is something you have suffered from in the past, and LRR pain is something you suffer from now, you might want to suggest to your doctor the possibility of trying an anti-acid medication like Nexium for a few months to see if it stops the pain.

5. Liver Toxins / Diet

We intake a lot of toxins in our diet — sodas, processed foods, artificial colorings — so much that we don’t even think about it. (Kind of like wireless and radio rays — we know that cell phones may cause cancer, but no one thinks about all the radio signals floating through the air and penetrating our bodies). Some doctors believe that people with LRR pain have too many toxins in their body, and it is overtaxing their liver, causing the pain. They have prescribed certain diets for their patients, which have met with much success in relieving the pain.

One patient takes a combination of

  • Milk Thistle
  • Digestaway
  • Artichoke Extract

to clean their liver.

Another found that by completely eliminating soda, white flour, and milk products from their diet, and by eating lots of fresh vegetables and fruit (and organic meat, when possible), their pain significantly decreased.

6. Too Many Vitamins

If a person with LRR pain is taking any sort of (multi) vitamin, it may be that they are actually getting too much of a certain vitamin. A,D,E, etc. vitamins are stored in your body and can cause problems if their concentration gets too high. This is especially true for Iron, which can be harmful if you get more than you need (if you are older than 45 or a guy, pay attention to this especially!). An easy way to tell if your pain is caused by vitamin overdose is to stop taking your multi vitamin for 2-4 weeks. It won’t hurt you to stop taking it for that period of time, but it will make obvious whether your pain is related to getting too much of a vitamin.


I hope that these suggestions help pinpoint your case!