Pain in The Right Side of Back Under Ribs: What It Means According to Science

Back pain is a common complaint, and feeling aches and pain in the right side of the back under the ribs can have many causes. Right-sided middle back pain can be a result of inflammation in your rib cage area, problems with the vertebrae in your thoracic spine, spinal injuries, or muscle or ligament strain. Middle back and rib pain can also be caused by organs under your ribs like kidney stones, gallbladder pain, or lung disease.

Your middle and upper back area is supported by the thoracic spine which is attached to your ribs. Surrounding your ribs are intercostal muscles and ligaments that work together to give strength and stability to your upper body. Although lower back pain is more common than middle back pain, acute or chronic pain under your back ribs can affect your daily activities.

Depending on the cause of pain under your right ribs, you may have a sensation of dull, throbbing aches that don’t go away. Or, the pain could start suddenly and feel like sharp stabbing pains that are worse when lying down or standing up. Some of the ways of getting rid of nagging pains in your back without painkillers include warm or cold compresses, stretching exercises, and getting plenty of rest.

In this article, I will look at the many causes of back pain on your right side that is felt under your ribs. You will also find out how to tell the difference between rib pain in your back and upper or middle back aches caused by internal organs.

Thoracic Back Anatomy and Right-Side Rib Pain

The thoracic back describes the area of your back from just below the base of your skull to about 5 inches below the lower part of your shoulder blades.

Doctors from MedicineNet say that the middle and upper part of your spine contains 12 vertebrae that are attached to your rib cage. Your ribs wrap around from your back to the front of your chest and connect to your breastbone.¹

The University of Maryland reports that between the 12 vertebrae in your thoracic spine are small jelly-like discs. These cushion your spine and act as shock absorbers to prevent irritation, inflammation, and back pain in your spine and ribs. Damage to the discs through wear and tear or injury can cause pain on the right side or left side of your ribs as well as the middle of your back.²

Another feature of the anatomy of your rib cage that can cause right-sided back pain is the muscles that lie between your ribs (called the intercostal muscles). According to the book Clinical Anatomy of the Spine, intercostal muscles also influence the spine. They wrap around your chest between your ribs and are attached to the sternum and thoracic spine. They help to stabilize your upper back and also play a role in breathing.³

Injury to your rib cage muscles, supporting ligaments, ribs, thoracic spine, or breastbone can also cause pain that radiates to other areas of your body. This is why middle or upper back pain can sometimes cause pain in your shoulder blades, abdominal pain, or even shooting pains down one or both legs.

Common Causes of Back Pain Under Ribs

Upper, middle, and lower back pain is one of the most common reasons why people visit their doctor. It is also one of the main reason for missed days at work.

According to doctors from the Mayo Clinic, some common reasons for aches, pains, and discomfort in your upper or middle back include:⁴

• Pulled or strained muscles that can happen as a result of lifting heavy items or being in poor physical condition. Also, improper lifting can cause damage to your spine and cause back pain.
• Herniated discs between the vertebrae in your thoracic spine can cause debilitating back pain that spreads to your rib area. Ruptured spinal discs can also press on nerves, sending shooting pains that wrap around your chest.
• Osteoarthritis that happens with wear and tear and is often a part of the aging process.
• Being overweight can put extra strain on your middle back and lower back and results in chronic pain that makes doing everyday tasks difficult.
• Injury to your right ribs can cause right-sided back pain and aches in your middle back.

Back pain under your right ribs can also be caused by issues with any of the organs in the right side of your rib cage or upper right abdomen.

Causes of Right-Side Back Pain and Rib Pain

Let’s look at the reasons for middle and upper back pain that are connected to your ribs and rib cage.

Rib muscle strain or injury

Incorrect lifting, trauma to your right-side ribs, or twisting your body awkwardly can strain the muscles between your ribs. Intercostal muscle strains caused by injury to your right rib cage can result in sharp, stabbing pains that may spread to your back.

According to Dr. Jack McPhilemy, an expert in orthopedic surgery, muscles strains or tears to the muscles between your ribs can cause acute or chronic back pain. As the intercostal muscle tear or strain heals, jabbing back pains might only occur when you sneeze or cough. Depending on the extent of the muscle injury, it may take a few weeks for the right-sided rib pain to go away.⁵

Doctors from the Cleveland Clinic say that other symptoms of pulled or strained muscle in your ribs are:⁶

• Pain that intensifies when you move your upper body
• Muscle spasms
• Reduced range of movement when bending forward or sideways

At the end of this article, you can find stretching exercises that can help to treat sore intercostal muscles that are causing back pain.

Damaged nerves in the rib cage

Another cause of pain in the right side of your back that is connected to your ribs is intercostal neuralgia.

The Journal of Neurology & Translational Neuroscience reported that damage to an intercostal nerve in the ribs can cause back pains in the thoracic region that spread to the chest. Pain caused by nerves between the ribs is described as shooting or burning pain that is very sharp. The painful sensations can also spread to the shoulder and also cause upper leg pain.⁷

Other symptoms of intercostal neuralgia include:

• Muscle spasms and twitches that affect your arm, shoulder, or middle back.
• Tenderness in your middle right back or left back.
• Loss of feeling in your back or chest.

Some of the causes of intercostal neuralgia that causes pain on one or both sides of your ribs are shingles, back or chest inflammation, injury to the rib cage, and pulled or strained chest muscles.

Because nerve pain in your rib cage can cause sharp pains in your left chest, you should be aware of the signs of a heart attack. The first symptoms of a heart attack are pressing or squeezing pains in your chest that spread to your left arm.

Poor posture

Standing or sitting with a hunched or slouched back can put extra strain on your thoracic spine and cause back pain under your ribs.

According to Dr. Laurence Knott on Patient.info, poor posture can put pressure on the nerves in your spinal column and your rib cage. This can cause pain from your middle back to radiate to other parts of your body. The middle back pain can develop over time and be caused by sitting for long periods of time or not standing straight.⁸

To find out how to reduce back pain under your ribs caused by poor posture, please read my article on how to improve your posture. This may also help your treat symptoms of sciatica that cause shooting pains down your leg.

Herniated thoracic disc

If one of the discs between the thoracic spine ruptures, slips or herniates, you can experience varying degrees of back pain. If the herniated disc presses on a nerve, the shooting back pains can be severe and cause weakness and tingling in your right or left arm.

Dr. Gerard Malanga who specializes in physical medicine and rehabilitation says that middle back pain is the most common symptom of a herniated disc. This may cause sharp pains in the groin if it happens in the lower back, or aching neck pain if the disc ruptures at the top of the thoracic spine.⁹

Other symptoms of a herniated disc may include:

• Pain on the right side of your back if a nerve on the right rib cage is affected
• Tingling in your arms
• Muscle weakness
• Abdominal pain and cramping
• Sharp, shooting, or constant pains on one or both sides of your back.¹⁰

Arthritis

Various forms of arthritis can affect your thoracic spine and cause inflammation in the spinal vertebrae. This can result in chronic middle back pain that is felt under your right or left ribs.

The Journal of Korean Medical Science reports that rheumatoid arthritis can cause middle back pain that spreads to the lower back. For some people, the pain can increase when lying down or standing for long periods of time. The reason for this is that degeneration of the vertebrae in the middle back puts extra pressure on the lower back.¹¹

Arthritis of the spine can make bending forward or backward difficult and can cause stiffness and upper and middle back pain.

If you suffer from arthritis, then you should include foods in your diet that reduce inflammation. Also, spices like ginger and turmeric reduce inflammation in joints and may alleviate pain under your ribs and other symptoms of arthritis.

Costochondritis

Pain that starts in the middle of your chest and spreads around your ribs to your back may be a sign of costochondritis. This is an inflammatory condition of the cartilage that joins your sternum (breastbone) to your ribs.

According to Dr. Carol DerSarkissian on WebMD, costochondritis causes tenderness and pain in the middle of your chest (sternum pain). This can feel worse when you press on the breastbone. The pain can come on suddenly and feel like sharp jabbing pains. Sometimes, the pain in your chest is more like a dull ache that is sharper when you cough.

Dr. Carol DerSarkissian explains that costochondritis can cause rib pain that wraps around your right side or left side to your back. However, the pain usually affects your left chest more often.¹²

Fibromyalgia

Fibromyalgia is a chronic pain disorder that causes widespread pain throughout your body and can be a reason for back pain under your right ribs.

Doctors from the Cleveland Clinic say that pain in the thoracic, cervical, or lumbar area is a common symptom of fibromyalgia. This can cause pain that affects the back and may be felt on just one side. Other accompanying symptoms of fibromyalgia can include:¹³

• Depression because of constant pain in the body
• Fatigue and extreme tiredness
• Poor sleep quality
• Skin that is tender to touch

Did you know that there are foods you must avoid if you are living with chronic pain? If you suffer from fibromyalgia then research has shown that D-Ribose supplements can help reduce the symptoms of fibromyalgia and chronic fatigue.

Causes of Right-Side Back Pain Under Ribs Due to Internal Organs

Not all cases of middle or upper back pain are connected to your ribs. Some causes of pain that feels as if it is under your ribs could be caused by an issue with one of your internal organs.

Gallstones

Your gallbladder is located on the right side of your upper abdomen, and gallstones or inflammation can cause right-sided back pain. The Journal of Family Medicine and Primary Care reported that chronic right side back pain is often a symptom of gallbladder blockages or inflammation. The pain is usually felt under your right shoulder blade.¹⁴

Lung issues

Inflammation or infection in your right lung will probably cause sharp middle back pains under your right ribs. Conditions like pleurisy, pneumonia, or a collapsed lung can be the result of an upper respiratory infection.

To care for the health of your lungs, please see my article on how to cleanse your lungs naturally. It’s also important to spot the early signs of lung disease to prevent health complications in your lungs.

Kidney problems

Your kidneys are located in the middle of your back, and kidney disease or kidney stones in your right kidney will cause right-sided pain under your ribs. Dr. Charles Patrick Davis says that kidney stones can cause intense cramping pain in your middle or low back area.¹⁵

Drinking apple cider vinegar can help to dissolve kidney stones and get rid of the back pain that they cause.

How to Treat Middle Back and Rib Pain

Many home remedies can help relieve pain in your upper or middle back that is caused by an issue with your ribs. Let’s look at some natural ways of relieving back pain without the use of painkillers.

If you have injured your back, most doctors recommend getting plenty of rest to prevent aggravating any injury in your back. However, you should not lay in bed too long because physical activity can help to prevent back pain from becoming chronic.¹⁵

It is also important to make sure that you improve your posture to avoid long-term pressure on your middle back and ribs that can result in chronic back pain.

Warm or cold compress

Applying a cold or warm compress to the painful area on the right side of your back can help to relieve inflammation, muscles strains, or nerve pain.

According to researchers from Johns Hopkins Medical Center, heat or cold can help to relieve the symptoms of middle or upper back pain. The advantages of this are as follows:¹⁶

• Cold treatment for back pain helps to reduce swelling and restricts blood circulation to prevent bruising or bleeding. This is effective in the first 48 hours after an injury or muscle strain.
• Heat treatment for middle back pain increase circulation to speed up healing and reduces stiffness in joints to relieve rib pain. Use only when swelling and inflammation have gone from the initial injury (usually after 48 hours).

How to make a cold compress for relieving injuries to your ribs:

1. Put crushed ice in a sealable plastic bag and cover with a thin damp towel.
2. Lie on your front.
3. Apply the ice pack on the right side of your back where you have pain for 15-20 minutes.
4. Repeat every hour to help reduce bleeding, inflammation, and swelling after a strain or muscle injury to your ribs or thoracic spine.

After 48 hours, you should use a warm compress for pain relief.

How to make a warm compress to relieve back pain under your ribs:

1. Fill an old sock 3/4 full with rice and secure at the open end.
2. Put the compress in a microwave and heat it on full power for 1-2 minutes.
3. Remove the sock from the microwave (be careful, it might be very hot!).
4. Wrap the warm compress in a warm damp towel.
5. Apply to the painful area on your back and leave for 20 minutes to improve circulation and relieve muscle stiffness and pain.
6. Repeat 3 or 4 times a day for 20 minutes to treat the symptoms of back pain.

If you need to, place the rice heat pad in the microwave and heat for one minute to keep the compress warm.

Exercises for Thoracic Back Pain

Many stretching exercises are effective to get rid of muscular or nerve pain in your back below your ribs. These help to strengthen the middle back. This gives your upper body more stability and helps to prevent injury that results in back pain.

Stretches to relieve back pain

The International Journal of Sports Physical Therapy says that stretching the muscles helps to relieve the symptoms of back pain. Gentle stretches help to lessen muscular tension and at the same time increase muscle strength.¹⁷

The child’s pose to relieve irritation in your middle back:

1. Begin by kneeling on your hand and knees. Make sure your knees are about hip-width apart.
2. Take a deep breath and put your hands on the floor.
3. As you exhale, slowly extend your hands as far as you can.
4. Keep moving your hands forward and try to lengthen your back as much as possible.
5. Keep your buttocks on your heels and touch your forehead to the floor.
6. Hold for 30 seconds to stretch your spine and relieve pain in your back.
7. Repeat the stretching exercise 2-3 times daily to increase flexibility and strength in your upper and middle back.

Exercises for back pain

According to the Journal of Physical Therapy Science, exercising regularly the middle back can help to get rid of the pain in the thoracic region. Exercising helps to improve strength in the muscles and ligaments of the upper back and reduces symptoms of lower and middle back pain.¹⁸

Foam roller exercise to strengthen your back:

1. Sit on the floor and place the foam roller so it is perpendicular to your back.
2. Lie back on the foam roller, making sure it is directly under your middle back.
3. Lift your pelvis off the ground and support your head by placing your hands behind your head.
4. Tighten your buttock muscle (glutes).
5. Use your legs to support yourself and slowly roll from mid-back to your upper back.
6. Roll back to the starting position so that the foam roller under your middle back. (Don’t allow the foam roller to roll to your neck or lumbar region).
7. Repeat a few times to exercise your upper and middle back.

When to See a Doctor

According to doctors from the Mayo Clinic, you should see a doctor for symptoms of back pain in the following circumstances:¹⁹

• Lower, middle, or upper back pain affects your ability to carry out normal activities without discomfort.
• The pain gets worse when you lie down or go to bed.
• Back pain that radiates from your middle or lower back down one leg below the knee.
• You get weakness, tingling, or numbness in your legs or arms.
• You notice swelling and redness on your back.
• You develop bladder or bowel problems along with severe back pain.

Read these related articles:

• How to Relieve Back Pain and Muscle Tension Naturally
• Effective Treatments for Pulled, Strained or Torn Back Muscle
• How to Crack or Pop Your Back Like an Expert: The Complete Guide

Medical Sources