Right-side pain under the ribs when coughing can be caused by a range of issues, from simple muscle strain or a strange sleeping position to more serious conditions like gallbladder problems or lung infections. Call your doctor if the pain persists for multiple days or becomes too sharp to allow you to perform simple daily tasks. It is important to differentiate this pain from other conditions, such as chest pain, which can be associated with slipping rib syndrome or other medical issues.
Pain on your right side under the ribs when coughing is usually caused by minor issues, such as a strained intercostal muscle, rib fracture/bruising, or passing inflammation of related nerves from arthritis or a temporary disc herniation. While these sound like serious issues, they’re more common than most people might think, and go away on their own through rest, movement, and over-the-counter pain management.
But when the pain becomes severe or remains persistent without change for multiple days in a row, then you should call your doctor. Severe or persistent rib pain could be caused by more serious sources of inflammation, such as a lung infection, pleuritis, or costochondritis. Some conditions also cause referred pain in the ribs, such as gallstones or heartburn. Severe or prolonged coughing, often due to respiratory infections, colds, smoking, or underlying lung diseases like asthma, can also lead to rib pain or injuries. A fractured rib can result from severe coughing or physical trauma, causing localized sharp pain that worsens with movement or breathing.
In short – if your pain is minor, and only felt when coughing, then it’s usually not something to worry about. Call your doctor if you’re concerned and schedule a check-up for peace of mind. It’s always better to be safe rather than sorry. If the pain is becoming worse without a reasonable explanation (such as a recent injury, manual labor, or sports) or remains persistent without losing severity, then call your doctor. A thorough physical examination can reveal the cause and the best course of action for treatment.
Common Causes of Right Side Pain Under Ribs
Rib pain is usually related to the rib bones themselves, the muscles between your ribs, the nerves connected to the ribs along the middle of the back, or pain originating from somewhere deeper in the body, such as a gallstone. The upper ribs can be particularly affected by conditions like acute cholecystitis, where a gallbladder attack causes severe and steady pain in the right upper ribs. Various methods such as over-the-counter pain relief medications, corticosteroid injections, and potential surgery can be used to relieve pain caused by conditions like slipping rib syndrome.
Muscle Strain
Muscle pain can be mild, becoming worse when certain muscles are contracted or moved, as is the case when coughing, often due to intercostal muscle strain. Severe or prolonged coughing and sneezing can lead to a pulled rib muscle, causing pain under the right rib cage.
Sore muscles, or even muscle damage, can occur from strenuous activity such as exercise or manual labor. Twisting in the upper body, especially with raised arms, is more likely to cause muscle strain around the ribs. Recovery time for strained rib muscles varies, with mild strains healing within days and more severe strains taking several weeks.
Bruised or cracked ribs can also cause long-lasting rib pain, made worse when coughing, laughing, or moving. Cracked ribs can be caused by chest compressions (such as CPR) or trauma to the ribcage, from a falling object or a contact sport. Cracked ribs heal with time, but it’s important to rest and give the bone time to heal before engaging in any strenuous activity.
Nerve pain can also feel sharp or persistent, depending on the cause. Your thoracic (upper middle back) spinal nerves are connected to the arms, shoulders, chest, and ribs, with different nerve roots connecting to different parts of the body. Inflammation or swelling around the spine can cause pain in your ribs, even if the origin point for the pain isn’t the ribs, but your spine. Thoracic nerve pain can also be unilateral (one-sided).
Gallbladder Issues
Gallstones or gallbladder inflammation (cholecystitis) can cause sharp pain on the right side under the ribs, especially when coughing or taking deep breaths. It is also important to monitor for high blood pressure as a symptom, as it can indicate serious underlying conditions.
Referred rib pain, such as through gallstones, will usually also come with other symptoms. Gallstones are formations of cholesterol that harden in the gallbladder. These stone-like objects can form for months without any symptoms, like kidney stones. They can block important ducts and cause inflammation of the gallbladder and pancreas, leading to infection and unbearable pain. Important symptoms of gallstones include fevers, light-brown pee, yellowing of the skin and sclera (white portion of the eyes), and nausea.
Liver Problems
Conditions such as liver inflammation (hepatitis) or fatty liver disease can also result in pain under the right rib cage. The liver’s proximity to the diaphragm makes coughing or breathing deeply especially uncomfortable. Jaundice (yellowing skin) is also a sign of liver inflammation.
Pleurisy or Lung Infections
Pleurisy, or inflammation of the lung lining, can lead to sharp pain when coughing, breathing, or sneezing. Severe or prolonged coughing, often caused by respiratory infections, colds, smoking, or underlying lung diseases like asthma, can also contribute to pleurisy and lung infections, such as pneumonia, which may cause similar pain on the right side of the chest.
These are more common after a viral infection, while the body is still weakened by illness. In addition to one-sided chest or rib pain, a lung infection or infected lung lining will usually be accompanied by frequent coughing, shortness of breath/difficulty breathing, and radiating pain along the arm, shoulder, and back.
Kidney Stones and Rib Fractures
Kidney stones can cause sharp, radiating pain on the right side that might be mistaken for rib pain. The pain of a kidney stone is immense and usually accompanied by bloody urine.
If you think you might have a kidney stone, then immediate medical attention is required.
Home Remedies for Pain Relief in Managing Right-Side Rib Pain
For mild cases, resting, applying heat packs, and using over-the-counter pain medicines (such as ibuprofen and acetaminophen) can alleviate discomfort while the affected area heals, and the swelling retreats. Pain relief methods such as ibuprofen and naproxen are effective in managing the pain associated with slipping rib syndrome.
Don’t stop all forms of movement, but take note of what feels painful, and what feels doable. Slow walks can help keep you active while improving your body’s recovery and healing. Take note of other symptoms and call your doctor if anything changes for the worse.
Medical Treatment Options
If the pain is linked to a more serious underlying issue like gallstones or pleurisy, professional medical treatment is required to relieve the pain. Conditions such as broken ribs may also require medical treatment to manage pain and ensure proper healing. Lung infections may call for antibiotics, while gallstones or kidney stones need to be removed surgically, or through specialized interventions to help break the stones down into smaller particles, allowing them to pass through your system.
Conclusion
Right-side rib pain when coughing can indicate anything from a minor muscle strain to a serious internal condition. It’s best to call your doctor for a check-up and note any related symptoms. Don’t jump to conclusions – most instances of rib pain go away over time. But sometimes, rib pain can be a key symptom of a serious health problem. Always consult your doctor for persistent or severe pain.
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