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Dr. Hasan
Dr. Hasan, Doctor
Category: Medical
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Experience:  MBBS, FCPS, with experience in all fields of medicine and surgery
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pain under the right ribs that radiates down the right arm at times

Resolved Question:

I have pain under the right ribs that radiates down the right arm at times. It does not hurt when I move in any direction. It seems to feel better when I lay flat or on my right side. It had gotten no better or worse for the past 3 days and my diet does not seem to effect the pain.
Submitted: 3 years ago.
Category: Medical
Expert:  Dr. Hasan replied 3 years ago.

DR HASAN :

HI

DR HASAN :

Thanks for your question

DR HASAN :

Does it hurt when you press that area under that right rib cage?

Customer:

It is sore when I press (or dig) under the right ribs and comparing that to the left side. It does not hurt to press on top of the ribs.

DR HASAN :

Do you have symptoms like yellow eyes, yellow skin , nausea, vomiting etc?

Customer:

I will also say that I have had areas that are numb to the touch at the same level (low shoulder blade) in the back for many years, on the same side - no one has been able to explain this and it may not be related. No yellow eyes or skin, no vomiting or nausea. I have always had low iron (may not be related, just letting you know) with the need for iron injections in the past.

DR HASAN :

Ok do you feel any pain on moving the shoulder?

DR HASAN :

Do you have constipation, diarrhea, abdominal distension etc?

Customer:

No. I am a hand therapist and I have completed some provocative testing on my shoulder with no indications. No pain with range, muscle testing or neurological symptoms reproduced from the shoulder. The pain that radiates down the right arm moves across the right shoulder blade and down to the right deltoid. No constipation or abdominal issues.

DR HASAN :

Actually the pain under right rib can be due to liver pathologies, gall bladder pathologies, intestinal lesions, muscular pains.

DR HASAN :

The questions i asked you were for ruling out these lesions

DR HASAN :

In my opinion your problem seems to be muscular.

DR HASAN :

specially the radiation of pain towards arm means that some nerve is being involved somewhere , might be just in some muscle

Customer:

Liver enzymes were checked and are normal. Do you think this could be coming from my gallbladder? Could it come from the nerves around the ribs are radiate to the arm?

DR HASAN :

Yes i think the second possibility about the nerves is likely because if it was gall bladder it should have radiated to just shoulder tip

DR HASAN :

you says its just arm , so not likely to be a gall bladder,

Customer:

Do you think the numbness to the mid back that has been there for years is related??

DR HASAN :

Numbness is a symptom of nerve compression so they all can be related

DR HASAN :

Which pain killer you have tried

Customer:

My primary care gave me Naproxen (sp.??) but it is not painful enough for me to take these unless I need to get better sleep. More than anything it is just aggravating and reduces my ability to do deep breathing.

Customer:

I have tried to do stretches/exercises - no improvements

DR HASAN :

ok fine

DR HASAN :

Do you have cough also?

Customer:

No cough but it does hurt when I cough, sneeze, hiccup, sniff, deep breathing

DR HASAN :

does it hurt when you take deep breath?

DR HASAN :

which doctor you have seen and has he done any investigations?

Customer:

I visited a PA on Sunday. She tested liver enzymes and ordered a gallballder ultrasound - still waiting on results. I just wanted to get a second opinion and make sure there isn't something that we are missing. WOuld you consider anything going on with the lungs that would reproduce my symptoms??

DR HASAN :

does it hurt when you take deep breath?

Customer:

Yes, but not with shallow breathing. Deep breathing is my main complaint.

DR HASAN :

well there can be associated pleuritic pain but this cannot be associated with all other symptoms you have

DR HASAN :

i think just a chest xray if not done already can be helpful

DR HASAN :

but doesnot looks like any seroius pathology

DR HASAN :

I suggest that you see an internal medicine doctor if all these issues donot resolve so that he get to a cause

Customer:

Thats what I wanted to make sure of. Thanks for your time.

Dr. Hasan, Doctor
Category: Medical
Satisfied Customers: 7580
Experience: MBBS, FCPS, with experience in all fields of medicine and surgery
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