It hurts between the ribs in the middle of the front when pressed, it is difficult to breathe

Pain between ribs the front in the middle may indicate the development of a serious illness. There are several ways to eliminate it, depending on the diagnosis. Usually, the nature of the clinical syndrome is different (from dull, aching pain to burning or acute).

Determination of the cause of pain between the ribs in the middle in front by the nature of the pain syndrome

Clinical pain syndrome can be divided into several categories by its severity.

Pain happens:

• blunt;
• aching;
• stabbing;
• encircling;
• sharp;
• burning.

Also, pain syndrome can occur only when bending, exhaling or palpation.

Pain only when pressed

Discomfort occurs on palpation of the chest. Patients complain of stabbing, cutting, encircling, dull, pulling, sharp pain. Spasm increases with pressure. By the nature of the manifestation, the pain syndrome can be paroxysmal or reflected.

A burning sensation in the patient arises in the center of the chest, in the area of ​​the shoulder blades and lower back. The pain radiates to the area of ​​the armpits or neck. Spasms can indicate the development of diseases of internal organs or mechanical injury.

The ribs hurt in the front in the middle with:

• pathologies of the stomach, intestines, pancreas or liver;
• respiratory diseases of inflammatory etiology;
• intercostal neuralgia;
• bruises, fractures.

A patient who has received a mechanical injury (for example, multiple fractures) of the ribs on palpation of the sternum experiences severe acute pain.

When inhaling / exhaling

When inhaling or exhaling, the pain is usually sharp and paroxysmal.

The predisposing factors for the onset of the clinical syndrome can be considered:

• pathology of internal systems;
• spinal column injuries;
• inflammation that has led to a violation of the integrity of the bone;
• pinched nerve roots;
• excessive stress on the paracostal muscles;
• hypothermia.

Constant pain in the ribs indicates the development of diseases of the respiratory system, digestive tract and biliary system. With light bruises, the patient complains of a sharp pain that turns into aching. With fractures, a sharp, acute spasm occurs.

When tilted

When bending over, the pain can be long-term, paroxysmal, short-term, sharp or aching.

Possible reasons:

• Mechanical injury. The pain syndrome is usually aching or intense. On palpation, the discomfort increases. A bump is often formed at the site of the impact. With fractures, patients complain of paroxysmal, throbbing pain.
• Neuralgia. Pain occurs when inhaling or when bending over. The clinical syndrome is of a shooting nature.

  

• Heart disease. The localization of the clinical syndrome is on the left, but sometimes the pain radiates to the right arm or neck. Spasm - aching or pressing.

With diseases of the respiratory system, patients complain of a sharp paroxysmal pain that occurs during bending or turning the body.

Burning pain

Burning pain usually occurs with the development of pathological processes affecting the thoracic spine, nerves, soft tissues and bone structures. Most often, the spasm increases with palpation or deep inhalation.

The main reasons are:

• Traumatic injury. With a severe bruise, characteristic bruises (hematomas) appear on the skin. Soft tissues are swollen, patients complain of burning pain.
• Inflammatory pathologies. With myositis, Tietze's syndrome and aseptic periostitis, pain is observed in the front to the right or in the center of the chest. The spasm is one-sided, with sudden movements it can intensify.

Chondromas, chondrosarcomas and other oncological diseases are also considered the cause of the appearance of burning pain in the ribs.

Sharp, stabbing pain

Stitching, sharp pain occurs in the walls of the chest. Most often, the clinical syndrome indicates deformation of muscles, fascia, pinching of intercostal nerves, violation of the integrity of cartilage or bone tissue.

The main reason for the manifestation of spasm is considered:

• mechanical injury;
• Tietze's syndrome;
• growth of tumors of a malignant nature;
• osteochondrosis;
• intervertebral hernia.

When nerves are compressed, patients complain of acute pain arising in the sternum from the front to the right.

Aching or dull pain

Dull, aching pain can be considered a manifestation of neurological diseases. Most often, patients complain of spasm that occurs when inhaling, bending over or changing position. The pain radiates to the epigastric region, scapula or heart.

The reasons for the development of the clinical syndrome are considered:

• shingles;
• diseases of the spinal column;
• mechanical injury;
• hypothermia.

Also, pain syndrome occurs with depression or other disorders of the psycho-emotional background.

Causes of pain between the ribs in front in the middle, additional symptoms

It hurts between the ribs in the middle of the front, not only in adult patients, but also in children.

There may be several reasons for the development of the clinical syndrome:

Pathology	Short description
Mechanical damage to the chest	With injuries, the integrity of the ribs is violated. The condition can be potentially life-threatening.
Intercostal neuralgia	Irritation or compression of the intercostal nerves.
Angina pectoris	One of the forms of coronary heart disease, is characterized by insufficient blood supply to the myocardium.
Shingles	Pathology of a viral nature, accompanied by the appearance of specific rashes on the skin.
Tietze syndrome	Chondropathy, in which the upper costal cartilage becomes inflamed.
Pleurisy	The disease is characterized by inflammation of the pleura. There are several main types of pathology.
Osteochondrosis of the thoracic region	Degenerative dystrophic changes in the intervertebral discs.
Gastritis	Dystrophic lesions of the gastric mucosa, often provoked by inflammation.
Ulcerative lesions of the stomach	Chronic pathology, which is characterized by acute pain, heartburn, vomiting and other dyspeptic disorders.
Oncology	The growth of benign or malignant neoplasms.
Diseases of the pancreas	Chest pain appears with pancreatitis, enzyme deficiency and pathologies of an inflammatory nature.
Gallbladder disease	Cholangitis, cholecystitis, dyskinesia and colic of various etiologies are characterized by severe pain syndrome and dyspeptic disorders.
Subphrenic abscess	Pathology is accompanied by the formation of an abscess in the abdominal cavity.
Gastralgic form of myocardial infarction	Abdominal infarction develops with insufficient blood circulation. A blood clot forms in the coronary artery, the muscle dies.
Hypertonicity of the pectoral muscles	Severe pain occurs even with passive movements when the person is relaxed. The muscles are constantly tense.
Fibromyalgia	Clinical syndrome of the chronic type. In addition to diffuse pain, the patient complains of fatigue, insomnia and depression.

Treatment is selected individually, depending on the patient's diagnosis.

Chest injury

With mechanical injuries, the integrity of the ribs, which form the frame of the chest, is usually violated. Damage can vary in severity and nature.

Closed injuries fall into the following categories:

• Squeezing. Occurs with traumatic asphyxiation. The condition is characterized by acute pain and suffocation.
• Bruises. The damage is accompanied by severe pain, swelling, and the formation of hematomas on the skin. Numerous bruises can provoke rupture of blood vessels, fracture of ribs and vertebrae.

Open injuries are accompanied not only by acute spasm, but also by rupture of soft tissues, bleeding.

Intercostal neuralgia

It hurts between the ribs in the middle of the front with intercostal neuralgia. The disease occurs against the background of compression of the nerve roots. The main symptom of the development of intercostal neuralgia is considered acute pain syndrome. Spasm - shooting, paroxysmal, or burning. The pain radiates to the area of ​​the scapula, neck, right or left arm.

Intercostal neuralgia occurs with diseases of an infectious etiology or against the background of hypothermia. Also, the cause of the development of pathology can be considered injuries of the spine and chest (fractures, severe bruises). Intercostal neuralgia can be triggered by the growth of a benign tumor in the pleura.

Angina pectoris

One of the forms of coronary heart disease is characterized by acute paroxysmal pain in the front left or right. The disease occurs against the background of diseases of the gastrointestinal tract (cholelithiasis, diaphragmatic hernia) or vascular lesions (endarteritis, vasculitis, periarteritis, aortitis).

With angina pectoris, patients complain of cutting, pulling, burning and pressing pain that radiates to the shoulder, epigastric region and scapula. Symptoms of the disease are also considered shortage of air, numbness of the limbs and increased heart rate.

Shingles

Pain syndrome usually occurs during the prodromal period. Patients complain of severe headache, temperature jumps, weakness, chills, dyspeptic disorders and neurological pain in the sternum. As the disease progresses, a rash appears on the patient's skin, characteristic of shingles. Viral infections can be considered the cause of the development of the disease.

Tietze syndrome

The pathology is characterized by inflammation of the costal cartilage. The patient complains of a sharp sharp pain, which increases with pressure, bending or taking a deep breath. Hypothermia and mechanical injury are considered the main reasons for the development of costal chondritis.

Pleurisy

It hurts between the ribs in the middle of the front with pleurisy. This disease is characterized by damage to the membrane surrounding the pleura.

The main symptoms of the development of pathology are considered:

• weakening of breathing;
• temperature jumps;
• cough;
• shortness of breath;
• severe chest pain.

Depending on the symptom complex, exudative and dry pleurisy are distinguished.

The main reasons for the development of pathology are considered:

• bacterial infections (pneumococcal, staphylococcal);
• fungal infections (blastomycosis, candidiasis);
• infections of a parasitic or viral nature (echinococcosis, amebiasis).

Also, pleurisy can provoke cancer, vasculitis, rheumatoid arthritis, pancreatitis, leukemia and diathesis.

Osteochondrosis of the thoracic spine

Osteochondrosis of the thoracic spine is a chronic type of disease. Pathology is characterized by changes in the intervertebral discs and the vertebrae themselves. Symptoms indicating the development of the disease are considered to be acute pain radiating to the shoulder and under the shoulder blades.

The spasm increases with a deep breath, bending and turning the body. In the absence of adequate treatment, there is a high risk of developing complications such as muscle atrophy, paresis, and spinal cord stroke.

Gastritis

It hurts between the ribs in the front in the middle, usually with diseases of the digestive system. Gastritis is characterized by inflammation of the stomach lining. Most often, pathology is diagnosed in elderly patients and children.

Reasons for development:

• helminthic invasions;
• candidiasis;
• tuberculosis;
• syphilis;
• chemical burns;
• poisoning with salts of heavy metals, alkalis;
• chronic duodenitis.

Gastritis occurs in people with eating disorders. The provoking factors are the systematic abuse of hot, spicy, fatty foods and alcoholic beverages.

Patients with gastritis complain of severe pain in the ribs, heartburn, nausea, belching, vomiting, stool disturbance and partial loss of appetite.

Peptic ulcer

Stomach and duodenal ulcers are recurrent chronic pathologies characterized by severe vomiting, nausea and heartburn. In the absence of adequate treatment, there is a high risk of developing perforation of the gastric wall (the contents of the organ are poured into the abdominal cavity).

There are several main types of pathology:

• ulcers caused by hyperparathyroidism;
• ulcers caused by long-term medication;
• ulcers caused by stress.

The characteristic symptoms of pathology include:

• pain in the right and left hypochondrium, radiating to the lower back, shoulder, shoulder blade, navel or arm;
• metallic taste;
• rapid weight loss;
• reticulocytosis;
• heartburn;
• burning sensation in the epigastric region.

The main reason for the development of peptic ulcer disease is considered terminal conditions (shock, collapse), hepatic or renal failure (including the acute phase), hypoxia, alcoholism. Cushing's ulcers occur as a result of damage to the nervous system caused by strokes, traumatic brain injury, myocardial infarction.

Oncology

The growth of tumors in the chest area can provoke a sharp, sharp pain under the ribs on the right or left. Lung cancer is associated with hemoptysis, severe coughing, shortness of breath, and shortness of breath. At the initial stages of development, the pathology does not manifest itself in any way, the characteristic symptom complex is absent.

The pain is worse when you take a deep breath or when you cough. Sometimes it is difficult for a specialist to determine the location. Discomfort is caused by an increase in lymph nodes or the spread of metastases to the pleura. People with lung cancer are losing weight rapidly.

Diseases of the pancreas

Diseases of the pancreas that can provoke acute chest pain include:

• Acute pancreatitis. Pathology develops against the background of inflammation of the pancreas. Symptom complex may vary depending on the type of disease. Most often, patients complain of acute pain in the sternum, which radiates under the shoulder blades and in the back.
• Enzyme deficiency. The patient's body is not able to properly digest food, an insufficient amount of nutrients is released into the intestines. Patients complain of diarrhea, acute pain in the upper abdomen and right hypochondrium, bloating, flatulence.

Another disease characterized by sharp pain in the chest area is pancreatic necrosis.

Gallbladder disease

Diseases of the gallbladder that provoke the development of pain in the chest area:

• Gallstone disease. Pathology occurs against the background of a violation of cholesterol metabolism in the liver and gallbladder. The disease may be asymptomatic. Sometimes the pathology manifests itself as hepatic colic.
• Acalculous cholecystitis. Pathology can be caused by infections of a bacterial type (streptococci, staphylococci, enterococci, Escherichia coli, typhoid, paratyphoid fever). Also, the carriers of the disease are considered roundworms, lamblia, feline fluke. Cholecystitis, in addition to various dyspeptic disorders, can provoke acute pain under the ribs.

Dyskinesia of the biliary tract is accompanied by periodic spasms in the right hypochondrium. Dyspeptic disorders (vomiting, nausea, stool disorder) are considered characteristic symptoms of pathology.

Subphrenic abscess

A subphrenic abscess is accompanied by inflammation affecting internal organs. Pathology occurs as a result of mechanical trauma, surgery, infectious diseases. In the immediate vicinity of the spleen, liver and stomach, pus forms under the diaphragm. Patients have chest pains, they complain of vomiting, shortness of breath, tachycardia, sweating, chills, temperature jumps.

Gastralgic form of myocardial infarction

With the gastralgic form of myocardial infarction, the pain is localized to the right behind the sternum. Spasm radiates to the left and right (shoulder blades, neck, shoulders, arms). The pain can be pulling, pressing, boring or burning. It is aggravated by palpation or severe coughing. Patients complain of anxiety caused by the fear of death.

Hypertonicity of the pectoral muscles

Hypertonicity of the pectoral muscles is characterized by a limitation of motor activity. Patients cannot perform their usual movements. The patient develops convulsions and acute pain syndrome. Allocate spastic and rigid hypertonia. In the first case, the nerve endings are damaged in a certain area (neck, shoulders, chest). Rigid hypertonicity is provoked by brain damage.

Fibromyalgia

It hurts between the ribs in the middle of the front with fibromyalgia. Chronic pain syndrome arises from central sensitization. Patients complain of acute pain in bones and muscles, their sleep is disturbed, weakness and fatigue are revealed. In some cases, fibromyalgia can be combined with psycho-emotional disorders. It is often diagnosed in people suffering from depression, anxiety, and migraine.

Differential diagnosis

Differential diagnosis includes several stages.

Before prescribing medication, a traumatologist or orthopedic surgeon should:

• Interview. The specialist finds out from the patient the dynamics, duration and time of the onset of spasms. He should also listen to the patient's complaints.
• Physical examination (examination). The specialist conducts percussion, palpation and external examination of the patient. This allows you to determine the presence of hyperemia, edema and various deformities. With the help of a physical examination, the localization of the pain syndrome is determined.
• Radiography. After a detailed examination, the specialist directs the patient for an x-ray. The procedure helps to identify diffuse and focal pathological processes in the lungs.

In the process of making a diagnosis, you may need to consult a neurologist.

First aid for acute pain

Acute pain can be treated with medication.

If an attack occurs suddenly, experts recommend taking one of the following medications:

• Spazmalgon;
• Dexalgin;
• Pentalgin;
• Nise;
• Movalis;
• Nurofen;
• Ketanov.

It is important to carefully read the instructions before use. If the patient's condition has not improved, then you need to call an ambulance or visit the nearest medical institution on your own.

What to do with prolonged pain between the ribs?

If the pain syndrome is periodic, then you need to contact a specialist who will select the safest and most effective treatment regimen. The composition of drug therapy can include systemic and local drugs.

Ointments and gels

Drugs that relieve pain in the rib area are divided into several categories:

• Anti-inflammatory non-steroidal drugs. They are prescribed for bruises of varying severity. According to reviews, the most effective ointments are Dolgit, Ibuprofen, Bystrumgel, Indomethacin, Nurofen.
• Venotonic. Drugs in this category are indicated for swelling and bruising. Troxevasin, Troxerutin, Lioton, Heparin ointment can be applied to the affected area.
• Local healing medicines. They usually contain snake or bee venom. Capsicam, Finalgon have a warming effect.

The composition of drug therapy may include drugs that are characterized by an analgesic effect. These include Lidocaine ointment, Sanitas gel and Olfen.

Systemic drugs

The drugs are selected depending on the cause of the pain syndrome.

After an accurate diagnosis has been made, the following medications may be prescribed to the patient:

• Allochol;
• Gastritol;
• Urolesan;
• No-Shpa;
• Gastal;
• Maalox;
• Omez;
• Tetracycline;
• Clarithromycin.

The above drugs have a number of contraindications. Before use, you must carefully read the instructions.

Folk methods and means

Traditional medicine can be included in drug therapy. Decoctions, infusions and other preparations for external use are selected by a homeopath depending on the diagnosis.

It is strictly forbidden to independently choose alternative medicine and use them without the permission of the attending physician. Usually, for pain in the right hypochondrium, ointments, infusions and decoctions based on geranium, potatoes, mint, lemon balm, plantain are used.

Pain between the ribs in the front in the middle indicates the development of diseases of the heart, digestive tract, respiration and biliary system. Any ailment is a reason to go to a medical institution.

Video about the causes of pain between the ribs

Malysheva on intercostal neuralgia: