Biting Pain Below My Ribs On The Left and Right Sides.

by Darnee
(United States)

I am a 58 year old man who gets debilitating pain on either my right or left sides, right under my ribs; pain does not move.

The pains can last up to 10 minutes and feel like a shark is taking a gnawing bite out of me. I have to lay down and wait for it to go away. Sometimes I feel a lump where the pain is. I don't notice it in relation to any particular activity, eating or movement.

There is no change in my appetite or bowel movements. This pain has been going on for 10 years. I have had the following tests done and nothing has been diagnosed: Cat Scans, MRIs, x-rays, blood tests.

For 10 years, I have also had a cough that takes my breath away, sometimes almost to the point of unconsciousness.

All types of testing has been done but no doctor could determine the cause. I think this started after taking antibiotics. Just recently, I uncovered that the cough might be a sensory neuropathy cough which my neurologist is now investigating.

In Nov. 2013, I had a brain bleed and stroke but since my pain existed long before that, I won't go into the medicine I am currently taking.


Hello Darnee,

Thank you for your patience and for posting your question a second time.

I did read it same day you sent it almost a week ago, as well as your follow up email. It's been so busy at work and I scheduled getting back to you today.

You gave an amazingly perfect description of a well known medical condition, but yet not so much spoken about. It is what we call "Lower rib pain syndrome" or slipping rib syndrome also known as "twelfth rib syndrome".

Sometimes, for reasons unknown, the joint where one of our rib's bone and cartilage meets on the sides of our chest wall could become weakened and loose, causing the two parts that make the joint to slide apart. To understand how this works, put the tips of your index fingers together for two seconds and then let the fingers slip apart - one moving upward and the other moving downward, mimicking our chest movement during respiration.

What brings about
that sharp gnawing pain as if you have been "beaten by a shark" is a component of the slipping joint catching on the "intercoastal nerves" that usually run under each and every rib. The pain could be dull or very severe, depending on how much or how rough of a edge of cartilage is catching on the nerve.

Though Lower rib pain syndrome is often one sided - often more on the left side, it can happen on the right side as well and certainly on both sides at the same time.

The good news is that, other than the annoying and sometimes debilitating pain this condition causes, it does not lead to a long term complication or illness.

In cases where it is very troublesome, we could identify the rib involved and inject it with a mixture of steroid and local anesthetic agent. This is not curative. It may need repeating a few times a year.

Slipped rib syndrome is a common causes of unwarranted operations and distress to patients when it is not identified by physicians, causing needless extensive tests or investigations and anxiety.

The pattern is that once most people understand what the cause of their pain is, they are able to "live with it", without seeking further interventions.

Other conditions that could cause the type of pain you've described would include:
  • Myofascial trigger point pain or pain from muscle knotting
  • Costochondritis - inflammation of part of the rib where the cartilage and bone meets
  • Tietze syndrome - similar to costochondritis
  • Gallbladder stone on the right side
  • Spleen pain on the left side.

But the quality of the pain from any of the above mentioned conditions would be so different from that resulting from 12th rib syndrome (lower rip pain syndrome). And. And should not last for 10 years!

Darnee, I hope this helps. Thank you so much for your time and persistence as well as this great question. I will be creating a post soon on lower rib pain syndrome and post same here on, as this condition needs to be talked about more than it is and help minimize the untold distress it brings to sufferers.

Kindest regards,

Dr. Omatseye Edema MD MSc MRCGP CCFP DRCOG
Web MD

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