Get E-Book on COVID-19

Q. I get pain in my lower ribs while coughing and taking deep breath with history of AS. Please help.

Answered by
Dr. Divya Agarwal
and medically reviewed by Dr. Vinodhini. J
This is a premium question & answer published on Jun 03, 2020

Hello doctor,

I have been having pain around my lower ribs towards the back side (left side) since the past eight days. The pain gets worse while lying down and trying to change sides in the night. It also hurts while sneezing or coughing (feels better if I cough or sneeze by holding the area with my hand). It hurts a little sometimes while deep breathing. While sitting or standing straight, the pain is almost not there and also it does not hurt while bending forward or backward. But it hurts a little while bending sideways.

I did a course of Hifenac Max for 5 days and the pain did come down slightly. However, it again got bad last night.

I was diagnosed with ankylosing spondylitis in 2009. Since then I have had two episodes of severe pain in my lower back right side (sacroiliac joint). But it has never pain in the area of ribs like what is happening now. I have also had multiple episodes of uveitis over the past eight to nine years. I am HLA-B27 positive.

I do not have any other symptoms. My appetite is fine and I do not feel any other discomfort. My motion is regular. Also, I am not on any regular medication. My BP is normal (measured using an electronic commercial machine at home) and my vitals were mostly normal (apart from slightly high cholesterol) when I did my health check up 3 years back.

Dr. Divya Agarwal



Welcome to

In the light of the fact that you are HLA B27 positive, the pain that you are experiencing is due to the same problem. This is called enthesitis, and it occurs due to inflammation at the attachment of muscles to bones. So the treatment also remains similar to that of AS. You need to take a full dose of NSAID (non-steroidal anti-inflammatory drugs) whichever suits you best.

For the present, you could take Voveran sr 75 twice daily with an antacid like Pantocid. If things still bad, Sulfasalazine may be added. Calcium and Vitamin D must be continued. Regular physical exercise is a must to control this disease. Please make sure you follow this.

I hope this helps.

Was this answer helpful?


Thank you doctor,

Could you please tell me for how many days should I take the Voveran SR before I take a call whether or not to add Sulfasalazine? Also, I had taken Hifenac Max for five days last week.

Dr. Divya Agarwal



Welcome back to

I think depending on how well you feel with Voveran take it twice a day for at least one week, then you can probably reduce it to once a day for another one week, by then we can take a call.

Was this answer helpful?


Related Questions:
Are spider veins related to Ehlers-Danlos syndrome?
I get sudden pain in the left ribs which seems radiating from abdomen. Is it due to pancreatitis?
Can Aleve and Goody's powder cause stomach upset?
Consult by PhoneConsult by Phone Video ChatVideo Chat
Also Read Answers From:

Comprehensive Medical Second Opinion.Submit your Case

Related Questions & Answers

Nausea and stomach pain after taking Panadol.

Query: Hello doctor, I am a female, 27 years old, 50 kg, 162 cm. Just before sleeping at 11:30 AM, I took two Panadol advance pills and one Muscerol 3 pill altogether. I have not eaten for the last five hours earlier. Later that night, I woke up around 2 AM feeling nausea which lasted for a few minutes. S...  Read Full »

I am suffering from ankylosing spondylitis. Kindly suggest new medications.

Query: Hello doctor, I am suffering from ankylosing spondylitis (HLA B27 positive and Rh factor negative) since 10 years, now on Saaz-DS, SI joints are fused. Movement restrictions of neck, forward bending and morning stiffness with sciatica. Kindly suggest the new medications and NSAIDs. I have attached ...  Read Full »

My new naturopath suggested iron and thyroid supplements for hair loss. I need an opinion please.

Query: Hello doctor, I have had a lot of hair loss in the past year. Mostly on top of my head. Lost half my hair. My regular doctor did not find anything wrong with my blood test and said hair loss affects a lot of women and accept it. My new Naturopath thought my numbers seemed low and suggested iron a...  Read Full »

Also Read

Can naked body to body massage spread HIV?
Hello doctor, I recently had some business trip during which I had some naked body to body massage wherein massager vag...  Read more»
Are COVID-19 Patients Infectious for up to 90 Days After Recovery?
There have been reports of recovered COVID-19 patients getting reinfected and testing positive for almost 3 months. Read...  Read more»
Crohn's Disease
Crohn's disease causes inflammation of the digestive tract, which results in symptoms like severe diarrhea, stomach pain...  Read more»

Ask your health query to a doctor online?

Ask a Rheumatologist Now

* guaranteed answer within 4 hours.

Disclaimer: All health Q&As published on this website is not intended to be a substitute for professional medical diagnosis, advice or treatment by a trained physician. Seek the advice from your physician or other qualified health-care providers with questions you may have regarding your symptoms and medical condition for a complete medical diagnosis. Do not delay or disregard seeking professional medical advice because of something you have read on this website.