Is my scoliosis responsible for pain in the ribcage?

Question

Hello doctor,

In some specific scenarios, for example, when I fill my lungs with air, if I press just below my rib cage (from the center all the way to the right side), I feel pain. As soon as I stop putting pressure, the pain is gone. I do not need to press intensively to feel pain. Also, I lean forward or I press with my fingers, and I feel the same pain in the rib cage.

If I press while standing, I do not feel pain. I can not pinpoint whether it is visceral pain or muscle pain. The pan feels internal. I also have scoliosis; my spine deviates to my right side. My back is more prominent on the right side.

I occasionally feel some episodes of pain right after I eat, in the top center right of the abdomen. But I do not think this is related. I did an ultrasound of my liver and gallbladder, and the reports were fine. Kindly tell me the reason for my pain.

Kindly help.

Answer 1

Hello,

Welcome to icliniq.com.

I read your query and can understand your concern.

Given your history and description, the pain you are experiencing beneath the right side of your rib cage, particularly when pressing or leaning forward, and absent during normal standing posture, raises suspicion for a musculoskeletal origin. Considering your known scoliosis and spinal deviation to the right. The scoliosis may be altering the mechanics and posture of your thoracic cage and abdominal wall, leading to localized tenderness or irritation of the costochondral junctions, intercostal muscles, or possibly nerve entrapment.

The fact that the pain is reproducible with light palpation, positional, and not associated with systemic symptoms strongly supports this. However, your note about occasional post-meal upper abdominal discomfort may be related to the abdomen. While your liver and gallbladder ultrasound were normal, it is appropriate that you have an endoscopy scheduled to rule out gastritis, acid reflux, or duodenal issues as contributing factors.

If the pain were visceral (originating from the liver, gallbladder, or stomach), it would typically not be increased by superficial or positional pressure. In the meantime, you may benefit from gentle core-strengthening and posture-correcting exercises under physiotherapy guidance to address the impact of scoliosis.

If symptoms persist or evolve, especially with signs like weight loss, persistent gastrointestinal symptoms, or nocturnal pain, further imaging such as MRI (magnetic resonance imaging) or CT (computed tomography) of the abdomen and thorax may be considered. Pain management with topical NSAIDs (non-steroidal anti-inflammatory drugs) or neuropathic pain agents may help if a nerve component is suspected.

I hope this information helps you.

Feel free to ask further queries.

Thank you.