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Having severe pain below rib cage, swelling on abdomen and feels like bruised. Painful to cough or sneeze. What to do?

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Severe pain left side of body below rib cage. seems to be some swelling upper left of abdomin. feels like bruised ribs or pulled rib muscles but there were no injury whatsoever, just woke up with the pain.

extremely painful to cough or sneeze. and deep breaths are painful
Posted Mon, 15 Jul 2013 in General Health
Answered by Dr. Grzegorz Stanko 29 minutes later

Thank you for the query.

Such symptoms can be caused by pulled rib muscle indeed.
However your pain can also appear due to rib nerve compression. This compression can be caused by spine disc herniation or an inflammation in the nerve area. Such pain is sharp, well localized, aggravates while coughing, breathing or moving the chest. Can be unnoticeable when not breathing.
If you have such pain, chest moving (to unlock the nerve) or massage can really help.

Pulled muscle gives less intense pain, present only with particular moves (when this pulled muscle is moving).

Your symptoms can be also caused by pneumothorax. This condition is caused by air presence between the chest wall and the lung. It is possible if you do smoke for years. This condition can appear spontaneously. Gives pain, shortness of breath, cough.

Abdominal issues like hernia (lump should be present especially when coughing), or peptic ulcer should be also considered if mentioned disease will be ruled out.

I suggest you to visit your doctor and have physical examination. If nerve problem or muscle issue will be the most probable, Diclophenac 50 mg twice a day (should be taken with Omeprasole 20 mg once a day to protect the stomach) should be prescribed. Magnesium 400 mg once a day supplementation can help with nerve issues as well. Hot bath is great to relax muscles.
If pneumothorax is possible, chest X-ray should be done.

To diagnose spine disc herniation, MRI should be done.
If abdominal issues will be the most probable, abdominal ultrasound and blood work should be done at first and gastroscopy as a next step.

Hope this will help. Feel free to ask further questions.
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