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How is chronic lower back pain and rib pain treated ?

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Practicing since : 2002
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I have noticed that i have a painful area when i touch my right rib very close to the tip, but not really underneath it, more on it. I have had some chronic lower back pain, but kately have been feeling feverish and tired
Posted Tue, 24 Apr 2012 in Back Pain
Answered by Dr. Robert Galamaga 19 minutes later
Hello and thanks for the query.

Your question is a very good one and I will try to provide you with information and recommendations regarding the symptoms you are experiencing.

Regarding the pain you're experiencing in your ribs I think this is most likely a musculoskeletal issue. The most common cause of this type of pain is a minor bruise of the rib. This could occur with even minor trauma what you might not remember in the recent past. The pain generally will slowly improve over a period of about two weeks.

Another possibility could be inflammation. Sometimes areas around the Ritz can become inflamed which contributes to a mild degree of pain. This also generally resolves within a couple weeks. Sometimes we give medication such as ibuprofen to address the inflammatory process. If you're interested you could try taking two tablets of ibuprofen three times a day for the next five days to see if this makes any kind of significant difference.

Regarding the fatigue which have been feeling recently of course there are several different possibilities here. One thing we must consider is mild anemia. If you have noticed any type of blood in your urine or blood in your stool this would be a concern. A second factor which can contribute to chronic levels of fatigue would be anxiety or depression. As long as you feel this is not an issue for you we don't have to worry about it.

For you I recommend that if your symptoms of fatigue and the rib discomfort processed for more than the next two weeks I would recommend you see your blood test which might help us roll out underlying causes of your symptoms such as anemia or viruses such as the one which causes mono or some other issue.

It sounds like you do not have any obvious signs of infection going on so I would consider infection to be somewhat unlikely. There is a possibility. However that a virus could cause a chronic level of fatigue any absence of symptoms such as coughing or congestion.

I thank you again for submitting your question. I hope you find my response to be both helpful and adequate. If you have any additional concerns regarding your question I would be happy to address them.


Dr. Galamaga
Above answer was peer-reviewed by
Follow-up: How is chronic lower back pain and rib pain treated ? 2 hours later
Thanks for your response - a new mattress haa been playing havoc with my consistently weak lower back and i wake up with lower back pain regularly. With this rib pain i wanted to be certain that perhaps i wasnt dealing with something other than muscular skeletal.issues. How do i differentiate the lower back pain and now rib pain from the symptoms of a kidney infection, or even appendicitis? the only other symptom out of the ordinary is a dry mouth and a slight increase in thirst, which i suppose could be attributed to anxiety?
Answered by Dr. Robert Galamaga 12 hours later

Thanks for the followup.

A kidney infection would be associated with painful urination, fever and mid back pain all together.

Appendicitis pain settles in the right lower quadrant and is commonly associated with fever as well. The pain is in the abdomen and sometimes radiates toward the belly button.

Dry mouth and thirst are highly associated with anxiety and may be an explanation in your case.

I would give this a bit more time and then discuss with your PCP who may order some tests to rule out a medical issue.

Thanks again for the query. I hope you found this interaction to be helpful and informative. Please let me know if you have any additional concerns.


Dr. Galamaga.
Above answer was peer-reviewed by
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