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Dr. Andrew Rynne

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Pain below rib cage and have degenerative arthritis in back. What cure should be done?

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Dr. Kulbir Singh

General & Family Physician

Practicing since :2010

Answered : 726 Questions

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Posted on Sat, 15 Dec 2012 in Arthritis
Question: pain in both sides just beliow rib cagepain in both sides just below rib cage.. started about 18 months ago and has gotten somewhat worse. feels sore. not present all the time. varies from 1 to 3 or 4 on scale of one to ten. averages maybe 2 to 3. have degenerative arthritis in back, mainly lower back. 3 disks beginning to collapse in lower back. have small bulge in sinal corf at mid back as shown on MRI. prescription drug tramadol helps. take this for lower back. x-rays show nothing wrong. 2 primary drs and also orthopedist have looked at this. none have a firm diagnosis.I'm thinking it may be offshoot of arthritis in my back. I suggested this to my orthopedist and he prescribed 3 injections in thorasic area of back. no firm diagnosis. have not begun injections yet but will around octoeber 1 then every 2 weeks. still no firm explanation by orthopedist. XXXXXXX
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Answered by Dr. Kulbir Singh 8 hours later
Hello and thanks for posting the query
I have read your query with diligence. You may be write that your rib cage pain is associated with arthritis problem you have at the back. The herniated disc at the vertebral level cause nerve compression, that result in the pain at the area supplied by the nerve. In my personal opinion herniated discs is the cause for your pain as it gets relieved by analgesic drug you are taking. Follow certain lifestyle changes to get rid from your problem:
1. Restrict the movement of your spine. If possible wear Lumbosacral belt.
2. Do hot and Ice fermentation at the site.
3. Can take analgesic and anti-inflammatory gel to reduce pain.
4. Apply local anti-inflammatory gel at the site and do not massage it.
5. Take complete bed rest till the pain subsides.
6. Use hard bed to sleep and avoid pillow.
7. Avoid long time standing and sitting. Get your posture changes every half hourly.
8. Do not lift or try to lift weight.
9. Do regular exercise or physiotherapy as per your physiotherapist advised you.

Follow the steps and continue if they help you. Else you have to go with your doctor for steroid injection at the back to reduce the pain and other symptoms. You can also go for the surgery if your spine surgeon feels that operating at one or two disc helps you. The best treatment can be planned under the guidance of spine surgeon.

The other possibilities that can cause this type of pain are Gall stones, GERD, Gastric discomfort. Need to be investigated for that. But these pains can not be continuous.

Hope I have answered your query. Will be happy to answer your follow up query if any.
Best Wishes
Dr. Kulbir Singh
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Kulbir Singh 14 hours later
thank u sooo much dr. XXXXXXX
you have answered my qiery
I add that sometimes it seems like pain is coming from top of pelvis and most of time from just below bottom of ribcage on both sides. hard sometimes to tell. so between bottom of rib cage and top of pelvis. I have 3 disks that are collapsing in lower back bit far from.needing surgery my orthopedist says. I have a gastro.dr. that is investigating some pains on colon. however I hsve diviticulitiisslso he doesn't indicate that pains are related. I accept your anseer as can't seem to get snswer from my doctors.wmi iake meds tramadol and doclofinaac? in there sonetjing over the counter I can add periodically? pan and/or anti inflamatory? XXXXXXX and thank you again sir.
doctor
Answered by Dr. Kulbir Singh 7 hours later
Hello XXXXXXX and again thanks for the follow up query
As your orthopedic doctor advised you for surgery you must go for that and get rid from your pain. I hope you have tried the other entire alternative methods to get resolve your pain but you have not succeeded. So the last option we have left is surgery and surely you can get relief from that. But even after surgery you have to follow the lifestyle changes I have explained in my previous answer. That helps you in getting painless spine.

I do not think that this pain is from diverticulitis. The pain of diverticulitis is not continues and you have an attack of pain once or twice depending upon the severity of the disease. Keep in touch of your Gastro doctor so that diverticulitis not disturbs you in future. Certain lifestyle changes like high fiber diet, avoiding fatty, alcohol and spicy food, Increase intake of fluid will help you in not getting attack of diverticulitis in future.

Now about anti-inflammatory drugs: Ibuprofen and Acetaminophen you will get over the counter. For other drugs you have mentioned you need a doctor prescription.

Write back for any other query. I will be happy to answer them.
Regards and have a painless spine
Dr. Kulbir Singh
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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