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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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Suggest Treatment For Burning Pain Under Ribs

started as burning pain high on right side, under ribs. I have had a hida scan and abd u/s....both neg. (although my gallbladder took a very long time to show up on the hida scan). I swear I can feel something inside when I bend to the right side. The burning has somewhat subsided but now I notice more of a dull pain running straight down, mid right side. It is also tender to the touch. My pcp wants to do a endoscopy/colonoscopy next but I think and CT of the abd might be a better idea. Your thoughts?
Wed, 2 May 2018
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Addiction Medicine Specialist 's  Response
Hello,

Several features of pain can be helpful in clarifying what is going on and the next steps for diagnosis and treatment.

Type of pain:
Burning mostly means a nerve is having problems. This can be either a sick nerve or a nerve that has had an injury. Electrical, shooting would be others implying nerve source for pain.

Location of pain:
There is a lot to this. First, if something goes in the pathway of a nerve, then that is the nerve involved. Nerves are long and the pain is in a belt-like long pathway. Smaller areas are smaller nerves. This also tends to say what might be going on. Obviously if there was an injury to the area and then there was pain outward from it "hit a nerve" would be a possibility. Sick nerves are multiple areas and tend to be the TIPS of the nerve not the whole nerve.

So, a localized irritated nerve often can be treated. But often the cause is not found if it is not trauma. It can be Lyme disease or lupus or autoimmune disease but these are rarely the cause.

Hope I have answered your query. Let me know if I can assist you further.

Regards,
Dr. Matt Wachsman
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Suggest Treatment For Burning Pain Under Ribs

Hello, Several features of pain can be helpful in clarifying what is going on and the next steps for diagnosis and treatment. Type of pain: Burning mostly means a nerve is having problems. This can be either a sick nerve or a nerve that has had an injury. Electrical, shooting would be others implying nerve source for pain. Location of pain: There is a lot to this. First, if something goes in the pathway of a nerve, then that is the nerve involved. Nerves are long and the pain is in a belt-like long pathway. Smaller areas are smaller nerves. This also tends to say what might be going on. Obviously if there was an injury to the area and then there was pain outward from it hit a nerve would be a possibility. Sick nerves are multiple areas and tend to be the TIPS of the nerve not the whole nerve. So, a localized irritated nerve often can be treated. But often the cause is not found if it is not trauma. It can be Lyme disease or lupus or autoimmune disease but these are rarely the cause. Hope I have answered your query. Let me know if I can assist you further. Regards, Dr. Matt Wachsman