Dear Ask The Doctor: Hi doctor. I get very sharp pains behind and under my ribs. it come and go, at times more than others. It really hurts, and when I get it I cant breath properly, because it hurts so much. My boyfriend is really the only one who have seen how bad it is, and he keep telling me to go to the doctor, but i have never been very keen to go, as I feel a bit silly if it is nothing. I know that maybe i should go, but i rather not ... Anyway, do you know what it could be? Ive had it for years, but its only the last year it has gone very bad. it feels like something is wrong inside me, like as if something should not be there, or something is pushing where it should not The pain can be there for 5 seconds, or 5 minutes.. Sometimes it really scares me :s I am 16 years old.
Dear Patient: Usually the pain that you described occurs after a violent muscle contraction or direct trauma to the intercostal muscles and/or nerves. The term "intercostal" refers to the location between two ribs. The intercostal areas of the body contain nerves, muscle and blood vessels. Eleven intercostal nerves inhabit the spaces between the ribs. When these nerves are affected by an injury, disease or condition that causes pain to radiate along the nerve, that pain is called intercostal neuralgia. A number of conditions can cause this symptom. The main symptom of intercostal neuralgia is pain in the rib cage area, often described as stabbing, sharp, spasm-like, tearing, tender, aching or gnawing. The pain may wrap around your chest or radiate from the back toward the front of your chest in a band-like pattern. Sometimes you may feel pain uniformly along the length of your ribs. Intercostal neuralgia may occur in sporadic episodes of acute pain or it may be dull and constant. The pain of intercostal neuralgia may intensify with exertion. This includes activities such as lifting heavy objects, twisting or turning your torso, coughing, sneezing, or laughing. Intercostal neuralgia can be caused by a variety of mild to serious diseases, disorders and conditions. This includes infection, surgery, pregnancy, inflammation, trauma, malignancy, and other abnormal processes. In the view that you do not recall direct trauma, chest injury, pregnancy, surgery or pulled muscles and the episodes are recurrent, I strongly recommend that you have a consultation with your doctor in order to rule out some other possible causes and accordingly proceed with the right treatment option.