Side Pain

Published: March 13, 2015
Last reviewed: February 22, 2017

What is side pain?

Side pain occurs between the armpit and the hip.

Causes of Sharp, Stabbing Side Pain

Side Chest Pain

Pleuritic Chest Pain

Pleurisy (pleuritis) is an inflammation of the pleura–the double-layered membrane that covers the lungs.

  • Causes:
    • Acute: viral infection (flu, infectious mononucleosis), pneumonia, tuberculosis, chemotherapy, pulmonary embolism, pneumothorax
    • Chronic: rheumatoid arthritis, systemic lupus erythematosus, inflammatory bowel disease, lung cancer, asbestosis, silicosis
  • Symptoms: sharp, stabbing pain on one side of the chest, aggravated by deep breathing, coughing or moving the torso, shortness of breath (to avoid pain); sometimes pain in the shoulder, front of the chest or in the back, dry cough or fever
  • Signs: crackling sounds during breathing detected by the stethoscope, slight chest wall tenderness
  • References: (1,2,3,4)


  • Cause: direct hit on the side of the chest
  • Symptoms: dull pain on the side aggravated by moving the torso and arms
  • Signs: moderate chest wall tenderness, a bruise
  • The pain and bruise should reduce significantly within about 3 weeks.
  • Reference: (11)

Rib Fracture

  • Causes: fall from the height, direct hit, violent coughing, bending over a hard ridge
  • Symptoms: sudden, severe pain on the side of the chest, aggravated by deep breathing, coughing, moving or bending
  • Signs: a bruise, intense pain and cracking sound upon pressing over the broken rib
  • Recovery time: about 6 weeks
  • Reference: (10)

Serratus Anterior Muscle Pain Syndrome

Serratus anterior is the muscle attached to the side of the ribs and the shoulder blade on each side of the body.

  • Causes: muscle strain caused by repeated fast running, workout exercises, persistent coughing or lifting heavy objects with an extended arm
  • Symptoms: moderate pain on the side of the chest below the armpit, below the shoulder blade and in the pinky side of the arm and hand; sharp pain can be triggered by deep breathing or coughing
  • Signs: Pressing upon the trigger points at the level of 5th-7th rib on the side of the chest causes pain in the side of the chest and in the arm.
  • References: (17,18)

Serratus Anterior Muscle Pain image

Picture 1. Serratus anterior pain syndrome
(free image use)

Flank Pain

Flanks are areas below the lower ribs on each side of the body.

Gas Pain (Trapped Wind)

  • Causes: irritable bowel syndrome (IBS), constipation, lactose intolerance, fructose malabsorption, Crohn’s disease, ulcerative colitis
  • Symptoms: transient pain after eating on the right or left side below the ribs or in the lower chest and, sometimes, in the shoulder tip (referred pain due to the irritation of the diaphragm, when gas is trapped in the horizontal part of the colon), upper abdominal distension (bloating) and slight tenderness below the lower ribs.
  • Reference: (19)

Side Stitch

Side stitch, “side cramp,” “runner’s stitch” or “exercise related transient abdominal pain” (ETAP) commonly occurs during running, swimming and horse riding.

  • Symptoms: exercise-related, transient, moderate or severe, cramp-like or stabbing pain below the rib cage, more commonly on the right side and, sometimes, in the shoulder tip on the same side; pain is relieved within a minute of rest (11).

Kidney Pain

Stones in the ureter can cause constant or intermittent sharp pain in the right or left flank lasting for 20 minutes to several hours; pain can be extreme and can radiate into lower abdomen and groin; you may occasionally pass blood or a stone but you typically have no fever (16).

Certain kidney conditions (infection, inflammation) can present with mild pain that can be make worse by slightly tapping over a kidney with a fist. Other symptoms may include nausea, fever, frequent urination and cloudy urine. In some kidney disorders, pain can be triggered by drinking large amounts of fluid, or severe dehydration.

Throbbing kidney pain can be associated with ureteropelvic junction obstruction, IgA nephropathy or Berger’s disease, or loin pain hematuria syndrome.

Kidney pain needs to be distinguished from other causes of lower back pain.

Adrenal Gland Pain

  • Causes: adrenal tumor
  • Symptoms: constant, dull pain in the flank, sometimes: fatigue, headache, excessive hair growth, weight gain, irregular periods, decreased libido, excessive thirst, frequent urination
  • Reference: (23,24)

Liver Pain

  • Causes: liver inflammation (hepatitis), lymphoma, cancer
  • Symptoms: constant fullness, discomfort or dull pain below the lower right ribs and, sometimes, anorexia, nausea and itchy skin
  • Signs: Enlarged liver (hepatomegaly) can be palpated below the lower right ribs, sometimes jaundice.
  • Reference: (22)

Gallbladder Pain

  • Causes: gallstones, acute gallbladder inflammation (cholecystitis), biliary diskinesia
  • Symptoms: severe pain in the upper right abdomen or right middle back or shoulder blade, lasting from several minutes to several hours, nausea, vomiting
  • Signs: Murphy’s sign (tenderness in the upper right abdomen)

Spleen Pain

  • Splenic infarction (in leukemia, lymphoma, blood coagulation disorders, endocarditis, vasculitis) or splenic rupture (in blunt trauma).
    • Symptoms: sudden, severe pain on the left side under the lower ribs and, sometimes, in the left shoulder tip; fever, chills, nausea, vomiting (5)
    • Signs: tenderness over the left lower ribs on the side; in internal bleeding: rapid heartbeat and breathing, anxiety, pale skin
  • Enlarged spleen (splenomegaly), for example, in infectious mononucleosis (Epstein-Barr Virus infection), malaria, liver cirrhosis, leukemia, lymphoma, sarcoidosis, hereditary anemias (sickle cell disease, spherocytosis)
    • Symptoms: constant fullness or mild, dull pain on the left side under the lower ribs, recurrent infections, paleness and weakness due to anemia
    • Signs: a large, soft lump below the rib cage on the left side
    • Reference: (7)


  • Cause: reactivation of a childhood Herpes zoster virus infection in one or more spinal nerves, usually only on one side, more commonly in older adults
  • Symptoms: moderate side pain, tenderness, tingling or numbness followed–after several days–by a red, itchy, burning rash that travels as a horizontal stripe from the spine around the torso, which eventually crusts over and heals on its own in few weeks without leaving scars.
  • Reference: (8)

Pinched Spinal Nerve

  • Cause: a bulging or herniated disc in the thoracic or lumbar spine, arthritis, nerve injury during rib fracture or kidney surgery
  • Symptoms: recurring stabbing pain, tingling or numbness on one side of the back and chest aggravated by moving the torso (11)


Adhesions are bands of an abnormal fibrous tissue (scars) in the abdominal or pelvic cavity.

  • Causes: retroperitoneal fibrosis, surgery, appendicitis, cholecystitis, peritonitis, radiation therapy
  • Symptoms: chronic moderate or severe pain in various parts of the abdomen or pelvis
  • Reference: (20)

Abdominal Aortic Aneurysm

The pain from an abdominal aortic aneurysm may mimic the pain from urinary stones (renal colic) (11).

Lower Side Abdominal Pain

Myofascial Pain in Latissimus Dorsi Muscle

  • Causes: muscle overuse due to rock climbing, gymnastics, strength training, ball games
  • Symptoms: pain above the hip, below the shoulder blade, in front of the shoulder and in the pinky side of the arm and hand
  • Signs: pain triggered by pressing near the lower shoulder blade angle (9).


Diverticulitis is an inflammation of pouches that form in the large intestine.

  • Symptoms: constant pain and tenderness in the lower left abdomen, fever, nausea, constipation or diarrhea, occasional blood in the stool (14)

Acute Appendicitis

  • Symptoms: vague, constant pain around the belly button, which within few hours moves to the lower right abdomen, becomes severe and is aggravated by moving and coughing; other common symptoms: nausea, vomiting, fever
  • Signs:
    • Tenderness in the lower right abdominal quadrant
    • Rebound tenderness: applying a pressure upon the left lower abdomen and quickly releasing it triggers pain in the right lower abdomen.
  • Reference: (21)

Lower Side Abdominal Pain in WOMEN

Ovary Pain

Ovulation pain occurs in the middle of the menstrual cycle (about 14 days before period) on the inside of the hip on either side, it can be severe and can last from few minutes to 48 hours (15); if it lasts longer, it could be associated with endometriosis or other disorder.

Other causes of ovary pain: ovarian cyst rupture, cancer (late stage).

Round Ligament Pain During Pregnancy

  • Symptoms: shooting or crampy pain near the hip or in the groin, more commonly on the right side; the pain can occur from early pregnancy on (25).

Ectopic Pregnancy

  • Symptoms: sudden, sharp or slowly developing pain on one side of the lower abdomen and, sometimes, vaginal bleeding and pain in the shoulder tip on the same side (13).

Other Causes of Side Pain in Women

  • Endometriosis
  • Pelvic inflammatory disease

64 thoughts on “Side Pain”

  1. Kelly b says:

    Hi. It would help a lot to set links to what to do if the discription fits us.

    1. Jan Modric says:

      We often are not able to say exactly “what to do,” but yes, we can link to further description.

  2. Kelly Smith-Shepherd says:

    Ive been to ER, cannot get help, pain on right side middle area so severe, say I have 2 small ovarian cysts on right, 1 larger on left one, but that my pain up to high and cysts on right small, to be the pain cause, help I’m in pure agony!!!!

    1. Jan Modric says:

      you need to go to the ER again, it’s impossible to solve medical urgencies via the internet.

      1. Sarah says:

        I’m in the same boat as Kelly an I’ve been to the ER twice and have been refused of ultrasound and X-rays. They said unless I’m in chronic pain an dying I need to go see my primary physician.

      2. Ashley Puckett says:

        Hello I’m looking for actual help I’ve been to er many times and doctors of all sorts for a very young age till now and have yet to figure out how to get the pain to go away I have several very small cyst’s on my left ovary (since around the age of 7 is when the pain started) I’ve been given norcos oxys (also started at age 7) things like that for temporary relief but as time passes it gets worse and worse I’ve been told that it will correct itself I’m now 23 years old and it’s becoming unbearable especially during my menstraul cycle Doctors refuse to pay any attention to what I have to say I’m told “im to young to understand what pain really is and I’m making it worse than it is” or my favorite ” oh hunny it’s supposed to hurt while you bleed it’s cramps get over it” I’ve had 3 children 2 of which were delivered all natural so I do understand what pain is and I can live with everyday pain but I need any kind of advice here a home remedy of a doctor from Rockford that is recommended any thing at all that might help get me to where I can pick my baby up or chase my toddler anything that will give me the opportunity to be there for my children please I’m begging for help

        1. Jan Modric says:

          Ashley, it’s not likely I’ll solve your problem, but it can help you search further if you know:
          – Your exact diagnosis? (PCOS?)
          – Any other abnormality detected by any investigation at any time?
          – Where exactly is the pain?

  3. Trish says:

    Extreme exhaustion, nausea, pain in rt side under ribs, diarrhea. Any ideas what might be going on? I have no gallbladder so I know it’s not that…

    1. Jan Modric says:

      Trish, it sounds like a medical emergency, so I strongly suggest you to visit a doctor as soon as possible.

  4. Larissa says:

    Ello 🙂 I went to the ER like a month ago, I had a miscarriage that went on for over 40 days. The same day that the bleeding stopped I was having what felt like contractions still. For days I couldn’t get out of bed (the pain was so strong that I physically couldn’t move my body) I felt like calling the ambulance, but I wanted my husband to take me to the ER when he got back from being out to sea. We went which was a week later and they mentioned something about fluid under my lungs and something else about one of my lungs… After that I saw my primary care provider and he said I was fine and that I just had a virus…. So, now a month later I’m starting to have the same pain from my “virus”… Last time I at least had a cold so it made sense, I’m not sick at all right now, are there any thoughts on what it could possibly be? I know virus’ never go away, but why would it trigger now when I’m not even sick? Thank you for your time 🙂

    1. Jan Modric says:

      Larissa, a virus can cause viral or atypical pneumonia, but it seems that was just a doctor’s hypothesis. To confirm that you would need to have some tests. “The fluid under your lungs” can result from a viral or other infection, from disorders of the lymphatic vessels, heart disorders and cancer. The fluid is usually associated with an inflammation of the lung membrane (pleurisy), which can cause pain on the side, back or in the front of the chest and is aggravated by deep breathing. If you don’t get better soon I strongly recommend you to visit a doctor and insist to get an actual test-confirmed diagnosis.

      1. Larissa says:

        Oh wow!! Thank you so much, it’s gotten progressively worse haha!!! As much as I hate going, I’m going to schedule an appointment this week, thank you 🙂

  5. Sandi Duvall says:

    I’ve had the same experience as Sarah. Been to the ER, treated like a crazy old woman, given pain meds and anti-angiety drugs that don’t help. Pain starts on left side near kidney, radiates up my side, into my left chest and shoulder. I cannot lay down, the pain gets so intense. I don’t know what to do!!

    1. Jan Modric says:

      Sandi, to expect a reasonable response, you need to mention when the pain started, is it constant, does it change with body movements, what are other triggers or relievers, does it radiate to an arm…any other symptoms or underlying diseases…are you physically active…?

  6. LINDA says:

    I keep getting bad pain in the middle of my id cage., it keeps me up all night, i already take pain meds for a back surgery, and they don’t stop the pain.. I had a cat scan. but nothing showed up.i don’t know what to do next.

    1. Jan Modric says:

      Linda, where exactly is your pain, what triggers or relieves it and where does it radiate?

  7. saugata mukherjee says:

    i m getting crumbling feeling on the left side under the rib cage and back side too sometimes…like some liquid is flowing there…please help me

    1. Jan Modric says:

      Saugata, it sounds like the bowel content moving. If you have eaten something wrong, it should go away in few days. Intestinal parasites can couse troubles lasting for months, though. If it is a repeating issue, you may want to think if you are intolerant to lactose, fructose or some specific food.

  8. David says:

    I have a hard time breathing properly if I’m bent to my right side and worsens when I lean all the way to my right and pain in that area becomes a factor. I’m able to catch a full breath when I lean towards my left side. Any clue as to why this happens or what it means?

    1. Jan Modric says:

      David, maybe something is pressing on your airways or lungs when you bend to the right. I guess, some investigation, like X-ray can reveal more, but go ask your doctor.

  9. Margarita Finlay says:

    I’ve had pain under left rib cage for around 5 years now, had scans done etc and nothing showed up but still have the pain -don’t know the cause (I also have Haemachromatosis).

    1. Jan Modric says:

      Margarita, to help a doctor to find the cause of pain, you need to tell him exact pain location, does it spread anywhere, is it tender to touch, is it affected by breathing, moving or lying down, when did the pain start and do you have any nausea or other related symptom.

  10. Elize says:

    Please I am very nauseas dizzy weakness stinging pain in lower ribs at sides especially left side near spleen and in diaphragm area vomiting bile no gallbladder.

    1. Jan Modric says:

      Elize, such symptoms can occur in impaired motility of the bile ducts or in intestinal blockage, for example. I strongly recommend you to visit a gastroenterologist.

  11. Tintaglia says:

    I am very sorry to bother any of you with my problems, but both me and my father suffer from the same problem (Inheritance?) that we both do not understand. We have gone to the doctor’s about our random pain and cramps (stabbing pain, Burning/Searing pain) in both our Rib’s usually around the 4-7th rib. As I read this article, most of what could come close, didn’t even make sense because some of it didn’t even exist, wasn’t a symptom, or was just too much. I thought that this would be the right place to ask about this, to see if you have any generalized ideas about this problem.

    1. Tintaglia says:

      Oops! I forgot to add, sometimes I will have pain in my area of ‘Fake Ribs’

      1. Jan Modric says:

        Tintaglia, by fake ribs you mean the ribs 8-10? I would need to know exact pain location (near the sternum, at the side, which side, one or both sides?), pain triggers (applying pressure, moving, breathing), how old are you, when did this start and what investigations did you have so far and what were the results.

  12. simon says:

    I really need help with this ive got a pain next to my right uper ribs the skin feels dead as well sometimes when i couth it hurts more even when i bend over or if i lay on my side.
    Kind greatings simon

    1. Jan Modric says:

      Simon, “dead skin” can mean a nerve damage, and it is a doctor who can check what it is.

  13. Kelsey says:

    What would be the cause of such bad pain in my right side above my hip that it is very difficult to get a substantial breath in?

    1. Jan Modric says:

      Kelsey, it could be trapped gas, strain of serratus anterior muscle, pleurisy, adhesions, endometriosis, for example, but these are just few possible causes. If worried, visit a doctor.

  14. Elaine Lowe says:

    I’ve been in chronic pain for over two weeks in the left side of my back from the middle to the lower part and sometimes round to the front. It feels like a pulled muscle. I’ve had congestion with a odd dry cough which kept making me wretch with green phlegm coming up in lumps. My chest and lungs are clear. I’ve been to my doctors, primary care twice and also to my heart failure nurse. My diagnosis is severe muscle spasms. I’m worried it’s something more sinister? I have never felt pain like it. I can’t shout, even when I scream out in pain and cry, cough or breathe it hurts. It’s worse than when I fractured my knee or gave birth! Pure agony

    1. Jan Modric says:

      Elaine, if nothing showed on chest X-ray, you may have bronchitis. Muscle pain could be from cough?

  15. Patricia says:

    I have a burning discomfort that radiates below my shoulder, under my arm and down left side of my torso. Feel it mostly while lying down. Wakes me up in the middle of the night.

    1. Jan Modric says:

      Patricia, there’s a long thoracic nerve that runs from the armpit vertically down by side of the body. A hit on the side of your body or excessive exercise that involve swinging the arms might be the cause. You may want to see your doctor.

  16. alicia says:

    Pain here an there on left side stomach across from my bellybutton under my rib it hirts a little an moves

    1. Jan Modric says:

      Alicia, a common cause of such pains is trapped wind. I can’t say if it is, though and I can’t exclude other causes.

  17. brwnsuga says:

    I have extreme pain on my right side.when I lie on my right side it literally take my breath away to the point I have to switch sides…Been too many doctors no one van figure out the problem…Please help the pain goes all the way to my hip bone

    1. Jan Modric says:

      brwnsuga, such pain usually originates from the muscles, but you revealed too little info for me to say anything more specific.

  18. Dar. belona says:

    I get pain on both an left side between the arm pit and waist and its severe these articles here need to be more clearer on what to do about it ….and tell us exactly what it could be frim i feel like i have to play guessing games……thank you for your consideration im not criticizing but it would help us to make it ckearer …

    1. Jan Modric says:

      Dar. belona, I would need more info, like, are you a man or woman, how old are you, is your pain affected by moving, how long does it last, is the painful area tender to touch, do you think it’s related to some physical activity and do you have any chronic disease?

  19. Angie Daqson says:

    Mine sounds like the surratus anterior pain syndrom. Luckily there is a diagram of exactly where the pain should be. That’s exactly where I’m sore but the pain is increasing. And when I breath in deep it aggravates the pain. It feels like a steady side cramp. ?

    1. Jan Modric says:

      Angie, serratus anterior pain is usually not crampy. If your pain is increasing I suggest you to visit a doctor.

  20. Carol says:

    I have pain,on my right side,upper back,waist area,it hurts to move walk, take a deep breath.

    1. Jan Modric says:

      Carol, have you being doing more physical work than usually?

  21. Osore E. O. Godfrey says:

    Which Doctor is specialized in dealing with such cases? Please advice.

    1. Jan Modric says:

      Osore, it can be gastroenterologist, nephrologist, orthopedist…depending on which organ system is affected.

  22. Diane Sharp says:

    Have a strange one. I have ovarian and peritoneal cysts, due for appointment to discuss further action next week. But last night, I noticed a dull ache on my left side, right at the bottom of my rib cage. When I rubbed it, I realized there was a lump under my skin about the size of a small orange. It’s not extremely painful, like I said a dull ache that gets a little worse if touched, or if I cough. Ideas? I did call the gynecologist’s office and report it, but am trying to wait it out until my appointment next week.

    1. Jan Modric says:

      Diane, it might be another peritoneal cyst, not sure. The transverse part of the colon also runs there. It could be also a collection of gas in the colon…An ultrasound could show what it is.

  23. Ron says:

    I have moderate to severe Pain on my lower right side, the only releif I get is from so many e borrowed pecadan and vicadins. Very persistent pain. Any ideas?

    1. Jan Modric says:

      Not enough information. I strongly suggest you to visit a doctor.

  24. Thomas says:

    Hello I have a sharp stabbing pain under the rib cage (left) side. It happened some times. And when it happens it radiates up wards but takes few seconds. And I am really worried if it is a serious health matter. Any idea will help.

    1. Jan Modric says:

      Could you be more specific about where the pain exactly is? In the relation to the sternum and lower rib?

  25. Danielle says:

    I have an acute pain middle left of my back. Suffered from a virus recently and recovered only to get it back Now have a chesty, tickly cough with this awful pain. feeling exhausted and have a mild fever…. Any ideas?

    1. Jan Modric says:

      Go to the doctor – bronchitis or pneumonia can cause such symptoms.

  26. Elizabeth says:

    My side pain started about ten days ago. I can reach it with a long vibrator made for the back. It’s extremely painful to the touch but I’m hoping that disturbing it will calm it down. The pain is on my flank, on my left side, about six inches down from my armpit. The pain is not constant but is excruciating. It feels like skeletal muscular problems but I did not injure myself. I also have knots or cysts or nodules in my stomach area, about 8 inches down and to the left. In reflecting I’d say they feel like when I had shingles a few years ago but I have no rash. Just a lot of pain, sensitivity to touch, itching, and a feeling of tightness around my feet. Emailed my pcp and waiting for a reply from her. In the meantime, any thoughts,

    1. Jan Modric says:

      Shingles can cause pain for 10 days or more before any rash appears.

      Other than that, there’s one flat muscle called serratus anterior in that area. The overuse of the muscle due to hyperventilation, arm swinging during running or repetitive lifting of heavy objects can cause severe pain, which is triggered by the movements of the arms or trunk.

      The spleen is also about there, but spleen pain is usually not associated with such tenderness to touch.

      The knots and nodules are on the surface or within the abdominal cavity?

  27. Cathy steele says:

    Fractured my eighth and ninth right side ribs, just from a simple fall and hit the back and broke them. It has been two weeks now and I am getting a stabbing pain on the left side between my spine and shoulder blade feels unbearable. It is a doll ache about the size of a Silverdollar and gets worse when laying on my back. Also feeling very nauseous, and threw up just clear fbile this morning

    1. Jan Modric says:

      Have you been to a doctor for broken ribs?

      1. Cathy steele says:

        Yes in the last two weeks I have been to two ERs. This is something new

        1. Jan Modric says:

          I suggest you to go back to the doctor and tell what happened. It sounds serious enough to me.

  28. Monique says:

    Hi I’m curious, I have severe sharp pains under my left arm, and over my left breast. If I press on the spots they feel sore but I haven’t pulled anything. I have severe GERD and a Hiatal Hernia that sits at the top of my abdomen. Is it normal to feel those sharp pains with those issues?

    1. Jan Modric says:

      No, I don’t think so. You may want to see a doctor.

    2. Julie says:

      Hi I’m curious, I have severe sharp pains under my left arm, and over my left breast. If I press on the spots they feel sore but I haven’t pulled anything. I have severe GERD and a “small” Hiatal Hernia that sits at the top of my abdomen . I don’t have a gallbladder,had that out three years ago . The ribs do hurt while I lay on my left side and stomach also . Would taking a ginger or apple cider supplement help with this ,or Is it normal to feel these pains with those issues?

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