Pain in the chest on the right is a stabbing, burning, squeezing pain in the right side of the chest. Soreness occurs with pathologies of the lower respiratory tract and pleura, chest injuries, diseases of the hepatobiliary system, damage to the neuromuscular apparatus. To determine the cause of chest pain, radiography and sonography of the chest and abdominal cavity, endoscopic diagnostic methods, ECG, and a set of laboratory tests are used. In order to stop the pain syndrome, analgesics, physiotherapeutic methods, etiotropic drugs are prescribed.
Pathological processes in the lung and bronchi are the most common causes of pain on the right side of the chest. In acute simple or obstructive bronchitis, the patient experiences moderate pain and a feeling of heaviness in the chest, which increase during coughing fits. Soreness does not have a clear localization, accompanied by shortness of breath, hoarseness. In chronic bronchitis, periodic discomfort and dull pains on the right side of the chest predominate, which are provoked by hypothermia, inhalation of polluted air.
With right-sided croupous pneumonia, the pain syndrome is very strong, diffuse, the nature of the pain is sharp, burning. Symptoms are aggravated by deep breaths and coughing, so patients avoid breathing "full chest". In the case of focal pneumonia on the right, there is heaviness and discomfort in the chest. Pain is combined with febrile body temperature, cough with purulent sputum, chills. Interstitial pneumonia begins less often, for which painful sensations in the chest and severe shortness of breath that occur without pronounced catarrhal phenomena are typical.
Patients with dry pleurisy are concerned about constant severe pain along the anterolateral surface of the chest. With deep breathing, coughing, talking, the pain syndrome is aggravated, it becomes unbearable. To alleviate the condition, patients prefer to lie on their sore side, slightly bent over to reduce friction of the inflamed pleura. The appearance of effusion with the development of exudative pleurisy is accompanied by a shift of pain in the lower parts of the chest. The pains are dull, constant, there are also difficulties in breathing, asymmetry of the chest.
The most common soft tissue bruises and bruises, which are characterized by moderate chest pain. Sensations are aggravated by tilting the torso, wearing tight clothing, and physical exertion. Normally, the pain syndrome disappears after a few days. Traumatic causes can cause fractures of the ribs, which is manifested by sharp pains in the chest. The pain is intense, aggravated by talking, taking deep breaths, and moving the body. On the right of the chest, edema and hyperemia of the skin are detected. On palpation of the damaged area, acute pain and crepitus are felt.
Spontaneous rupture of the lung parenchyma on the right with the release of air into the pleural cavity usually occurs against the background of persistent moderate chest pain in chronic diseases. At the time of the formation of pneumothorax in the chest on the right, it hurts a lot, it becomes difficult for a person to breathe. With a strong pain syndrome, pallor of the skin, cold sweat, and a decrease in blood pressure are noted. More dangerous is valvular pneumothorax of traumatic etiology, in which sharp pain is combined with increasing shortness of breath and cyanosis of the skin.
The pathology of the intercostal nerve endings is manifested by sharp stabbing or burning pains along the anterior and lateral surface of the chest on the right. The pain syndrome in intercostal neuralgia is often paroxysmal in nature, unpleasant sensations are provoked by causes such as touching the affected area, loud laughter or coughing, deep breathing. In addition to painful sensations, the patient is concerned about tingling and twitching of the pectoral muscles, numbness of certain areas of the skin. Often pain is given to the collarbone or shoulder blade on the right, sometimes the pathological process extends to the lumbar nerves.
Inflammation of the gallbladder (cholecystitis) and perivesical tissue is accompanied by irritation of the nerve endings of the phrenic nerve. This causes irradiation of pain from the right hypochondrium to the chest and collarbone area. The pains are sharp, paroxysmal, reminiscent of neuralgia in nature. With biliary colic, excruciating unbearable pains occur in the upper abdomen and chest on the right, which force a person to constantly change the position of the body. For biliary dyskinesia as the cause of the symptom, a dull pain in the lower chest on the right is typical.
Liver damage leads to thoracalgia much less often, pain is only disturbed with extensive organic damage to the organ with stretching of the capsule. Visceral sensations do not have a clear localization, so they can be perceived as chest pain on the right. With hepatitis A and E, the symptoms persist for several weeks, for hepatitis B and C, a chronic pain syndrome is typical, lasting at least 2-3 months. Pain is also caused by the formation of volumetric formations in the liver tissue: echinococcal cysts, hemangiomas, malignant tumors.
With a pain syndrome in the chest on the right, a consultation with a therapist is shown, in the future, the doctor can refer the patient to narrow specialists. Diagnostic search involves instrumental imaging of the organs of the chest and abdominal cavities, to clarify the cause of thoracalgia, specific laboratory examination methods are performed. The most informative are:
Chest X-ray
With moderate pain in the chest on the right, caused by a bruise, it is enough to remain calm for several days, apply dry compresses and ointments with anti-inflammatory drugs to relieve discomfort. If the pain does not subside, accompanied by swelling and cyanosis of the skin, you should visit a specialist to timely identify a fracture of the ribs as a likely cause of the symptom. The pain syndrome that occurs against the background of coughing and shortness of breath is an indication for going to the doctor - self-treatment of diseases of the respiratory system is fraught with serious complications.
In most cases, it is sufficient to treat the underlying cause of pain, but with severe and unbearable pain on the right side of the chest, analgesics are indicated (both NSAIDs and narcotic drugs). To eliminate the pain syndrome, physiotherapy methods are used: electrophoresis, compresses on the affected area with dimexide, corticosteroids, anti-inflammatory drugs. As an etiotropic therapy, drugs such as:
With pneumothorax, it is necessary to make a pleural puncture in the 2-3 intercostal space to aspirate air and ensure rapid expansion of the lung. In the case of severe atelectasis or recurrent pneumothorax, continuous active drainage is used. Pleurisy refractory to conservative therapy is an indication for pleurodesis - obliteration of the pleural cavity. In advanced cholelithiasis, cholecystectomy is performed by laparoscopic or traditional methods.