Back pain radiating to rib are some of the most common symptoms in a wide range of diseases. Possible difficulties in diagnosis are compounded by the frequent spread of pain from hypochondrium to the back and Vice versa.
This phenomenon of pain radiation caused by the close anatomical and functional relationship of the organs of the upper tier of the abdominal cavity and lower part of the chest.
The spread of pain to adjacent areas of the body (e.g. pain) is due to the concept of a dermatome, which is a segment of skin that is innervated by one spinae spine.
The cause of back pain radiating to the hypochondria and Vice versa can be pathological processes from the following systems and organs:
The most common diseases of the spleen, characterized by pain in the back, which gives to upper quadrant at the front, listed below.
Infarction of the spleen: this error occurs when acute circulatory disturbance of the organ due to the blockage of the lumen of the splenic artery, its branches by a blood clot or embolus. The causes of infarction of the spleen are most often systemic atherosclerosis, cardiac arrhythmias, malignant neoplasms, hematologic and autoimmune diseases, injury, liver cirrhosis etc.
Clinical manifestations vary depending on the caliber of the affected vessel. Typically, the patient complains of sharp pain in left side of back radiating to the corresponding half of the abdomen, chest.
Also, the patient might be bothered by weakness, fever, chills, nausea, vomiting. Occasionally in the event of the closure of the segmental artery complaints are inexistent.
Benign or malignant tumors. May long be asymptomatic.
Important! Pain whining, stupid character in the back or the left half of the abdomen joins after germination the tumor capsule covering the spleen. The patient may be concerned about the lack of appetite, asymmetry of the abdomen, loss of body weight, etc.
Abscess of the spleen. Develops as a result of infection of tissues of the spleen through the lymph or blood vessels. Characterized by dull pain in left upper quadrant radiating to the back or shoulder girdle (may be aggravated by movement), fever with chills.
Cysts of the spleen: parasitic (echinococcosis, alveococcosis) and nonparasitica. The latter may be congenital or acquired (trauma). For large size manifested by pain, heaviness in left hypochondrium and protrusion of the left half of the abdomen.
Angina. In a typical case is a pain, which is localized behind the breastbone or in the left side of the chest, provoked by physical or emotional stress, lasts from seconds to several minutes and is relieved by rest or taking nitroglycerin.
The specific symptom is pain under the shoulder blade, in arm and jaw on the left side. Quite often, atypical angina occurs: the patient may disturb the pain in the back and left abdomen radiating to upper quadrant (peripheral form of angina pectoris). The pain may be crushing, squeezing, stabbing, cutting, aching.
Myocardial infarction – a condition which can lead to the death of the patient.
Pain in myocardial infarction pain similar to angina, but differs severe intensity and no effect of taking nitroglycerin.
Myocardial inferior wall myocardial pain may be localized in the upper abdomen and radiate to the back (abdominal form).
Other forms of heart disease. Pericarditis, cardiomyopathy, myocarditis are much less, and in exceptional cases also may be accompanied by pain in the left side of the back radiating to upper quadrant.
Pancreatitis – acute or chronic inflammation of the pancreas, leading causes are errors in diet and alcohol abuse, cholelithiasis.
The most striking symptom of acute pancreatitis – severe pain in the upper abdomen or left upper quadrant radiating to the back and under the shoulder blade. It can be so intense that the patient brings great suffering and relieved only by narcotic analgesics.
Also, the patient worried about nausea, repeated vomiting, disorders of stool, fever, in severe cases, hemorrhagic rashes on the body.
Attention! Chronic pancreatitis in remission are asymptomatic. At an aggravation of symptoms of acute pancreatitis.
Back pain radiating to upper quadrant typical for degenerative disc disease of the thoracic-lumbar spine, pathology of the peripheral nervous system. Osteochondrosis pain may be constant or paroxysmal.
Most often they are shooting, cramping, and piercing in nature and aggravated by movement. To provoke a pain by pressure on trigger points in place of painful nerve root near the spine.
For neuralgia of a strong burning pain that increases when pressed and the change of body position.
In the neurological diseases, the patient may disturb sensory disturbances (pins and needles, reduction of certain types of sensitivity) and the motor deficits (difficulty in movement).
Liver failure is called an acute or chronic condition in which liver cells are not able to adequately support the metabolism due to various reasons:
Most often liver failure occurs as a result of liver cirrhosis of different origin (viral, alcoholic). In this case, for patients characterized by a dull, unbearable pain or heaviness in the right hypochondrium radiating to the back.
In decompensated liver failure join edema, ascites (fluid accumulation in the abdominal cavity), a tendency to bleed, the smell of ammonia from the mouth, yellowness of the skin, brain damage (altered speech, confusion, loss of coordination, etc.)
Inflammation of the gallbladder (cholecystitis) occurs as a result of his infection. Characteristic symptom is pain under the right rib, which may radiate to the right back.
The intensity of the pain can vary widely: from mild aching to severe paroxysmal. Also, the patient can disturb nausea, vomiting, the taste of bile in his mouth, fever, discoloration of feces and urine (in violation of the outflow of bile).
The cause of acute cholecystitis is usually a violation of the diet.
In 60-70% of patients cancer affects is the head of the pancreas. Leading symptoms are pain, jaundice and weight loss.
Help. The pain is localized in the right hypochondrium or in the epigastrium and may radiate to the interscapular region or the spine.
She usually wears dull arching or oppressive in nature (sometimes extreme), is enhanced after violation of the diet, in the supine position at night. During germination in the solar plexus, the pain intensity increases, it becomes surrounding the character.
Jaundice, weight loss, pruritus, darkening of urine and lightening of stool occur due to compression by a tumor of the bile ducts.
Most often, gallstone disease affects middle-aged women with excess weight.
A typical symptom of gallstone disease is acute pain in the right side that appears after a heavy meal (fatty, fried, smoked).
It may radiate to the right scapula and interscapular region.
Along with the pain patient has nausea, vomiting, fever, weakness.
Exacerbation of pain is of moderate nature, or may be absent.
Inflammation of the Appendix is the most common emergency surgical pathology. Usually the pain of appendicitis is localized in the lower abdomen.
However, with the high location of the Appendix it occurs in the right hypochondrium extending into the right half of the back and can simulate an attack of cholecystitis. The pain in this case are varied:
As a rule, the patient is also concerned about nausea, occasional vomiting, moderate fever.
It is a degenerative disease of the spine, which is accompanied by a decrease in the thickness of the intervertebral disks, excessive overgrowth of bone and displacement of the vertebrae.
These factors lead to pinching of spinal nerves, which is manifested pain syndrome.
Important! The pain usually has a wavelike nature, increases with movement, in forced position. It is often accompanied by numbness, tingling, burning sensation in the affected area.
Periodic dull pain in this case is usually localized in the epigastrium but may radiate to the back on both sides or interscapular region with involvement of the posterior wall of the stomach.
It can occur immediately or hours after eating (ulcer) or to disturb the patient most of the time (gastric cancer).
Other warning signs are:
The most frequent diseases of the stomach, accompanied with pain extending into the back include:- stomach ulcer;- gastritis;- gastric cancer.
Usually abdominal pain radiating to the back is characteristic for:
Pain in diseases of the colon or small intestine associated with food intake.
It usually is aching in nature and rarely reaches a high intensity.
Can be localized in different parts of the abdomen and to give in the corresponding part of the back.
Diagnosis of pain without clear localization or spread to other parts of the body represents a difficult clinical problem. This is caused by the extensive functional relationships of adjacent organs.
The most important value for differential diagnosis has a character of pain (sharp, dull, aching, burning), its persistence, causes and time of occurrence. These features allow to suspect a specific pathology and to hold the sighting further examination.
Mutual pain are a must reason for consulting the doctor. Treatment in case of mutual pain must be carried out after the establishment of the final diagnosis using laboratory and instrumental methods of diagnosis.
Please note! In some cases, effective conservative therapy (low back pain, gastritis, gastric ulcer), others may require surgery (malignant neoplasm, cholelithiasis, appendicitis).
Primary diagnosis and determine the cause of the pain syndrome involved the therapist. He may refer the patient to a relevant specialist for advice or treatment after the establishment of the final diagnosis.
In pathology of the digestive system therapy performs a gastroenterologist, osteochondrosis neuralgia and a neurologist, in cancer – the oncologist. If necessary (appendicitis, cholecystitis) aid is provided by surgeon.
Back pain extending into the quadrant (or Vice versa) has a wide clinical variety and can meet at the extensive list of diseases of the gastrointestinal tract, cardiovascular, nervous system. Knowledge of its features allows you to suspect a specific pathology, to conduct a qualitative diagnostic search and to appoint adequate treatment.