Pain On The Right Side of Your Chest: What Might Cause It?

Chest pain has many different causes. This article will discuss the main reasons for pain in the right side of the chest.
Pain On The Right Side of Your Chest: What Might Cause It?

Last update: 16 September, 2022

Chest pain is a frequent symptom that usually worries whoever suffers from it. Although it can be caused by many different conditions, it’s important to consider its characteristics as well as its location. With this information, it’s possible to have an initial diagnostic suspicion. In this article, we’ll focus on some of the causes of pain in the right side of the chest.

The severity of these conditions varies as much as their origin. Therefore, timely medical evaluation is of great importance in these cases, as the symptom should not be taken lightly.

It’s important to inquire about other clinical manifestations accompanying the pain. Likewise, it’s necessary to reassure the patient to avoid omissions and thus facilitate the understanding of the patient’s condition.

The chest wall and pain in the right side of the chest

In general, the most frequent causes of right chest pain are related to the structures that make up the chest wall. Although these are usually clinical entities that aren’t serious, they should always be carefully evaluated.

It’s necessary to rule out a more severe origin. A history of injuries, sudden movements, coughing, or intense physical exercise is usually involved in the cause of pain attributed to the chest wall.

Intercostal neuritis

Irritation of the nerve fibers that accompany the ribs is called intercostal neuritis. This is a clinical picture with multiple causes: traumatic (injury), infectious, and even by compression of the nerve at some point along its path.

The chest pain of intercostal neuritis worsens with deep breathing, sudden movements, and coughing. When the affected nerve is on the right side, the pain encompasses that area of the thorax.

It’s important to note that the pain doesn’t usually extend beyond the intercostal space corresponding to the sensitivity of that nerve. In addition, on physical examination, it’s characteristic that palpation is painful when pressure is applied to some points of this intercostal space.

Acupressure is believed to be enough to make the diagnosis.

pain in the right side of the chest
The chest wall is more susceptible to pain and inflammation in people who are overweight or obese.

Costochondritis: When joints cause pain on the right side of the chest

Another condition that triggers pain is costochondritis. This involves one or more joints between the ribs and the cartilage that attaches them to the sternum.

The pain usually comes on gradually and is usually located at the second and third costochondral junction, but may involve other locations. In addition, it also frequently radiates to the shoulder and the limb on the same side.

Tietze syndrome is one form of this condition.

Rib fracture and other causes of bone pain

One cause of pain on the right side of the chest, which particularly affects elderly people, is a rib fracture. In these cases, it’s usually a secondary symptom of osteopenia, but it may also be the manifestation of bone metastasis.

However, in young people, recent chest trauma should be suspected. It’s important to assess the person’s respiratory function in detail, as this may be compromised.

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Other conditions of the rib cage

There are other chest wall conditions that are capable of triggering pain. Muscle contracture is one of them and is usually caused by intense exercise, although sudden movements and trauma can also cause it.

On the other hand, certain infectious diseases, such as herpes zoster, affect a dermatome in the thoracic region and produce pain on the right side of the chest. In this condition, vesicles appear that respect the path of the corresponding nerve.

Respiratory system processes that cause pain in the right side of the chest

In this section, we will cover some conditions of the pleura that are capable of triggering pain in the right side of the chest. The pleura is a structure formed by two layers: the visceral and the parietal. It’s in the latter that the innervation necessary to transmit pain is found.

Right-sided pneumonia

Infection of the lung tissue constitutes pneumonia, which is a serious entity that warrants immediate medical evaluation. Symptoms include the following:

  • Cough
  • Fever
  • General malaise
  • Respiratory distress

If the infectious process is located in the right lung, pain may appear on that side of the chest. A thorough physical examination and complementary tests are necessary in order to establish an effective and timely treatment.

Right pneumothorax

The presence of air between the layers of the pleura is known as pneumothorax. Although an injury can cause it, other possible causes include certain medical procedures and even spontaneous rupture of a fragile area in the pleura.

Pneumothorax is associated with sudden pain on the affected side and shortness of breath. Treatment depends on the severity of the clinical picture.

pain in the right side of the chest X-ray
X-rays are common complementary methods used for the diagnosis of chest pain.

Tumor processes as causes of right-sided chest pain

Tumors located in the right lung are another cause of right-sided chest pain. However, when these conditions are located in the lung tissue, they’re usually asymptomatic in the initial stages because they don’t involve the parietal pleura.

In these cases, it’s important to inquire about weight loss, tobacco use, and chronic exposure to asbestos and biomass smoke. In addition to pain, cough and shortness of breath are common.

Other causes of pleuritic pain

Inflammation of the pleura, also called pleuritis or pleurisy, is another possible source of right-sided chest pain. It’s usually intensified by coughing and deep breathing.

Likewise, enterovirus infectious processes, such as group B coxsackie, can trigger epidemic pleurodynia, constituting Bornholm syndrome.

Right-sided chest pain of cardiovascular origin

Although right-sided chest pain is not usually related to ischemic processes of the heart, such as myocardial infarction, the location of the pain does not rule it out. It is also possible that it may be caused by vascular structures of other organs with equal importance.

Thus, the fact that the pain is on the “wrong side” of the body for a heart attack shouldn’t be enough to assume it’s a harmless condition. Cardiovascular causes of right-sided chest pain include the following:

  • Pericarditis
  • pulmonary infarction
  • Coronary artery disease
  • Pulmonary thromboembolism
  • Dissecting aneurysm of the aorta

Other causes of right-sided chest pain

There are other causes that aren’t related to respiratory, cardiovascular, or chest wall conditions that also cause pain in this region. These include some digestive tract disorders, especially esophageal diseases, and also liver and gallbladder disorders.

It’s also possible that pain on the right side of the chest may have a psychogenic origin. Anxiety and psychosomatic causes should also be considered.

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