Costal arch pain during pregnancy

introduction

The costal arch is the cartilaginous connection between the lower ribs and the sternum. This is where many abdominal muscles come into play, which are excessively strained during pregnancy. The liver and gallbladder are also located in this area, which can also cause pain there.

Especially in the second half of pregnancy, some women experience more or less severe pain in the area of ​​the right and / or left costal arch. These can have different causes and manifest themselves in different ways.

Causes of costal arch pain in pregnancy

The pain in one or both of the costal arches is often harmless. As the baby grows, this takes up more and more space in the abdomen, so that the abdominal muscles are heavily strained. Since the muscles have their origin at the costal arch, there is an increased pull here, which can manifest itself as pain in the area of ​​the costal arch.
The expanding uterus can also put pressure on the liver and gallbladder, which can be very painful but is harmless. Such pain can also occur when parts of the baby's body are stretched out and press on the organs.

At right-sided Pain in the area of ​​the costal arch or the upper abdomen can also be caused by what is known as HELLP syndrome. This is a serious complication during pregnancy and must be recognized and treated immediately by a doctor. However, the HELLP syndrome occurs very rarely.

Rib pain caused by coughing

Like all muscles in the body, the respiratory muscles can be affected by sore muscles from overuse. The cough is a reflex of the body against foreign objects in the airways or when the lungs or bronchi are inflamed. Extremely strong coughing can lead to exhaustion and pain in the respiratory muscles, which manifests itself as breath-dependent pain in the costal arch.

The lungs can also be involved. In the case of pneumonia, an inflammatory effusion can form in the gap in the lung membrane. Since the pleura is extremely sensitive to pain, it can cause additional pain. As the lungs move while breathing, the pain from coughing is intensified.

Read more on the subject at: Pain in the costal arch from coughing such as Infections in pregnancy

Localization of pain on the costal arch

The localization of the pain can provide an indication of the cause of the discomfort. For this reason, these are dealt with first and the most common Ursacehn discussed later. The localization of the pain is classified as follows:

• Right costal arch pain
• Pain in the left costal arch
• Pain in the anterior costal arch
• Pain in the posterior costal arch

Costal arch pain during pregnancy can be unilateral or bilateral. If they occur on one side, the right side is usually affected, as this is where organs are located that can be compressed by the growing baby. But the left side can also be affected.
This pain is very likely harmless and will be caused by the baby growing, widening uterus, or parts of the baby's body that are stretched out.

In most cases, costal arch pain occurs on the right side of the body during pregnancy. This is because the liver and gallbladder are located in the upper right abdomen. These organs can become painful as the baby grows in size and moves when they are compressed.
Most of the time, however, these pains are harmless and short-lived. However, if the pain gets worse or does not go away, a doctor should be consulted, because in rare cases it is caused by the so-called HELLP syndrome, which is a serious complication of pregnancy. This leads to a severe swelling of the liver and an increase in liver values, which can be detected in the blood.

Read more on the topic: HELLP syndrome such as Pain in the ribs during pregnancy

Right costal arch pain

Pain that is limited to the right costal arch can have a variety of causes. A distinction must be made between superficial injuries and complaints of the bones, muscles, skin or nerves and organic causes.

Bones, muscles and nerves are the most common triggers for pain in the costal arch. In the context of accidents, sports, falls and blunt acts of violence, bruises, breaks or even series breaks of the ribs can occur. Despite a certain elasticity and cushioning of the ribs, they can break under heavy pressure loads. This is especially the case in older people with pre-existing osteoporosis.

A fracture is often painful on the costal arch and can be made worse with deep breathing, pressure, and touch. The deep breathing causes movement and displacement of the fracture ends towards each other. Under certain circumstances, the broken bone inside can injure the lungs and lead to dangerous complications.

Often only muscle tension or nerve entrapment are responsible for sharp pain in the costal arch. The symptoms usually improve within a few days. If there is constant pain that is made worse by breathing, pain relievers can be taken to bridge the healing time.

Organic causes are rarely behind it. The upper abdominal organs lie at the level of the right costal arch. The pain in the right costal arch during pregnancy can be an indication of liver disease. The HELLP syndrome is a rare but extremely dangerous clinical picture. This results in disorders of the blood with greatly increased blood pressure, pain in the ribs on the right side and sometimes further complications in the liver, kidneys and uterus.

The pain in the costal arch is caused by the swelling of the liver. Adjacent upper abdominal organs can also swell and cause pain. Under certain circumstances, the stomach and intestines can cause such pain in the course of digestion. Gallbladder complaints or the condition after a gallbladder removal are often associated with pain in the costal arch.

Read more on the subject at: Gestosis

Pain in the left costal arch

Even with pain in the left costal arch, there is initially no reason for serious organic causes. A problem with the muscles and nerves below the ribs is the most likely diagnosis in these cases. Below the left costal arch are mainly parts of the stomach and the spleen. In the case of long-standing pain that is accompanied by other symptoms, involvement of these organs should be excluded.

The spleen serves as an organ for blood filtration and immune defense in the body. In blood diseases such as leukemia or in the context of severe infections with blood poisoning, the spleen is overwhelmed and swells up. Normally it cannot be felt under the costal arch. However, it can swell so much that it can be felt on the left side of the stomach. It also exerts strong pressure in the direction of the ribs and provokes pain in the costal arch. A disease of the spleen must urgently be clarified during pregnancy.

Pain in the anterior costal arch

Next Injuries to the sternum and the cartilage with which the ribs are attached, organic causes are also possible in the case of central pain. Below is the stomach with the esophagus. Symptoms that occur immediately after ingestion suggest these organs. If the portions are too generous or the bites are too large, stinging or burning discomfort can be felt in the middle below the breastbone.

The pain may also be due to the heart be due. Especially after physical exertion, a Pain with shortness of breath be indicative of a heart problem. In most cases, acute heart diseases requiring treatment manifest themselves with numerous other symptoms, pain and shortness of breath at rest.

Pain in the posterior costal arch

The pain in the posterior costal arch indicates a problem in the Interaction with the spine down. But here too, in most cases, nerve entrapment or muscle tension are the causes. A rare but conceivable cause is that Herniated disc of the thoracic spine. It is much rarer than in the lower back, but nerves can be affected, so that the pain radiates to the upper body and the posterior costal arch.This disease must be taken into account, especially due to the increased stress on the spine during pregnancy.

Pain in the costal arch after pregnancy

Since pregnancy puts a considerable strain on the mother-to-be's body, the symptoms do not go away with the birth. Abdominal and back muscles were used for a long time, and possibly organs too, if they were subjected to a lot of pressure.
For this reason, pain in the costal arch area can also occur after pregnancy, or this can initially persist if it was there before.

Carrying the born baby all the time puts a lot of strain on the muscles that attach to the costal arch, even after pregnancy, and this too can be painful.

How are rib pain expressed?

Depending on the cause of the pain, this manifests itself in different ways. The harmless pain caused by strained abdominal muscles, the expanded uterus or the stretched out parts of the baby's body usually occurs selectively and express themselves as stabbing Pain that goes away quickly. If this pain is very severe, it can even radiate to both sides of the spine.

As a rule, the pain in the costal arch disappears from the 38th week of pregnancy. Because then the baby's head enters the pelvis and the weight is distributed differently.

The HELLP syndrome manifests itself in an enlarged liver, increased liver values ​​and worsened blood clotting values.

therapy

Since in most cases the pain is caused by excessive pressure on one side of the upper abdomen, it is often helpful to take pressure off that side. If there is pain on the right side, it is therefore advisable to lie on the left side and sleep. This shifts the baby's weight to the other side and relieves the muscles on the sore side.
There are also special pregnancy pillows that are also intended to help relieve and reduce pain.

Please also read: Physiotherapy for pain in the costal arch during pregnancy

Homeopathy for pain in the costal arch

Pain in the costal arch during pregnancy should always be discussed with the attending gynecologist. After a serious illness has been ruled out, pain-relieving measures can be taken.

There are homeopathic globules that are said to help with pregnancy-related pain through the growth of the child. Examples of homeopathic globules are the remedies Aletris farinosa and Aristolochia clematis.

Which doctor treats this?

First of all, you should consult the treating gynecologist. The doctor can use the description of the symptoms and an ultrasound examination to gain an impression of the possible causes of the pain. A blood test may be helpful to rule out HELLP syndrome.

In most cases, a visit to the gynecologist is sufficient. A subsequent visit to the orthopedic surgeon may rarely be indicated.

diagnosis

If there is pain in the costal arch, the gynecologist should be asked for advice. An exception is when the mother-to-be's pain is due to the baby's movements.
However, if the pain persists or worsens, the doctor should do a blood test to rule out HELLP syndrome and to rule out possible damage to the liver or gallbladder. Soft tissue complaints can be shown well in the ultrasound and is the leading diagnostic tool in pregnancy. Radiation-stressing forms of examination such as X-rays or CT are contraindicated in most cases. Even if the unborn child is not exposed to radiation, the MRI during pregnancy should only be carried out under very strict indications. Soft tissue processes that cannot be visualized with ultrasound can be made visible in MRI.

Read our own topic: MRI during pregnancy

forecast

In the case of harmless causes of rib pain in pregnancy due to the growth of the baby, the prognosis is good. After the end of pregnancy, the pain on the costal arch disappears.

If the symptoms are caused by a liver disorder, for example in the context of a HELLP syndrome, the prognosis depends on the severity of the syndrome and the therapy. Early therapy can have a positive effect on the course of a HELLP syndrome.

Can this be dangerous for my baby?

In the last trimester of pregnancy, many women suffer from rib pain. Often the causes are harmless and begin with the baby's growth. The baby's size can put pressure on abdominal organs or stretch arms and feet, which can be painful.

However, rib pain during pregnancy can also be dangerous for both mother and child. A pain in the right upper abdomen and costal arch can be a symptom of HELLP syndrome. This is definitely in need of clarification. Even if rib pain is usually harmless, you should consult your gynecologist if you have problems on the right side in particular.

Can that also be a sign of pregnancy?

Pain in the costal arch is particularly common in the last trimester of pregnancy. It is not a classic sign of pregnancy. However, many women experience rib pain in the last few weeks of pregnancy, so it is a common symptom during pregnancy.