Do you have pain on right side under ribs towards back at night? Having back pain that gets worse at night can create a cycle of sleeplessness that doesn’t allow your body enough time to recover. There are muscles, bones, connective tissue, and organs in this area, so it can be hard to tell exactly what’s hurting. There’s also the possibility that it could be referred pain coming from somewhere else.

Any other symptoms that you’re noticing may be important clues that can tell you about the type of pain you’re dealing with. Take some time to write down exactly how your pain feels while it’s happening, and note anything that seems to make it better or worse. Keep track of when the pain started and how frequently it comes back. If your pain is keeping you from sleeping, or if it lasts for more than a week, it’s a good idea to seek medical attention. Depending on the symptoms you’re noticing, you might decide to go to your primary care physician, a specialist, or a physical therapist. Having these details ready will help you have better conversations with your care providers and receive high-quality treatment.

In this blog post, we’ll share 10 possible causes of pain on your right side under the ribs and toward the back at night.

10 reasons you may have pain on your right side under the ribs and toward your back at night

The part of the abdomen on your right side under the ribs is called the upper right quadrant. Medical professionals use this term to differentiate from the upper left and upper middle areas of the abdomen. The upper right quadrant contains most of the biliary system, which includes the gallbladder, half of your pancreas, most of your liver, and bile ducts. The right kidney also sits in this area toward the back as well as part of the duodenum or small intestine.

The following are 10 potential reasons why you might have pain on your right side under the ribs and toward your back at night:

1. Sleeping wrong or overexertion — Muscle pain and strain in the upper right quadrant near the back can be caused by sleeping in the wrong position or overexerting yourself. This may happen if you sleep on your side, on your stomach, or in a twisted position. Try sleeping on your back or in a reclined seat to avoid aggravating your pain.
2. Gastrointestinal (GI) issues — A GI issue like acid reflux or GERD (gastrointestinal esophageal reflux disease) and irritable bowel syndrome (IBS) can cause pain in the upper right abdomen toward the back. This may be especially noticeable at night after you eat dinner or later at night when you haven’t eaten for several hours. Ulcers, gastritis, and other forms of stomach irritation can also cause pain in this area. If you suspect you have one of these conditions, talk with your doctor and consider seeing a GI specialist.
3. Trapped gas — Gas can get trapped in the bends of your intestines in the upper right quadrant. This can be very painful and last up to a few hours. Try an over-the-counter anti-gas medication. It’s also a good idea to add more fiber as well as pre- and probiotics to your diet.
4. Fall or trauma — Sudden impact can bruise your ribs or even break them. In these cases, your pain may feel worse when you’re lying down or when you breathe in or cough. Bruised and broken ribs are usually treatable at home with pain relievers, heat, and ice. It can take about two to six weeks for a bruised or broken rib to heal.
5. Coughing — Ribs can also bruise or break from coughing too hard or too much. This sometimes happens when people have conditions that cause a chronic cough. It’s especially likely in people who have osteoporosis. However, it can happen to people with normal bone density, too.
6. Costochondritis — Costochondritis is inflammation of the cartilage that connects your ribs to the sternum. It can cause sharp pain in the chest wall, which is sometimes felt toward the back. Most of the time, the cause of costochondritis is unknown. It can usually be treated using NSAID pain relievers.
7. Kidney problems — The kidneys are located below the rib cage toward the back. There are a few different types of kidney problems that can cause pain in this area. These include kidney stones, a kidney infection, or a urinary tract infection. These are diagnosed with a physical exam, urinalysis, blood tests, and imaging tests.
8. Liver issues — Liver problems aren’t common, but sometimes the most noticeable symptom is pain under the right ribs. With liver problems, your pain won’t get worse during physical activity. Liver abscess, cirrhosis, fatty liver, and liver cancer are all liver problems that can cause pain under the ribs. Other symptoms that may indicate liver issues include fatigue, jaundice, itchy skin, dark urine, changes in stool color, and appetite loss.
9. Gallstones — The gallbladder sits under the right ribs toward the front. However, referred pain can sometimes be felt around the back as well. Pain from gallstones usually shows up suddenly and worsens over time. With gallstones, you might also notice a fever and chills, dark urine, light-colored stools, jaundice, nausea, or vomiting.
10. Shingles — Shingles is an infection caused by the same virus that causes chicken pox. People who have shingles usually notice a rash around the side and back of the abdomen. The pain may be constant and dull, burning, or gnawing. Or it can be a sharp, stabbing pain that comes and goes.

A handful of the conditions on this list can be taken care of at home. You might not need to see a doctor or physical therapist if you’re sleeping in the wrong position or dealing with overexertion, costochondritis, or trapped gas. Though there isn’t much your doctor can do about a bruised or broken rib, it may be a good idea to get an examination and some advice on how to care for yourself while you’re healing. Your doctor will be able to treat GI issues, infections such as shingles, or problems with organs like your liver, kidney, or gallbladder. There’s also a chance they may refer you to a specialist.

For musculoskeletal pain or any of the conditions affecting your bones, muscles, or connective tissue in this area, a physical therapist may be most helpful. For conditions like these, a doctor might send you home with some pain medication or instructions for self-care. A physical therapist, on the other hand, can provide natural treatments that help heal soft tissue and relieve pain and stiffness.

At Lattimore PT, we specialize in musculoskeletal conditions like costochondritis and bruised or broken ribs. PTs at nearly all of our clinics have a Certification in Orthopedic Manual Physical Therapy (COMT). This means they’ve completed specialized training in identifying musculoskeletal issues through simple tests and observation. They’re also experts in prescribing movements and nonpharmacologic treatments to help support your body’s natural healing processes.

Physical therapy treatments are covered by most health insurance plans. Your physical therapist is there to help you learn about what’s happening in your body and suggest lifestyle changes to promote long-term wellness. You’ll likely see your physical therapist for several weeks, depending on your condition, and you may see them more than once a week. We enjoy getting to know our patients and providing highly personalized treatment.

Are you looking for a physical therapist who can help you with pain under the ribs and toward your back at night? Contact our team today. Let’s talk about the symptoms you’re noticing and start exploring treatments that can help.