Expert: Gerald Anzalone, D.C. - 4/18/2007

Question
I have a sharp pain 2 inches under the right nipple behind the ribcage. It
started 2 days ago while I was on my laptop computer in my bed. It felt as
though I injured my rib although that could not be the case since there was
no injury involved. I also had a lot of burping and gas during the whole time. I
can only take shallow breathes, a medium breathe is extremely painful. Also I
cannot turn on my side or on my stomache in my sleep. Sitting slightly up
with my head propped up is my only  position. Sometimes if I move too
suddenly there is the sharp pain.
I thought the pain might be related to diet but after not eating for 15 hours
the pain is still the same. I also have a mild headache and slight nausious.
I hope that gives you enough to go by
Thankyou and blessings,
Michael

Answer
Michael,

There can be many causes of pain in the area of the rib cage and chest.

Pain along the breastbone could indicate costochondritis, an inflammatory condition affecting the cartilage.

Pain and pressure under the breastbone brought on by cold air, activity or eating could indicate angina pectoris, a type of heart condition usually caused by blockages in arteries.

Pain and burning or pressure in your upper stomach or chest, particularly after eating, could indicate a hiatal hernia.

Pain in the sternum or in the right side of your abdomen near the top, accompanied by burning, belching, or bloating of the stomach, especially after a greasy or fatty meal, could indicate pain referring from the gallbladder.

Pain or a burning sensation relieved by eating could indicate an ulcer or irritation of the esophagus.

Or, there could be a musculoskeletal component. Because of the need for a physical examination, it is impossible for me to give you a more definitive answer to your question.

It is essential for you to see a medical doctor and have your personal physician perform a thorough examination to rule out a more serious problem, and if the cause of your pain turns out to be musculoskeletal, you could seek treatment from a chiropractor or physical therapist skilled in soft tissue manipulation techniques.  

I hope that this answer points you in the right direction.