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Pain felt under the ribs on the right side that may extend to the back is a common symptom with many possible causes. Depending on its intensity, duration, and any other accompanying signs, this pain can suggest minor problems or more serious conditions that need medical attention.

In this article, you’ll find the main possible causes of back rib pain, treatment options, and when it’s necessary to see a doctor.

Possible Causes of Back Rib Pain

Liver Conditions

Liver issues such as hepatitis, fatty liver (hepatic steatosis), or inflammation can cause discomfort under the right ribs.

Gallbladder Inflammation or Gallstones

Cholecystitis or gallstones may trigger sharp or constant pain on the right side, often with nausea, vomiting, or fever.

Kidney Issues

Urinary tract infections or kidney stones can cause pain that begins on the right side and radiates to the back.

Muscle or Bone Problems

A strained muscle or an injury to the ribs or spine can lead to local pain that may spread to the back.

Intestinal Disorders

Irritable bowel syndrome or other bowel inflammations may cause pain in this area, especially if bowel habits change.

Atypical Appendicitis

Although appendicitis pain typically occurs in the lower right abdomen, it can sometimes extend under the ribs or into the back.

Treatment — What Solutions Are There?

Treatment depends entirely on the underlying cause. Some general recommendations include:

Rest and avoid physical strain if the pain is muscular.
Pain relievers or anti-inflammatory medication — only on medical advice.
Antibiotics for infections such as urinary tract infections or cholecystitis.
Surgery for gallstones, appendicitis, or other conditions that do not respond to medication alone.
A balanced diet for liver and gallbladder problems — low-fat meals, no alcohol or processed foods.
Proper hydration, especially for kidney conditions.

Important: Never self-medicate and do not ignore pain that is severe or ongoing.

When Should You See a Doctor Urgently?

Seek urgent medical care if:

The pain is severe and does not go away.
You develop fever, chills, or yellowing of the skin (jaundice).
You have severe nausea, vomiting, or trouble urinating.
You notice major changes in your stools or urine.

A specialist consultation — with possible investigations such as an abdominal ultrasound, blood tests, or other exams — is essential to find the cause and begin the right treatment.