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Avatar universal

Right side, lower abdominal pain, groin pain

’m a 35 y/o male, 178cm and 155 lbs. I’ve been experiencing right sided abdominal pain for about 6 months now. The pain is under my right ribs. The pain radiates to my right side back as well. I’ve practiced weight lifting, swimming and karate for years. I'm completely unsure what caused it. It started as very minor pain, more like pressure. I’m fairly athletic and exercise 3-4 days per week, or used to… I haven’t been able to since I’ve had this side pain. The odd thing about the pain is that over few weeks it has gotten a lot worse, rather than getting better and since then stayed almost at the same pain level. This pain has stayed with me every single day for the last 7 months. It gets worse when I sit down. It’s not a sharp stabbing pain, it’s more of a severe ache. It feels like a warm/burning/almost tingly sensation on my right side. The pain goes over to the right side of my back, above my hip bone just below my ribs. It’s like my whole right torso is affected! Sometimes I feel the pain in my right testicle, which feels swollen and painful at the bottom of the right sac. I have a hard time sitting at my desk for work. Also, driving long distances is very uncomfortable and painful now. It feels like someone is poking me right below my right ribcage and I feel a lot of pressure and a pulling sensation on the right side of my back at times. My right oblique muscles are felt very tight on examination. When sneezing I feel a strong tingling in my right side. Sleeping on my right side doesn’t bother it at all, and when I wake up in the morning, the pain is pretty much gone! But of course within the first 10-15 minutes I start walking around a little bit and sitting down to eat my breakfast, it starts. It progresses throughout the day. (I have a desk job, and of course sitting makes it worse….) I can no longer exercise, all I can do is walk, and even that aggravates it sometimes. Food doesn’t seem to make any difference. What I eat doesn’t bother it. Nobody can figure out what I have. I’ve had many different types of blood tests, I’ve had a CT scan of my right side abdomen, a colonoscopy, an ultrasound of my right side, MRIs on my abdomen and thoracic spine and everything has shown up normal. I’ve been checked for kidney stones, gall stones, kidney problems, liver problems, gallbladder problems, hernia but so far, everything is normal! I did go to physical therapy for a couple of weeks, but it did not help, it only caused me more pain. Same thing with a chiropractor. I have also tried acupuncture and injury massage therapy with no luck. I think it is an abdominal muscle tear - sports hernia (athletic pubalgia), inguinal hernia or something urological (epididymitis, varicocele, prostatis, etc). It looks like some of the nerves are affected, because of the tingling sensation, but the spinal MRI did not reveal anything. Do you have any idea what this can be and how can be treated? What other diagnostic tests should I have?

Please, help if you can.

44 Responses
Avatar universal
Here are some new developments today. I have received the results from the scrotum ultrasound and they found "prominence and echogenicity involving the right epididymal head which measures about 7 mm. These findings are consistent with regional or focal epididymitis". My STD urine samples came back negative as expected.
My family doctor has prescribed Cipro 500 mg bid for 10 days. He does not think the pain is related to the right side lower abdominal pain and tingling, but I think he is wrong. I had this sensation of swelling in the groin area and pain, approx. since my abdominal pain has started. But I do not think at this point there is a bacterial reason. If this is epididymitis, it is probably chronic. Interesting enough, on the CT scan I had 4 months ago, they mentioned enhanced 9 mm Meckel diverticulum and suggested possible Meckel diverticulitis, but the surgeon neglected it. Was there some infection going on related to the whole picture?!? I will ask for urological referral, but meanwhile how do you think I should proceed?


Avatar universal
Update: My costochondritis diagnosis was made by the doctors at the Sunnybrook Pain Management Clinic, after reviewing all diagnostic tests I have collected for the last 10 months - MRI (thoracic, abdomen), contrast CT scan (pelvis, abdomen), abdominal ultrasound, blood and urine, colonoscopy report. Every test came back negative and I was getting really frustrated. The doctors at the clinic performed the hooking maneuver, which caused a lot of pain on the right side, but almost none on the left side. My pain is just below the ribs, on the right side and it refers to the back. The pain is position based, more aggregated when sitting, almost pain free when in bed. There is a condition similar to costochondritis called slipping rib syndrome, which may be what I have. Currently, I am going for myofacial release massage and I would like to include the prolotherapy in my treatments. Some people have reported very good results in decreasing the pain. After 10 months of drug trials (meloxicam, neurontin, cipro), which did not help at all, 2 months of acupuncture and physio I am not very optimistic, that this will be fixed at all. And I used to be a competitive swimmer, also have a black belt in karate and used to run in marathons. Very sad!

Avatar universal

My current diagnosis is costochondritis with reffered pain in the abdomen and low back. I have some slight pain in the lower ribs 11/12. It does not make much sense to me, since costochondritis is self-limiting and should disappear in 2-3 months.
There are other conditions though, which could make it chronic like seronegative spondylopathies. My pain is traveling thru the T10/T11 nerves, like a band.
The pain is burning with tingling and muscle twitching when worse after prolonged sitting. My family doctor is doing the following blood tests to check for any of the seronegative spondylopathies:

Erythrocyte sedimentation rate (ESR)
Immunoglobulins (Ig)
C-reactive protein (CRP)
rheumatoid factor (RF)
antinuclear antibodies (ANA)
human leukocyte antigen HLA-B27
Sacroiliac Joint X-Ray: Looking for abnormalities of the SI

Something else to consider is a MRI of the brain for MS, but with the Canadian health care system this is not going to happen soon. Good thing is, next month I will be in vacation in Europe, where I can pay and have the test on the day and bring the CD back.

I will keep you posted,

Avatar universal

I have just returned to Canada from a vacation in the country I was born (in Eastern Europe). I have spend two days in one of the best hospitals there, meeting 6-7 specialists and undergoing many additional test, trying to confirm the diagnosis of costochondritis or finding something else. I will not go into details, but very few people have been tested so extensively. The only test I have opted out was the diagnostic laparoscopy. I have spend a small fortune, but in Canada this would cost me a downpayment for a condo and take about a year.

The end result was: chronic insertionitis, or inflamation at the insertion of the internal
oblique muscles into the lower ribs. Prescribed therapy: anti-inflamatory  physiotherapy - ultrasound, magneto therapy; cortico-steroid shots, anti-inflammatory medications, etc.

Again, my symptoms are burning pain and feeling for pressure, just below the right ribs, which starts building when sitting for a long time (at least 1 hour). I have started
special exercises complex and Tai Chi each morning with 1 min cold water shower afterwards. This builds my energy level and gives me some temporary releif. There is no pain when sleeping.

I am about to start the physiotherapy, but first wanted to check if somebody else out there has this condition or knows how to treat this chronic insertionitis of the abdominal muscles.


Avatar universal
I have same pain... it started 2 month ago when i went to doctor and he gave me voltaren :S
Voltaren helped a lot and after 10 of treatment the pain was gone but came back after almost a month. Tomorrow I will go to see another doctor....
I am form Europe and all test are free here so I hope that they will find the problem...
I will update after that ;)
Avatar universal
my lower right back/lower right abdomen has actually been bothering me for quite some time.  i would feel discomfort (pressure) only when i was sitting and it was completely random.  sometimes it wouldn't even hurt at all but other times it would hurt not too long after i sat down.  thought it might have been a pinched nerve since it only occurred when i was sitting.  it got progressively worse the past few months until i went to get it checked out.  i had all sorts of tests done including ultrasounds and MRIs but they all came back negative.  the only test i wasn't able to get done was the MRN (basically like an MRI but for nerves) since i didn't have health insurance (and still don't since i'm currently temping).  i even went to acupuncturists and had them do acupuncture and cupping but it didn't really seem to help.  just recently i went to a massage therapist and he seemed to work wonders.  most of my lower back pain is gone after a few sessions but i'll occasionally feel pins and needles accompanied sometimes by burning sensations and tightness on my lower right abdomen.  i have a feeling it's connected with whatever's going on in my lower back.  i've been going to the hot tub at my local gym a few times a week because i heard the heat helps injuries. i'm still not sure what it is i have but i'm going to stick with this regimen and will try attending some hot yoga classes as well.

vnenov and croat, any updates on your current situations?
Avatar universal
The best thing about you is there is nothing in your scans and MRI, so you have not damaged anything.
Ergonimics at work is very important, please select the best chair for you and also keep moving and walking after you sit for some hours.
Massage and other things are a good idea but always go to a professional and take care of your back, do regular exercise and strengthen your back muscles which support your spine.
Take care
Ergonomics at work is indeed important, but unlikely to make a difference in such a case. Moving and walking around is good general advice, but again, not sure if it helps in such a chronic case. For me, nothing really helps except lying down and having a rest. And of course, after getting up it starts again.
Avatar universal
I just read your complaint about right-sided abdominal pain under the ribs with accompanying testicular pain on the same side. You described my symptoms perfectly. It only bothers me while sitting for some length of time or perhaps while bending over to pick up an object from the floor (which results in a compression of my abdominal area).  This condition started in January of 2009 and continues to this day.

I am a very active 59 year old male in otherwise good health, however I was diagnosed with a common liver cyst after an abdominal ultrasound two years ago. Most liver cysts are asymptomatic and are usually discovered incidentally while looking for causes to other conditions.

I have been to my internist (abdominal ultrasound), to a gastroenterologist (CATscan, and colonoscopy) and to a urologist. All test results are normal and they have no idea what is causing my pain.

A close friend who had hip replacement surgery claims that her symptoms were similar to mine prior to her diagnosis of her hip joint  deterioration and that she has not experienced the problems since she had hip surgery. I am going to an orthopedist next to see what they can find, but I am frustrated by the continuing pain and lack of a clear diagnosis.

Please let me know if you find an answer to your symptoms and I will do the same.

Avatar universal
I’m male, 38 and have very similar same symptoms and it's been going on for 7 months.  The doctors don't seem to know and I found it hard to find a reason as test were normal and I couldn't link it to what I was eating or doing.

I have now finally worked out that the pain gets bad when sitting too long in the same position (e.g. at a computer or driving) but it didn't always happen until I finish my journey (ie. move from sitting position) which is why I couldn't link it.

It reduced greatly over the summer and came back in Sept. I didn't drive much over the summer and wasn't at work.

I have found that if I stretch my torso by leaning back my abdomen muscles are pulled and it is painful, but after a few stretches much less overall pain for the rest of the day.
I am trying now to research the reason for this. It’s as if compressing my muscles for too long a period is perhaps building up something in the muscle to cause pain? A chemical imbalance of some sort?

Avatar universal
im 22 y/o male who has the same exact syptoms. (right abdomen and right testiclular pressure. Its not pain, they just feel sensitive. I haven't had this problem until I started working a desk job in June, so I think theres a general consesus that staying in one place for too long causes this. I will start exercising and keep you posted.
Avatar universal
39 y.o.male with similar symptoms. CT scans negative, although there is a stable 1.5cm liver hemangioma. No testicular pain, but some other tear-like symptoms in the right abdomen (I'm an active overage soccer player).

In addition to the right pain below rib cage, pain also bounces about hitting on kidneys, below sternum, and also higher on the rib cage. 90% of the discomfort is centered below right rib cage, though.

Recently I've developed belching/burping that might be related and point towards a GI cause. Any thoughts anyone?
Avatar universal
I just came across your posts and am so happy I have.
I'm 39 year old male, that has had the EXACT symptoms for almost 7 months now. I have had test after test after test and still nothing has come up. I will be going for a colonoscopy in the New Year and am very nervous about it. It is one of the only tests left, and get very stressed at the prospect of colon cancer.
I will take all of your information with me to see my Doctor and hopefully the colonoscopy results will be as negative as the rest of the tests.
Once again, I thank you for your posts. It truly has helped.

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