Right subcostal pain

A 29-year-old woman.Complaints of acute pain in the right subcostal region, which occurred about two weeks ago after a stressful experience. The stress was not only severe but also prolonged: two consecutive days of company management meetings, reporting and strong psychological pressure. No other complaints were noted.

Objective examination: the patient is of athletic build, in good physical shape, regularly does physical activity, fitness, running, big tennis. Spine and thorax movements are full, but slight discomfort in the area of the lower ribs in front on the right side (increasing with deep inhalation), springing of the ribs is free, painless, diagnostic mobilization of the lower ribs does not eliminate the discomfort when turning and inhaling.
Palpatorily there are areas of tenderness, especially in the places of diaphragm attachment and to a lesser extent in the fascial structures of the abdomen, in the epigastric region on the right side.

Diagnosis: dysfunction of the right part of diaphragm of spastic character, of psychological genesis, fascial restriction in the surrounding connective tissue structures.

Treatment: fascial manipulations for appropriate fascial restrictions, fascial release techniques using respiratory synergies.

Results: after treatment, gradual symptom reduction over about two days, residual discomfort after a week. We repeated the treatment, as the patient said: "To strengthen the result". Breathing exercises and relaxation were recommended.

Pain in diaphragm in the right subcostal area. Conclusions.

An interesting and very revealing case of mind-body interdependence, psychosomatic manifestations. This is not something imaginary, but real, quite specific disorders of the function of certain body structures.
In this case, the weight of the impact came to the diaphragm, which is not surprising, because breathing has a direct relationship with the emotional sphere. For example, the most ancient reflex which has arisen long before appearance of species of people and even primates - to stop and make silent the breath in order not to reveal the location to the predator, whether it is a tiger in a jungle or a boss in an office.
P.S. It is also interesting that this pain in the right subcostal region appears against the background of full health and excellent form - psychosomatics in its purest form.

Grigori Tafi
Osteopath, sports medicine doctor
15 years of experience in osteopathy and manual therapy. Read more...

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