Throbbing on n off pain below right axilla. Since morning. Cones and g

Throbbing on n off pain below right axilla. Since morning. Cones and goes

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Here is a thorough breakdown based on your symptom - throbbing, intermittent pain below the right axilla (right lateral chest wall), present since this morning.

Pain Below the Right Axilla - What Could It Be?

Important disclaimer: This is general medical information only. Throbbing chest-area pain with sudden onset today should be evaluated by a doctor, especially if it worsens, spreads, or is accompanied by breathlessness, fever, or sweating.

Most Likely Causes (Common to Less Common)

1. Musculoskeletal / Intercostal Muscle Strain (Most Common)

The intercostal muscles run between the ribs. Trigger points or strain here cause localized, throbbing, intermittent pain that gets worse on inspiration (breathing in).

Key features pointing to this:

Pain localized to one spot
Worsened by deep breathing, twisting, or pressing on the area
Often follows physical activity, coughing, or awkward sleeping position
Roberts and Hedges' Clinical Procedures in Emergency, p. 3855: "Pain emanating from the exterior intercostal muscles is usually localized near the site of the trigger point and is emphasized during inspiration."

What to do: Press gently on the painful area - if the pain reproduces, it strongly suggests musculoskeletal origin. Rest, heat, and an anti-inflammatory (like ibuprofen) typically help.

2. Costochondritis / Chest Wall Pain

Inflammation of the rib cartilage or its joints. Can feel like throbbing, aching pain that comes and goes.

Murray & Nadel's Respiratory Medicine: "Costochondritis and intercostal muscle cramps are the most commonly confused with angina... reproduced by palpation or manipulation."

3. Right-Sided Pleurisy (Lung Lining Inflammation)

Inflammation of the pleura (lung lining) causes sharp or throbbing pain on the side of the chest, typically worse with breathing, coughing, or movement. Causes include viral infection, pneumonia, or pulmonary embolism.

Key warning features:

Worsened by deep breaths or coughing
Associated fever, cough, or breathlessness
Feel short of breath

4. Herpes Zoster (Shingles) - Pre-Rash Stage

Shingles often causes unilateral throbbing, burning pain along a dermatome (stripe of skin) BEFORE any rash appears - sometimes by 2-3 days. The area below the right axilla is a classic dermatome (T3-T5).

Look out for: Any redness, blistering, or rash developing on the right side of your chest over the next few days.

5. Referred Pain from Liver / Gallbladder (Important to Consider)

The gallbladder and liver sit in the right upper abdomen. Pain from gallstones or cholecystitis can radiate to the right lateral chest and lower right axilla area.

Murray & Nadel's: "Cholecystitis, peptic ulcer disease, and acute pancreatitis may present with pain perceived in the lower thorax."

Gallbladder pain features:

Comes in waves (biliary colic - "comes and goes" pattern)
Often worse after fatty meals
May radiate to right shoulder or back
Nausea may accompany it

6. Axillary Lymph Node Swelling

Enlarged lymph nodes under the arm (from infection, etc.) can cause throbbing, tender pain below the axilla. Check if there's a lump or tenderness in the armpit itself.

Red Flags - See a Doctor Urgently If You Have:

Symptom	Concern
Shortness of breath	Pleurisy, PE, pneumothorax
Pain spreading to jaw, left arm, or both arms	Cardiac involvement
Fever + cough	Pneumonia, pleuritis
Severe, constant, worsening pain	Aortic, splenic, or hepatic emergency
Rash developing on chest	Shingles
Nausea + pain after eating fatty food	Gallbladder disease
Swelling or lump in armpit	Lymphadenopathy

Most Likely Scenario (No Red Flags)

If the pain came on today, is throbbing and intermittent, is localized below the right axilla, and pressing on the area reproduces the pain - intercostal muscle strain or chest wall irritation is the most likely cause.

Rest, avoid heavy lifting/twisting, apply warm compression, and take ibuprofen if tolerated. Monitor for 24-48 hours.

However, given the sudden onset and throbbing nature, a same-day or next-morning doctor visit is prudent to rule out pleurisy, shingles (early), or referred visceral pain.

This information is for educational purposes. Please consult a healthcare professional for a proper clinical evaluation.

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