The hypochondrial region of the body is the area along the sides of the ribcage. When there is pain in the side area of the ribs, whether on one side or both, it is referred to as hypochondrial pain. In Western medicine, hypochondrial pain can be very puzzling.
In Chinese Medicine, the liver meridian pathway travels bilaterally through the rib cage, and for this reason rib pain on either side of the body is always related to a liver disharmony. The development of hypochondrial pain can arise from a few factors. One of the most common is emotional strain. Anger, frustration, loathing, and resentment can all block the liver’s energy from circulating, especially if these emotions are repressed. Hypochondrial pain related to stagnation of liver energy would have symptoms of pain and distention along the sides of the ribs, often linked to emotional state, oppression in the chest, poor appetite, frequent sighing, and belching.
Hypochondrial rib pain can also develop from dampness and heat invading the liver meridian, however this type is not too common in northern countries but more so in tropical areas. Diet can also play a role in the development of damp heat. Excessive consumption of dairy and/or greasy-fried foods can cause damp heat to accumulate in the body and settle in the liver channel, especially if the irregular eating is associated with emotional strain. Damp-heat in the liver channel will result in symptoms of dull pain along the sides of the ribs, fullness of the chest, a feeling of heaviness, a sticky taste in the mouth, nausea, yellowing eyes, and dark urine.
Overwork and even too much sexual activity can cause a deficiency of the liver yin or blood and also lead to hypochondrial pain. Because energy and qi are what help the liver circulate blood, if there is a deficiency of the blood, the liver’s energy will stagnate, causing stagnation of liver-energy or in severe cases, blood stasis of the liver. Blood stasis of the liver will cause symptoms of intense, stabbing, fixed location rib pain which is worse at night. Sometimes there is a feeling of a mass on palpation of the area.
Liver-blood deficiency has many of the same symptoms as liver-energy stagnation but not as severe. Symptoms are slight rib pain and distention, premenstrual tension, frequent sighing, depression, moodiness, dizziness, insomnia, tingling of limbs, blurred vision, menstrual irregularities, and fatigue.
Acupuncture addresses rib pain by looking at the accompanying symptoms and determining which of these patterns is the cause of the pain. By doing so we get a clear picture of which areas of the body are in a state of irregular functioning, allowing the acupuncturist to focus on the underlying cause of the pain with the goal of improving health. By correcting imbalances, the body is able to return to normal functioning and the liver’s flow of energy can travel smoothly and without disruption. Healthy liver functioning will resolve rib pain and may result in improvements in other areas of health as well such as emotions, sleep, energy, and digestion.
James Kaufman is a Registered Acupuncturist at Okanagan Acupuncture Centre, 1625 Ellis St in Kelowna, BC.