Where do you Feel Liver Pain? (Pain Location Diagram).

Our content is not intended nor recommended as a substitute for medical advice by your doctor. Use for informational purposes only.

Liver pain is different from “Pain in the liver area”. Liver pain is rare, and most chronic liver diseases are entirely painless.

The reason why most liver diseases are painless is that the liver itself is insensitive to pain.

Liver pain results from either rapid distension of the liver capsule (enveloping the liver as the apple peel) or infiltration of the liver capsule.

Common causes of liver pain include:

  • Acute inflammations of the liver (acute hepatitis).
  • Liver congestion (often due to congestive heart failure or chronic chest diseases).
  • Liver abscess or cysts.
  • Liver tumors (benign or malignant).
  • Portal vein thrombosis.
  • Budd-Chiari
  • Perihepatitis (Fitz-Hugh-Curts) syndromes.
  • Chronic liver diseases as fatty liver disease, chronic hepatitis, and liver cirrhosis RARELY cause liver pain.


Liver pain locations include (see the diagram).

  1. The right upper quadrant of the abdomen: is the most common site.
  2. The lower right rib cage.
  3. The right shoulder (referred pain).
  4. The mid-back area is to the right.

1. Liver pain in the right upper abdomen.

The right upper part of your abdomen is the primary area of liver pain. However, Several diseases and conditions can also cause pain in the liver area.

As we mentioned before, the liver rarely causes pain. Therefore, not every pain in the right upper abdomen is liver pain.

Liver pain is often associated with other symptoms of liver diseases such as jaundice, swollen abdomen (ascites), or swollen legs.

The two most common causes of upper right abdominal pain are gallbladder pain (Biliary colic) and colonic pain. So, don’t think of the liver as the primary cause of pain in that area.

The characters of liver pain in the right upper abdomen include:

  • Constant dull aching pain.
  • The pain increases when pressing on the liver area.
  • The pain can be very sharp in severe cases (as with liver cancer).
  • Also, The pain can be throbbing (pulsation or beating pain sensation), especially with a hugely enlarged liver and vascular obstruction.

Moreover, you have to know the difference between liver and gallbladder pain. The biliary pain often results from a stone or inflammation of the gallbladder.

Gallbladder pain (also called biliary colic) often comes as an episode of severe right upper quadrant pain (lasting about 30 minutes to a few hours).

The pain episode is often severe squeezing pain that disappears completely and may re-appear again. The differences between gallbladder and liver pain are in the table below:


Biliary colics

Liver pain

1. Location.

Usually, The right upper quadrant of your abdomen.Usually in the right upper quadrant (more diffuse than biliary colic).

2. Spread

– The pain may spread to the back of the right shoulder.
– Also, it spreads to the epigastric area.
– The right side of the rib cage.
– The right shoulder.
– The right mid-back.

3. Character

– In the form of attacks, it constantly builds up then disappears gradually.– Constant dull ache, often less intense than the biliary colic.
– May be sharp in severe cases as malignancy.
– Maybe throbbing (pulsating) pain.

4. Duration

At least 30 minutes. It may last up to 6 hours.Prolonged for days, weeks, or months.

5. Related to

– Triggered by foods (especially fatty food and large meals.
– However, it can start spontaneously.
– The pain is continuous, not related to food.
– Pressing on the liver area or moving may exacerbate the pain.

6. NOT related to:

Movement, bowel movements, nor the passage of flatus.– Not related to food, bowel movement, nor the passage of flatus.

7. Nausea

Often Present, severe.Mayor may not be present.

8- Commonly associated symptoms

Vomiting, sweating during the attack, and nausea.There are jaundice, dark urine, swollen lower limbs, swollen abdomen (ascites), coma, and weight loss.

The complete list of the causes of right upper quadrant pain (Other than the liver)

  • Biliary colic (often due to gallstones).
  • Acute cholecystitis (Acute inflammation of the gallbladder) and its complications.
  • Acute cholangitis (inflammation of the bile ducts).
  • Sphincter of Oddi dysfunction.
  • Irritable bowel syndrome.
  • Gas pain.
  • Abdominal muscle pain.
  • Lower right rib cage pain.

2. Liver pain in the lower right rib cage.

The liver lies mainly under the ribs; We only feel the liver under the costal margin when enlarged.

So, the liver pain is felt under the ribs in both the front and the lower right side of the rib cage.

Other causes of pain in this area include:

  • Pleurisy: Inflammation of the lung envelope (called the pleura).
  • Lung inflammation (pneumonia) involves the middle and the lower right lung lobes.
  • Lower right lung abscess or tumor.
  • Rib cage pain (chest wall pain at the right side).
  • Intercostal muscle strain.

3. Right shoulder pain (due to pressure on the nerves under the diaphragm).

This type of pain occurs in advanced diseases such as large-sized liver tumors. In such cases, The enlarged liver press on the nerves supplying the diaphragm.

Irritation of the nerves supplying the diaphragm is often referred to as the right shoulder. However, mild cases of liver pain often don’t cause right shoulder pain.

Also, please note that gallbladder pain is referred to the right shoulder.

So, the right upper quadrant, referred to as the shoulder, is more suggestive of gallbladder diseases, especially if you have no other symptoms of liver affection.

4. Liver pain in the back.

Less commonly, liver pain can be felt in the right back. This area can be confused with kidney pain and vertebral column pain.

Liver Pain in the back is often accompanied by the classical right upper quadrant pain and other symptoms of liver affection (jaundice, light-colored stool, abdominal and lower limb swelling, etc.).


When to see a doctor for liver pain?

See a doctor if you have:

  • Unexplained pain in the liver area.
  • Jaundice (yellowish discoloration of the sclera and the eye whites.
  • Swollen abdomen or lower extremities.
  • Fever or chills.
  • Dark urine.
  • Nausea or vomiting.
  • Vomiting of blood or passage of dark stools.