The most typical pain manifestation of appendicitis is migratory pain, which generally starts in the upper abdomen or around the navel, and in most cases moves to the lower right abdomen and becomes fixed within a few hours. During physical examination, the pain usually localizes to a fixed point in the lower right abdomen, typically at McBurney's point, although this can vary with the position of the appendix. However, as the condition of the appendix progresses, such as when it becomes purulent or even gangrenous, the inflammation worsens and the area of tenderness can expand. This is mostly manifested by symptoms of peritoneal irritation, which are generally indicative of the timing for surgery. In most cases of appendicitis where the diagnosis is clear, early surgical intervention is recommended, as surgery is the only cure. Most patients who improve with conservative treatment are likely to experience recurrence later on.