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Slipping Rib Syndrome - any info?
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wonderwoman


Jan 31, 2006, 8:30 PM
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Slipping Rib Syndrome - any info?
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So here I am self diagnosing myself after a truly frustrating visit to urgent care resulting in a chest x-ray and a 'You have asthma - it's going to hurt for you to breathe sometimes' pep talk from a doc who insists the remnants of athletic adhesive stuck to my back is really tattoo removal.

About 2 weeks ago I started getting a random stabbing pain in my right side when I inhaled along with chest pain. I could also feel something rubbing together inside my chest while I was breathing. I did the sensible thing and called my doc (who I have not met yet because I have a new primary care physician since my old doc moved on) to tell her that it is hurting me to breathe. When I tell her that I don't have a fever, she says that she can't see me for 4 weeks, but if I do develop a fever or start spitting up blood to go directly to urgent care.

Every day I had had a little bit of pain in one way or another. Sometimes it lasted for over an hour. Sometimes it went away when I got up. But it was the same pain only inconsistent when it came and went. Last night I woke up gasping for air, and this morning when the pain came with dizziness (maybe I was freaking out by now after 2 weeks of painful inhalation) I decided to go to urgent care to meet an unhelpful doctor who just tells me 'people with asthma have a hard time breathing. No Duh!

Anyway, as much as this guy wasn't getting that I don't usually have pain when I breathe (that's why I came to urgent care in the first place) I found this on the internet:

Initially the symptoms may feel like those of a heart attack: pain moving from side to side of the chest and to the arms and neck. Some sufferers find it more difficult to breathe, but there is usually no reason for alarm when the cause of these symptoms is costochondritis. The cause of this condition is generally unknown but it can be the result of trauma to the rib cage, a viral infection or part of an inflammatory disease.

During the acute phase, pain is usually worse and it hurts to breathe, wear a bra or move suddenly. Eventually the pain subsides to a dull, constant ache or tenderness in the ribs.


This is my pain. So, my questions are: Will this show up in my x-ray? Will this heal soon? And can anyone in the Boston area recommend a good doc?


majid_sabet


Jan 31, 2006, 11:53 PM
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In the past 5 years, I been getting this pain on the center of my rib cage which comes and goes, my Doc said, it is climbing related. If you are a active climber, your body does ok but once you slow down or stop your regular climbing, mussels starts to pull every thing back to its original position, making things tighter, so yours may be similar to what I got which includes sharp pain when I breath hard and pain on the left side of my chest.


catbird_seat


Feb 1, 2006, 1:03 PM
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It's not clear to me whether you have a prior diagnosis of asthma or not. Also, have you had any recent or past trauma to the rib cage.


wonderwoman


Feb 1, 2006, 1:32 PM
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In reply to:
It's not clear to me whether you have a prior diagnosis of asthma or not. Also, have you had any recent or past trauma to the rib cage.

Yes, I was diagnosed a few years ago as having excercise induced asthma. But I had a very active summer and managed to avoid using my inhaler the entire time. No problems breathing up until now.

No, no trauma to the ribs.

Maybe I'm spending too much time dangling from a rope that's lost all it's stretch. Or maybe I'm just getting old! :cry:


harmonydoc


Feb 1, 2006, 1:48 PM
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Costochondritis won't show up on an xray. Here a fairly decent overview:

http://www.emedicinehealth.com/articles/5058-1.asp

If it's costochondritis, you should be able to reproduce the pain by pressing on the chest.

Like most symptoms, intermittent chest pain on respiration has a long list of potential associated diagnoses. If it continues to bother you, be persistent until you find a doctor that will do a detailed enough history and physical exam to figure out what is going on. Good luck!


aerili


Feb 1, 2006, 8:15 PM
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I had costochondritis once...came on one morning for no reason when I woke up. I imagine it can come on to different degrees, but mine was agonizing, stabbing pain in my chest--so bad that it was interfering with my speaking abilities; I called my doc and she said to call 911 right away and go to the ER.

Nothing showed up on X-rays as stated previously... Basically it seemed like a default diagnosis since nothing could be established. They gave me NSAIDS and sent me off.

It gradually got better that day and the next, although I was protective of certain movements that affected the musculoskeletal region there for quite some time....maybe 6 months? It didn't really hurt all that time, I just could feel that it hadn't healed yet.

The only other things I can think of would be pleurisy...but you probably don't have the symptoms for that or some climbing doctor around here would have suggested it. It's an inflammation of the lining of the lungs and can be quite excrutiating and often felt during inhalation or exhalation.


Partner pt


Feb 1, 2006, 8:44 PM
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I treat people very commonly with costochondritis or a costo-vertebral joint dysfunction. Usually pain with deep breath, coughing, sneezing, rotation of the thorax, and should be reproducible with direct palpation to the spine where the rib hooks on or along the rib at your side or under the armpit. Pain can be very sharp and stabbing with provacative movements but then will calm down to a dull aching type pain. IF your heart/lungs have been cleared by the MD's, have a skilled manual physical therapist or reputable chiropractor look at you. If the problem doesen't resolve with a few months it can become a chronic pain problem and is difficult to treat. A true rib dysfunction that has not been present for too long should get better with a few weeks.


dukeandbeads


Feb 1, 2006, 8:47 PM
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Okay, let me get this straight...No cough? No recent viral infections? It began as a right sided anterior chest pain, or was it on the side of your rib cage?

Costochondritis is along the border of your ribs where they connect to your sternum. Pressing on this area should reproduce the pain. Xrays won't detect it. Treat with anti-inflammatories and rest.

Pleurisy can feel like "friction" when you breathe. Won't always have a cough. May or may not be seen on chest xray (docs, do you concur with that?) May be a diagnosis of exclusion. Usually treat with anti-inflammatories.

Rib dysfunction? May not show up on xray. Usually after an injury, but you may not remember the injury because it may not have hurt at the time. Treatment--find a good chiropractor to get the rib back in place.

You really need a good history and physical exam. Forums are tough places to get an accurate diagnosis. I just don't like that you wake up gasping for air...doesn't sound like asthma to me if you haven't had a cough. A pulmonary function test may be in order, though, if nothing else seems to fit...

Good luck, and get well soon!

Anne


harmonydoc


Feb 2, 2006, 8:18 AM
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Pleurisy can feel like "friction" when you breathe. Won't always have a cough. May or may not be seen on chest xray (docs, do you concur with that?) May be a diagnosis of exclusion. Usually treat with anti-inflammatories.

Right, you shouldn't see the inflammation of the pleura (lining of the lung) itself on chest xray. However, sometimes there is an accompanying collection of fluid (pleural effusion) in this condition that would show up. Also a health practitioner might be able to hear a sound called a "friction rub" on listening to the lungs.

Pleurisy: http://www.emedicinehealth.com/articles/17644-1.asp

Another one of many possible differential diagnoses. Impossible to suggest the best one without a thorough history and physical.

Oddly enough, I think I have a mild costochondritis myself right now ... pain reproducible on palpation of the anterior chest wall and with deep breathing. Taking ibuprofen. It's been 2-3 weeks, but it's not interfering with my daily activities so I'm not too concerned.


craftedpacket


Feb 2, 2006, 9:47 AM
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I had this problem for about a yaer when I was younger. When I would breathe in I would get a sharp stabbing pain in my lower ribs on the left side. I would breath in really deep and feel a popping sensation...and then the pain would go away for a day or so...only to rinse and repeat. Doesnt happen anymore though. I never saw a doctor about it.


fishbelly


Feb 2, 2006, 10:30 AM
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Initially the symptoms may feel like those of a heart attack: pain moving from side to side of the chest and to the arms and neck. Some sufferers find it more difficult to breathe, but there is usually no reason for alarm when the cause of these symptoms is costochondritis. The cause of this condition is generally unknown but it can be the result of trauma to the rib cage, a viral infection or part of an inflammatory disease.

During the acute phase, pain is usually worse and it hurts to breathe, wear a bra or move suddenly. Eventually the pain subsides to a dull, constant ache or tenderness in the ribs.

Had problem for years. Took a kick to the back of my rib cage while sparring. I was in the Navy at the time . Few months later the symptoms you described. The ships Doctor and others after my discharge would treat me for congestion. A few years went by my family doc moved. I had a flair up. The new Doc was also the wrestling teams trainer. He identified , diagnosed and treated me in 2 minutes. Gave me some stretches to-do. no prob now 20 odd ( some very odd) years later

Find some one in sports med.. I also have allergy problems witch may lead to my family Doc. toward the original diagnoses

Your family physician should be able to refer you to some one.

.


wonderwoman


Feb 3, 2006, 5:28 AM
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Wow - Thanks for all the feedback!

Well, no one called regarding the x-ray so I assume there is nothing to report. They said someone would call within 24hrs if there was anything suspicious in the x-ray. Follow up visit with my doc on Monday.

I have laid off climbing all week and feel better. Still getting the occassionally stab and less of a feeling of my ribs rubbing together when I lay on my side.

I think I am going to do some easy top roping tonight at the gym just to do something with myself. Maybe some downclimbing and foot work.

I am wondering if this is my body is reacting badly too many non-soft catches because of an old rope. I mentioned this to my husband yesterday, and he thought I was crazy! But the urgent care triage people did ask if I had recently experienced being caught short in a seat belt. That's kind of like taking a fall on a static rope, right?


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Feb 3, 2006, 6:37 AM
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Go to the Chiropractor.My rib "pops out" every couple of months. Sharp pain through the chest. Most can fix this for you easily.

Tom


justthemaid


Feb 3, 2006, 7:03 AM
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I normally think chiroprators are quacks, but I second Tomcat's suggestion.

I had similar problems for over a month, and it turned out two of my ribs were slightly dislocated. I was totally shocked when ONE $40 visit to the chiropractor fixed a month of chest and back pain.

Popped and dislocated ribs are common for climbers, and (at least in my case) caused a whole host of symptoms that didn't make it obvious it was a rib problem.


akornylak


Feb 3, 2006, 7:30 AM
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Wow never realized how common this was.

I had that problem for a couple years - diagnosed as Costochondritis also. Every so often I would feel a tension and sharp pain near my sternum that was very uncomfortable, and finally it would "pop" and relieve the tension. Sometimes it wouldn't relieve the tension and would be extremely painful (and scary). One morning I passed out from the pain and decided to see the doctor. When a mid-20s fit male comes in complaining of stabbing chest pains you get some attention!

This was when I was training very hard, and it gradually went away about the same time I got smarter about training many years ago: stretching properly, warming up, taking rest days, and especially working opposing muscle groups in cycles to battle what was surely a muscle imbalance in my upper back and abs. Also, working on my resting posture and breathing! It makes sense.

Obviously, see your doctor, but I think collective wisdom can be helpful with these kinds of things as well!

Good luck.


wonderwoman


Feb 6, 2006, 8:03 PM
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Well, as far as the doc can tell, costochondritis it is. Heart and lungs appear to be clear. X-Ray did not come back from the hospital yet, but we are both calling tomorrow. Pain is in the sternum, hurts when I inhale, no fever, blah blah blah. The good news is, it's getting better and it doesn't look like my lungs!

I have decided to take 2 weeks off (and have a follow up appt in 2 weeks). I did try to climb on Friday, just some easy stuff, and decided it wasn't going to work out after doing 3 climbs. I paid for it big time the next day and alternated between ice and heat on my chest all the next day.


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