Costochondritis

After a journey that began the first week of February, this past year, and with declining health, I hope by sharing some of my story to help those of you that have been diagnosed with Costochondritis.

I developed inflammation in my abdomen that led to a small bowel obstruction and major surgery at the Cleveland Clinic. Before diagnosis there were repeated trips to the ER with crushing, burning pain in my chest, yet no tests revealed the source of pain. I was convinced it was my heart.

For five months doctors searched for clues as my bowel obstruction worsened until I had surgery at the end of June. I had spent months losing weight and vomiting, and the chest pain was continuing to spread.

Surgery corrected the obstruction and stopped the vomiting, but shortly after I developed shortness of breath. I would start shallow, fast breathing, struggling until I could take a deep gasp, and the shallow breathing would return. At a second post-op follow-up I told my surgeon I realized it was being triggered by my bra. He didn't understand why, but made a referral to a new gastroenterologist hoping to get to the bottom of my ongoing pain.

By a thorough examination by my new GI he determined the source of my pain (but not the cause) and referred me to a chronic pain management physician, and I was diagnosed with Cosochondritis. By this time it was early November. I had been subjected to one test after another - all coming back normal. During the exam the CPM doctor noticed I was wearing a sports bra and he asked if I had traded in my under-wires for sports bras. I had. Under-wires had become too painful. He said this is one of the first indications to a diagnosis of Costochondritis - women changing their bras because of pain. By gently pushing on the cartilage that connects to the rib cage he was able to make the diagnosis.

It's not a common condition, and one doctors tend to overlook. It can be brought on by vomiting, coughing, the flu, or chest wall trauma. The pain has been debilitating, but for the first time in months I'm being provided some much needed relief.

I'm using a TENS meter - it provides electrical stimulation using four electrode patches placed on my abdomen at the most acute source of pain. The interruption of pain as been nothing short of remarkable.

I'm also wearing a Flector patch - it's an NSAID patch meant for acute muscle pain. It's one patch every 12 hours and it helps to reduce the inflammation.

I'm also starting physical therapy in a warm water pool to restrengthen my abdominal wall, hopefully to put an end to this. Months of pulling in on myself and hunching my shoulders in an attempt to reduce the pain has aggravated my condition more. The muscles where my ribs attach to my spine have become frozen and I have acute attacks of pain at night if I fall asleep on my back because it over extends the front muscles, cartilage and sternum.

For those of you that are seeking answers there is help. Costochondritis can be chronic or acute - short term or ongoing. Doctors may say it's not a cause for serious concern, but the ongoing pain takes it's toll in the form of depression, fatigue, and restriction of your normal day to day routines.

I hope this has provided some answers, and you know you are not alone, and there's hope.

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14 replies. Join the discussion

Hello DebiSue - quite a remarkable story! Medicine is often like a detective novel, a process of eliminating what the problem is NOT in many cases.

I too am wearing a TENS unit every day, dawn to dusk, recommended by my cardiologist and my Pain Clinic specialist for chest pain due to inoperable coronary artery microvascular disease, after a round of cardiac meds that didn't touch the chest pain.

The TENS unit is amazing - as you say, "nothing short of REMARKABLE!" I am puzzled by how few of us are being prescribed this therapy for pain management of all kinds. My friend's son who is a dentist says he has even started using TENS therapy for his patients with TMJ pain.

Like costochondritis, microvascular disease is not considered life-threatening - a description that COMPLETELY MISSES THE POINT when one's quality of life is affected every single day.

The Pain Clinic has also referred me to a series of Health Recovery program it offers its clients, free of charge: Tai Chi, Meditation, Yoga, etc. All good for the body/mind effects of ongoing pain.

Good luck to you - Happy Christmas!

XOXOXO

http://www.myheartsisters.org

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Hello, my costochondritis pain was in the bottom of my rib cage. The pain was bad and when you touched it I went through the wall. I was told that I had a hot gall bladder. Tests after tests. Finally after a surgeon examined me he told me the problem. It still comes and goes. The way I understand it is arthritis of the rib cage and I have it a lot worse on the right side with knots on both side of my rib cage. I have tried Tens for arthritis of the back and it did not help me. I am glad it is working for you. I know it can be very painful. Merry Christmas

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Dear DebbieSue,

I am suffering from a bout of costochronditis for the umpteenth time as we speak. (Once you've had it, it's very easy to do again.) A week, or so, ago we had a terrible blizzard here where I live on top of freezing rain, and -20 wind chill factors. My car door was totally frozen shut. So I gave it a major body slam to try to break it loose. I'm afraid, however, the door slammed me! It knocked the wind right out of my sails, I just about puked, and for a few hours I thought I might have broken a rib. I really must remember that I'm now 63 and body slamming car doors has GOT to be removed from my agenda.

You had complications with bowel problems so it would, indeed, be difficult to isolate your pain. I have found, however, that the best treatment (for me at least) is muscle relaxants, heating pad, and rest rest rest. I'm talking months of rest. No heavy lifting of any kind. It takes longer for a muscle to heal than a bone and if you do not treat yourself with tender loving care it will spread and you will continue to make it worse. We have had several women on this site before who have thought they had heart problems as a result of costochronditis.

I am a massage therapist and I know a few tricks. So if you want to discuss it further, other things you can do, and how to discriminate between heart and muscle spasm symptoms let me know.

In the meantime don't cough--oh, no, no, no, you DO NOT want to cough. And don't even consider laughing. OMG! THE PAIN! But I'm a'achin' right alongside ya' here sista'. OUCH!

May the Blessings Be!

Sherrie

P. S. And you might want to reconsider watching Ellen. She can make you laugh so hard that you want to just die!

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DebbiSue,

Any idea whether people who have osteoarthritis are more prone to this ?

I actually felt pain on my rib cage when i exercise and was wondering what it was..there is so many different kind of pain after CABG...i sometimes don't know what it is, where is it and what do i do about it... Very confusing.

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I've just seen these replies! I've checked the Inspire site and never saw them, but by deleting emails I saw there were posts. Sorry!

Malaygirl, I don't know if there's a connection between osteoarthritis or not, but a previous reply referred to it as "arthritis of the rib cage."

@ Sherri: Apparently costochondritis is a common cause of ER admissions for people thinking they are having a heart attack.

Mine has recently grown more severe and is encasing my entire rib cage and into my spine. I'm undergoing some pretty intensive warm water pool therapy and it seems to be helping, but now I'm feeling a bit nervous. I would need several TENS units to block the pain I'm in.

I also seem to have recently developed allergies with constant sneezing and coughing. My doctor has put me on two inhalers and steroids with very little effect. I was violently ill for the past year, had extreme weight loss, and my immune system was battered from malnutrition. As my health is slowly improving I'm hoping these reactions stop.

Laughing?!? A friend made me start laughing hysterically on Friday and you're right - OMG! In the end - NOT so funny!

@ Kennarina: I agree about the TENS unit. I was scheduled to start a series of celiac plexus blocks, but I'm high risk for the procedure because of my medical history. Such a simple device that provides remarkable relief for a lot of people. I too, have a friend who uses one for TMJ pain.

Sherrie, I'm open to any suggestions you may have. I spend my nights with a heating pad, but now that this is involving much more and spreading I'm going out of my mind. (BTW - the new heating pads all have a two hour shut-off which is making me crazy and waking me during the night to turn it back on!)

Thanks everyone for your replies.

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Malaygirl, By hooking your finger under your lower rib cage, just about three inches from the center of your sternum, and applying pressure up on the cartilage will give you a good indication if it's costochodritis. The pain can send you through the roof!

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OK DebbieSue, here ya' go--

1) No bra at all. If you've got some big boobies, prop them up with some sanitary napkins and then tape them down if you have to so they are not flopping around. (Definitely not a problem of mine even after 10,000 Hail Mary's.)

2) Feel around your rib cage pushing with your fingers toward your sternum until you can find the exact spot. It will usually feel like a bruise, or start to spasm. You will know when you have hit it.

3) Take a pair of panty hose and loosely tie it around the place where you find the sore spot. Usually this will give you immediate relief from spasming.

4) Take muscle relaxants. Flexeril works. (Plan on doing some sleeping.)

5) Make a heating pad out of men's long white cotton sport socks. Fill one with a pound of ordinary rice (you will probably need a funnel or to invent one). Tie a knot in the top of the first rice-filled sock. Turn that sock upside down into another sock. (A covering that you can wash.) If you want moist heat, soak and then wring out a small hand towel or a dish towel. Wrap around sock. Place in microwave for no more than 4 minutes--unless you like popped rice or plan a future as a firefighter. Nice heating pad you can carry around with you and reheat as necessary. Be VERY CAREFUL! HOT!

6) Got to CVS, Rite-aide, Walgreens, Walmart, etc., where you can find heated waist/back bands. They are not terribley expensive 2 or 3 for $5.00. You can only heat them once but you can use them over and over. They are made of some kind of paper and small rubber band kind of thingies. Just wear them until they shred. You can also use Icy Hot or Chinese Tiger Balm (the best.) You may need to go to a health food store or a Chinese grocery to find it. These bands are generally just enough to hold the muscles in place and to prevent them from spasming without causing you to stop breathing. After all, you should probably go on breathing.

7) And rest. There is nothing to do but rest. Rest. Rest. Rest. It is probably spreading across your diaphragm. It takes a long time to heal. You have no other choice. After about 3 or 4 days of straight muscle relaxants, the muscles should naturally fall back into place and the pain should ease up. But you still must be very careful or you will just re-injure it.

8) Dress very warmly of you must go out in the cold. The cold makes it worse because you tense up in response to it. But you can even heat up your sock and stick it under your coat if you have to.

I've still got it here. I need to take my own advice. I temporarily forget about it and then WHAMMO! That's the problem--the pain eases up and you begin to forget about it. Lift something heavy or slam a car door and you are back to Square One.

If it's really spread, I'm telling you it can take 6 months to heal. It's a real bitch! So be nice nice nice to yourself and if you have help, take it. Let husband/kids carry in the groceries. No deciding to change all the furniture all around or cleaning behind the refrigerator. You will just have to learn to be a slob like the rest of us for a while. A long while.

If I can help you further, let me know.

Still spasming right along with you,

Beamie

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Dear DebbieSue,

I just read your profile and checked out your photo. (Very pretty woman!) My first thought, before even reading your profile was, "She's small like me."

BEFORE I read about your intestinal problems and that you have lost weight!

I LOVE your comment to you doctor, "So if it's rare it can't happen to me?"

My daughter's co-worker, aged 31, a brilliantly gifted artist, was recently diagnosed with stomach cancer.

So rare in young women, that it couldn't POSSIBLY be that! Now she will probably die. I can tell you she is going to Hell trying not to!

Ask your doctor about a prescription for Nutren 1.0. If you get a prescription, it will be covered by insurance/Medicaid and delivered right to your door.

You need to put some flab back onto those skinny spasming ribs!

But take my word for it, praying all the rosaries this side of the Mississippi is not going to get you some big boobs. Forget the sanitary napkins, forget the tape. "Suck Up, Buttercup"--it just ain't gonna happen.

May the Blessings Be!

Beamie

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owweeeeee! Costochondris is something I dread almost more than heart attack. I've had 3 or 4 bouts of it. Starting at age 7. Stopped wearing bras 4 years ago because I can't stand any pressure. Have found layering tees and camisoles works well w vests to dim those 'headlights' when out in public. : )

Debisue,
If you can stand it......I go for an extensive neck and back massage about once a month. The massage table is deliciously heated. I'm not sure my ribs would ever unclench on their own. Even swimming doesn't help unclinch my back ribs completely. Love my massage therapists....they work miracles and I always leave breathing fully and easily. Chair massage might be a better option for you at this stage.

take care and hang in there,
Jaynie

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Sherrie is right about the long healing times. Even just having costo on both sides of sternum where ribs attach took 11 weeks before I could move without searing pain. As a child I was beset with racking coughs all winter long.

Jaynie

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I am having chest pain right under my sternum. Feels like bigfoot is standing on my chest when I exhale at times. Nausea and SOB. I just saw my doc today and he feels it is musculoskeletal ( EKG normal )... Plus I've had a basic cardiac workup in the last few years....last stress test April 2010 normal. I also have some tenderness in the upper part of my right rib cage below my armpit. Is this what you are speaking of as costochondiritis?

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As they say in Jaynie's neck of the woods, "Yes, Maaaam!"

Jaynie--you are one to talk. Do you realize what you and Kennie together have done, in just one day, to re-activate my costochronditis?

As mentioned above: NO LAUGHTER!

It'll kill ya'!

You both owe me rice packs, panty hose, and massages--BIG TIME! And throw in some Chinese Tiger Balm while you are at it!

And I intend to collect!

OOOOOOOWWWWWWWIIIIIIIIEEEEEEEEE!!!!!!!!!!!!!!

Beamie

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All of you are wicked! I can't stop laughing at the comments!

I'm definitely going to try the pantyhose trick! I've taken to wearing camisoles and giving up bras too, while trying to dim the headlights! Chinese tiger balm - I used to live in Bangkok and always had it in my purse. The Thais would rub it on their temples for headaches. I know where to pick it up here too - I love the smell of it - the good kind is really spicy.

Suzyq40 - it sure sounds like it could be - and yes - the pain is crushing. My chronic pain management physician hooked his finger up under my rib, which sent me to bed the rest of the day with a heating pad. I had warm pool therapy yesterday and the costo is flared more in my ribs on the sides under my armpits, than more than anywhere else today.

I'm re-reading the suggestions. Thank you to everyone for your input and ideas. I'm ready to try all of them.

I've also got to check out my profile. I don't recall what is says! It's been a long journey since I first was on this site!

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Oh, Beamie...rare...I'm sorry about your friend. My journey that began a year ago in February has been a harsh lesson in the realities of the medical field. We know our bodies, yet time and time again doctors don't hear us when we speak.

I re-read my profile. That was right after surgery. I have no idea how I managed to post it. The quick return of pre-op symptoms revealed I have SIBO disease. It's most likely the underlying cause of all I went through. I got hit with 3 rare conditions at once. I was being dumped by one doctor after another and came very close to dying. By the time I had surgery at the Cleveland Clinic I could only get down 500 - 800 calories of Ensure a day.

I'm slowly on the mend, and have managed to put on about 7 pounds. With the malnutrition I suffered, I lost a lot of muscle mass - so to you Beamie - I AM FLABBY - and sagging and skinny! That's just not fair. (BTW- I love your sense of humor - it's right up my alley!)

Now...back to costochondritis...OUCH...laced with a lot of profanity it more accurate.

Alright...I'm headed to bed with my heating pad. To all of you who have replied - thank you. It's an ugly condition, but it's good to know I'm not alone.

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