COSTOSTERNAL CHEST PAIN

ANATOMY

Costosternal chest pain - in the joint between the rib and the breastbone - is the most common cause of "non-heart" chest pain. Chiropractic treatment of this breastbone pain is built around a thorough understanding of the anatomy of the chest.

The costo-chondral cartilage (see pic below) is the cause of one third of patients complaining of chest pain in one hospital's heart clinc - THE MOST COMMON CAUSE of non-heart chest pain.

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PREVALENCE

• In the emergency department, approximately 10 to 15 percent of adults and 23% of children presenting with chest pain have a musculoskeletal breastbone condition, like Costosternal Chest Pain.

• In one large study 11 percent of adults presenting with chest pain were felt to have a costo sternal cause. The incidence rose to 26 percent in those patients considered at low suspicion for myocardial infarction, making this THE MOST COMMON category of non-cardiac chest pain in this setting.

• In an emergency department study of 122 consecutive patients, 30% were felt to have chest wall tenderness due to a costo-sternal syndrome. In 17, the tenderness reproduced their pain. (NB. Two of these patients had acute myocardial infarction, indicating that chest wall tenderness does not exclude the presence of serious coronary disease.)

• In a study of 250 patients hospitalized for chest pain, 23% of the non-cardiac patients were felt to have a Costo-sternal (musculoskeletal) cause.

• In a review of 399 episodes of chest pain evaluated in primary care practice settings, 36 percent were categorized as costo sternal (musculoskeletal) in origin, making this the most common diagnostic category.

From the Coalface

On further questioning about conditions, he spoke of the frequent debilitating pain in the chest - pointing directly over the costo (rib)- sternal (breast-bone) joints.

He was clearly a non-heart patient. Young, strong, non-smoker with low blood pressure. In any case he had been medically assessed.

Whilst the condition has not completely abated, he reported that within a month of starting treatment that the pain was at least 80% better. It does rear its ugly head occasionally, but abates now of it's own accord. He comes for management of his chestpain and headaches about once in 6 weeks, which keeps it under control. We are not going to cure him, alas. But he is well pleased.

In an average primary care clinic, at least one third of patients complaining of chest pain, have this costo-sternal pain syndrome.

For more information on heart-related chest pain, click here … CHEST PAIN

More anecdotes from the CHIROPRACTIC COALFACE ...

Tietzes syndrome

USEFUL LINKS: Chiropractic RIB PAIN TREATMENT

Costosternal chest pain

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