Chronic Pain, 3+years Tietzes or Costochondritis?

by Melissa

Thankyou for the opportunity to discuss my ongoing pain. My question is what would you suggest as treatment for me? I have a lovely Chiropractor who is willing to follow a program if I suggest it. I have avoided visiting him as of late due to feeling worse after a lumbar back/hip adjustment.

I am a 38 year old female, wife, and mother of two young children. My Tietzes began in July 2011 after a very strong chest infection that went to Pneumonia. Treated with antibiotics. I have had random episodes with short sharp chest pains, visited the ER and had ECG monitoring, other tests etc. was sent home both times and told I was having panic attacks. It's been a rollercoaster of pain ever since.

Some days are better than others, but always the worst at night. I need to sleep on my stomach every night as it is the only way to avoid the stabbing pain. Heat packs can help.

Fast forward 3+ years later, my primary care doctor is really great and has exhausted his avenues with tests and medications to try. My Rheumatologist diagnosed me with Costochondritis and said unfortunately it is linked with my Fibromyalgia and possibly will never improve.(I'm not willing to accept this!)

I do take Ibuprofen which is the only drug that helps a little. I have tried oral Prednisolone twice which makes me very unwell but persevere to take the whole course on the chance it will clear the costo. Then several rounds of xray guided and unguided cortisone injections by Rheumatologist and Physician directly into the costal joints. So very painful and I also have a drug reaction to these. I have found the cortisone drugs simply do not help me for this condition.

I have had several chest xrays, a chest cat scan, spine and neck cat mri and two bone scans (for other health issues too...I have Trigeminal Neuralgia bilaterally which is a terrible indescribable thing to live with, lumbar L4 and L5 S1 disc herniations, right foot plantar fasciitis, and diagnosed with Fibromyalgia; need a new body!! lol).

The bone scans were both showing contrast had settled in my costal joints. Consistent with Costochondritis.
Physically I am having trouble sleeping with the flares of aching stabbing and burning pain, this past 2 weeks I have had ongoing aching and stabbing pains especially at night. Even during day naps I have a conscious feeling of a burning aching pain in my ribs back and especially my sternum.

I have only had 3 physical hands-on examinations of the area and each time the doctor involved has agreed there is swelling and palpable lumps. They are reluctant to hands-on examine me. The swelling seems to be getting worse over time. It is so painful to touch at times and the sternum feels very swollen to me, as though it is pointing sharply inwards. I am so surprised this does not show on any xray or scan I have had.

Thankyou for reading this far. Hope you can reply with suggestions for my Chiropractor, I hope to find a way to move forward in my treatment.

Hello Melissa,
The one thing that is encouraging is that your history is remarkably typical of those suffering from Tietze's syndrome. That makes it easier to treat. The only aspect that is missing is indigestion and heartburn. Do you have them too?

Firstly, you have able a generalised inflammatory condition of your whole body. That means you probably are on a diet with high omega-6/omega-3 ratio. Radically decrease the omega-6 oils in your diet (sunflower, corn and soybean are the most common) by changing to olive oil, and increase the omega-3 oils. That means more fatty fish and freshly ground flaxseed.

Secondly, get on to an anti inflammatory diet. Avoid all foods made with white flour and sugar. Perhaps even start making your own whole grain flour bread. Make sure you are getting plenty of salad, fruit and veg. The chilli family oddly is strongly antiinflammatory.

Thirdly, take a block of ice with you to the shower, and give yourself an ice massage directly over the painful joints, alternating with hot water.

Fourthly, after your shower, take a little cream and gently massage with your index and middle fingers, starting at the breastbone with the painful rib between your fingers, and moving towards your breast. Has the collarbone-sternum joint been affected?

I've worked out a chiropractic protocol that will improve this condition, but alas won't cure it. Would you be happy with say 50% less pain and a monthly chiropractic visit? If so, ask your chiropractor to contact me via Contact, and we can talk about it on Skype.

If you have a visible, palpable lump, I'd appreciate a photograph. You have to get the light just right so that it can be seen.

There's hope Melissa, let's see where this all takes you. Perhaps nowhere, you'll be healthier for it anyway.

Dr B

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