Pain after anterior sternum/chest adjustment


First I need to mention that I had breast cancer 7 years ago at age 40 (BRCA1), and had a double mastectomy and implant reconstruction. From what I understand, some muscles run over the implant, and there is very little "tissue" in my chest area left.

I had a workout injury a couple weeks ago: an intercostal rib sprain. This past Monday, 5 days ago, I went to see a friend recommended chiropractor to see if he could help the healing go a little faster. He was super aggressive. One of the things he did was an anterior chest wall, sternum type adjustment. It was painful.

Immediately afterwards he looked a little scared and said something like "that was very different than anything I have ever felt". He said to expect some soreness, and I did - pretty intense for like 48 hours.

But now 5 days later, it is still hurting quite a bit. Low-grade constant pain when not moving, and intense pain if something like hiccuping or using certain muscles in the area; for instance I was carrying a bottle, almost dropped it and moved quickly but not too much to catch it, and it hurt like crazy. Even coughing, laughing, or talking loud hurts.

I saw my GP the next day, and we had decided to wait it out a bit before subjecting myself to radiation or scans, treatment for anything broken would be the same anyway, so why do unnecessary radiation?.

Do you have any knowledge of issues that could arise with a situation like this? Any thought on how long this pain could last, or suggestions for what to do?

Thanks so much.

Hello Dana,

Breast amputees are vulnerable to a condition called Tietze's syndrome. It affects the joints with the sternum which become painful and sometimes swollen. Vigorous manipulation aggravates it, particularly if done heavily in the midback.

The manipulation obviously didn't cause the problem, but it seems may have aggravated it.

Increased pain, or drug reactions, occurs all the time with all treatment; it's known as iatrogenic or doctor caused disease. The usual way is to face the practitioner squarely that he has increased your pain. Yours is a scenario that occurred in my office until I got interested in Tietzes syndrome after increasing several patient's pain. That's if you choose to go back.

I'm afraid that the prognosis with Tietzes syndrome is not great if untreated. Do you have a visible lump over the joint? If you press on the rib breastbone joint is it painful? Of course, I'm speculating about Tietzes, but it does sound typical.

I have evolved a treatment that works pretty well; if you want to ask your chiropractor to contact me, we can discuss the nuts and bolts of it; is the kind of guy who will listen to you, and work with me? Or a know it all?

Meantime start using alternating ice and heat over the joints involved.

I hope this contributes.

Dr B

PS. Sorry to be blunt but have you made a radical lifestyle change since the cancer? If not if will come back. In particular, research fingers hormone replacement treatment and animal protein; start using legumes like chickpeas, hummus, tofu and lentils for your protein. Use the Sitesearch facility to find out how to make your own hummus; it's very easy. Good luck.

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Interesting challenges of the day

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Despite a hectic job, she wisely took my advice and stayed home for what I call exercising bed rest.

4. Mr S has had lower back, groin and back of thigh and calf pain for fourth months.

He has a pincer deformity in the hip causing the stabs in the groin, and a degenerative facet causing the sciatica. Both are responding well to chiropractic and he is well pleased; sixty-five percent better after three treatments.

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6. I too have had serious lower back issues, luckily fixed by my own chiropractor; so I too have to do my exercises, take care when lifting supers full of honey, gardening and using the chainsaw. Regaining the function of your spine is just as important as the pain.

7. My own granddaughter, only 7 is hypermobile giving her pelvic, knee and ankle issues. X-rays show a mildly dysplastic hip. Years ago we would have called it growing pains. She too regularly needs chiropractic care and luckily responds well. Increased range of motion is more difficult than too stiff in my opinion. Our care is for kids too.

8. This 65-year old lady is a serious gardener; every day she is bending, lifting and digging for 2 to 3 hours a day. It regularly catches her in the sacroiliac joint, so she has a treatment once a month that sorts it out. She does her lower back exercises faithfully.

9. This 88-year old lady is an inspiration; every day she is busy in the community. With a nasty scoliosis she manages very well with a chiropractic adjustment every six weeks and exercises faithfully done. 

10. Mr X is a 71-year old retired man who wants to continue with maintenance care every six to eight weeks; he had suffered from two years of lower back pain when he first came a few months ago. He has no discomfort now after 8 chiropractic treatments, but is aware that danger lurks.

11. Mrs C has been having severe headaches, and taking a lot of analgesics. It is a non-complicated upper cervical facet syndrome, and she is doing well.

12. Mr D is a 38-year old year man with chronic shoulder pain after a rotator cuff tear playing cricket. It responded well to treatment, but he knows he must do his exercises every day; for two years he could not sleep on that shoulder.

13. Mr D, a 71-year old man, has a severe ache in the shoulder and midback since working above his head. Trapped nerve tests are negative but he has advanced degenerative joints of Luschka; after just two treatments he is 50 percent better. Can we reach 90?

And so the day goes; chiropractors should not be treating the elderly most medical sites state but that is so much bunkum.

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