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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