Tietze syndrome?

Hi!

I am a 32 year old female runner. I have been dealing with chest pain on and off for about 3 years now. My doctor diagnosed me Costochondritis. I recently went to a medical massage therapist for some relief. She proceeded to press on my front chest to adjust my breathing. It was quite painful. When I left her office, I noticed swelling of my 2nd rib on the right side. It was tender but not super painful. It’s been two weeks and the swelling of my rib remains. I had a chest x-ray to rule out anything serious. Is this Tietze?

Yes, it could quite possibly be. I think it unlikely that the treatment actually caused the lump; it was probably already there, but when you realised how tender the area was, then you first noticed it.

As I read it, Tietze's is just a further development of costochondritis, so your doctor was probably correct in his diagnosis.

It's a stubborn condition as you've discovered. Medicine reckons there is no cure, and they are probably right; rather, it needs to be managed. Like many medical and chiropractic conditions.

The one treatment that will definitely increase your pain is a heavy manipulation in the middle of the back; make sure your therapist and perhaps chiropractor in the future understand that.

I have worked out a protocol that certainly helps, will decrease your pain by probably 50% plus, but certainly won't cure it. I'm happy to share that with anyone treating you.

It is an inflammatory condition, hence the pain and swelling, but it doesn't respond to inflammatories. I have no evidence to prove this, but I suspect an anti-inflammatory diet is something you should consider. Frankly it is a good thing to do anyway.

Have a breast examination.

I hope this contributes. It may also give you indigestion.

Dr B.R. Lewis DC.

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