Tietzes Syndrome - left chest and arm pain

this doesn't show it too well :/

this doesn't show it too well :/

I went to the emergency room last week for pain in the left of my chest and my left arm panicked that I was going to have a heart attack (which would be highly unlikely because I'm a healthy 19-year-old girl). After many tests, I went home still clueless as to what I had. I then had a follow up appointment with my regular doctor, who told me it was costochondritis.

Then, later that day, I realized that the area beneath my collarbone, more on the left side, was swollen and appeared to be a shallow, though rather large-in-area lump. The lump is a little tender to touch. I called my doctor and he said it could be due to the costochondritis. I then did some research of my own about costochondritis which took me to Tietzes syndrome.

This must be what I have, even though I don't remember having any trauma to my chest. I've been using a heating pack and ibuprofen for the pain, but I'm finding it extremely hard to avoid lifting things and twisting my body too much (which my doctor would worsen it.)

How do I get rid of this? Can I exercise without making it worse? In addition to the pain in my chest and arm, there is now pain in my neck and back. I also have some indigestion (constant rumbling stomach that feels empty even though it's not.) Please help!

You're right, the pic isn't too clear. Could you send the full file, without reduction to me brlewis@mweb.co.za This website may reduce it automatically and I'd like to see the full graphic.

When Tietzes syndrome affects either the first rib, or the collarbone, it may affect the "brachial plexus of nerves" and hence the pain down the arm. Inter scalene triangle ...

And, because the diaphragm attaches to the underside of the (lower) ribs, it may also cause indigestion.

I presume a chest X-ray was taken. If not, I would recommend. What's vital is that the correct diagnosis is made, as there are other conditions that can mimic Tietzes syndrome. Keep in touch with your doctor and if concerned, ask to see a physician specialist. Were blood tests taken?

There is no proven treatment for Tietzes syndrome. Because it's something that kept arriving periodically in the clinic, I developed an interest and came up with a protocol that managed the condition quite well. I can't promise that the average chiropractor, or any doctor for that matter, will have any idea about the treatment of it.

If you decide to see a chiropractor and s/he would like to skype me, I would be very happy to discuss the chiropractic management of your condition with him/her.

Keep active, but I wouldn't exercise at present. But likewise, keep moving, otherwise everything is likely to stiffen up.

Meantime ice is good for pain relief and to reduce the swelling.

What does concern me a little is that the mass seems to be central rather than unilateral. Send me the full digi pic.

The pain often travels along the whole length of the rib, back to its attachment to the spine, hence your back and lower neck pain.

I wish I could be more helpful...

Dr B

Click here to read or post comments

Join in and write your own page! It's easy to do. How? Simply click here to return to Tietzes syndrome.

Did you find this page useful? Then perhaps forward it to a suffering friend. Better still, Tweet or Face Book it.

Interesting challenges of the day

1. Mr S is a 76 year old man with neck pain of some 9 months duration. Luckily, most of the discomfort is upper cervical which is only rarely arthritic; his lower cervical spine is a degenerative mess that I've left alone. After seven treatments his pain and stiffness is 50 percent better, and he's happy in the circumstances. He can sleep through the night now and that makes a huge difference.

2. Mr P is 32 year old man with very severe lower back pain radiating to the big toe which is 30 percent numb. He had an episode three weeks ago, took anti inflammatories and was soon better as is typical of the medial disc herniation. But before it healed, after a trivia it came roaring back, much worse. The characteristic crossed sign was evident; sitting in a chair, straightening the right leg provoked severe left back pain and tingling in the leg. He's doing well.

3. Severe lower back pain is scary; just ask Mrs P. Just watching her get out of the car I she was in trouble; she had a slipped disc at L4 making her lean towards the opposite side; luckily she had no pain in the leg. Despite family pressure that this was far too severe for a chiropractor, she persevered. Within five days she was standing upright, and after two weeks almost painfree. 

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's well pleased; sixty five percent better after three treatments.

5. Mr T is a wise man; he's taken a warning TIA seriously and has lost 15 pounds, and has at least as much again to lose. A change to a low starch diet and half hour daily walk has made the difference; but the walking is making his foot and back miserable. The expensive orthotic is hopeless; luckily his hips and back are fine, but he needs a simple heel lift.

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. Xrays 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 year 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's a non complicated upper cervical facet syndrome, and she's doing well.

12. Mr D is a 38 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 couldn't 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 shouldn't be treating the elderly most medical sites state but that's so much bunkum.

Have a problem that's not getting better? Looking for a different slant on your pain? Want to pose a question?

Interesting questions from visitors

CLS writes:

Greetings, Dr B.
You helped me quite some time back with a soothing and professional response which turned out to be exactly correct. I now consult a local chiropractor. You write a superb newsletter, too.

Your own unresolved problem. Pose a question

Knowing that up to 70% of the time the correct diagnosis is made with no examination, no special tests, no xrays, but just from the history, there's a fair chance I can add some insight to your unresolved problem. But at least 30% of the time, I may be quite wrong! Give plenty of detail if you want a sensible reply.

You visited this chiropractic help site no doubt because you have a problem that is not resolving and want to know more about what chiropractors do.

The quickest and most interesting way is to read one of my ebooks of anecdotes. Described by a reader as gems, both funny and healthful, from the life and work of a chiropractor, you'll love them. Priced right at $2.99, though Kindle fiddles the price without telling me.