Tietze's syndrome unresponsive to medicine and chiropractic

Tietze's syndrome unresponsive to medicine and chiropractic is probably the norm with th

I am a 46 yr old female. For 2 years I have suffered from what I think could be Tietzes syndrome. I have had numerous CT/MRI/Xrays and the Doctors can not find what is causing my chronic pain.

My pain started when I had what I think was a rib head out. I couldn't bend my neck down and was having a lot of upper back pain (between shoulder blades). After being adjusted again, I was still having a lot of pain.

I then developed costochondritis about 8 mths ago and I'm thinking now I may have Tietzes syndrome. I have chronic pain in my mid back and sternum area (about the 3rd rib down). There has been a swollen hard lump there on the right side and my pain runs down through my breast area. My chest has popped several times. I cannot lay on my stomach at all because of the chest pain. It is still painful to laugh even though the costochondritis has improved.

I have mentioned Tietze's syndrome to my chiropractor but he brushes me off. I desperately need help with this chronic pain and I don't know what avenue to take at this point. Any advice would be greatly appreciated.

Hello Michelle,
I'm not sure how wide to open my mouth, and whether to stick both feet in!

I've walked the walk with Tietze's syndrome and it's been a long a difficult journey; I first encountered it as a young chiropractor, not knowing its name and it was quite painful to discover that my treatment actually worsened it, and may have actually caused it. That was the beginning of the journey; in medical terms I was faced with what's known in the jargon as iatrogenic illness; doctor caused disease.

There's a fine line between costochondritis and Tietze's syndrome; firstly the former may be due to inflammation, but Tietze's is apparently not, and hence doesn't respond to anti inflammatories and in fact responds to very little; it becomes a chronic and debilitating condition, as you are experiencing.

The second feature is the presence of a lump over either a rib-breastbone joint, or over the joint between the collarbone and the breastbone.

The third is that often there is associated indigestion, and if it affects the collarbone, tingling in the arm.

Both have associated midback pain, often thought to be the start of the whole problem.

What I eventually realised was two things. Firstly a heavy manipulation in the midback worsens the condition. And secondly that, whilst it's not curable, it's a very treatable condition with chiropractic, but is unlikely to go away completely, and well require an occasional but regular adjustment; but the midback adjustment must be skillfully and gently done, or it will worsen the condition.

The treatment of choice is the so-called 'anterior thoracic" adjustment, and mobilisation of the whole rib.

Doctors in general, when they are out of their depth, brush off and dismiss patients' complaints. I know because I did too until I started to get interested in Tietze's syndrome, and whether chiropractic had any contribution to make. Medicine generally seems to admit there's nothing much they can do.

Which brings me back to your own chiropractor. If he has an enquiring mind, and is ready to face up to his limitations, and would to help patients with Tietze's syndrome, then I suggest you ask him to contact me. It's a difficult condition, and I make no claims to being a guru, but I have worked out a protocol that brings relief somewhere between 50-80%. It makes it manageable instead of being a daily struggle as you are experiencing.

I'm sorry if I've thrown petrol on the fire, but it's the way you may make progress. I know of no other, and it seems your doctors don't either.

Start by icing the painful spot on the sternum every day in a hot shower; alternating hot and cold helps.

Dr B

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