Tietzes Syndrome

by Janine
(Johannesburg, South Africa)

Hi I live in Johannesburg, South Africa. My 15 year old daughter has been in severe pain now for 11 weeks. After numerous tests and specialists, finally at 9 and a half weeks she was diagnosed with Costochondritis. She is extremely sporty and is frustrated and despondent beyond description, at not being able to participate as she did 3 months ago and before that. It really has been quite debilitating for her.

As you say we have tried numerous anti inflammatorys and pain killers, but nothing seems to bring her any relief. PLEASE HELP!

I have never been to a chiropractor before and honestly I am quite scared of them. At this stage I am desperate to help my daughter, but at the same time petrified to take her to someone who doesn't know what they are doing and will end up making it worse. Please can you advise me of any reputable chiropractors in Johannesburg or even how I should go about assessing / finding one that can help her.

Much appreciated


Hello Janine,
There's no need to be anxious and scared of consulting a chiropractor; mostly we are careful and thorough and well trained.

Having said that, Tietzes syndrome is something of an enigma, and it took me a long while to figure it out. Just as your medical doctors are taking a long time.

It's a good thing they have ruled out the medical causes; they are rare but do occur.

Does she actually have a lump over the breastbone? If so, I'd like to have a photo please.

There are four grades of Tietzes syndrome, but only the last has a palpable, tender, visible lump over the joint between the breastbone and the rib. Mostly it just hurts a lot but there's little to be actually seen.

One small warning that it took me a long time to figure out; a heavy chiropractic adjustment, P to A, will aggravate the condition. An "anterior thoracic" adjustment, mobilisation of the whole rib, and soft tissue therapy along the intercostal muscles is what will help her.

You can start with alternating ice and heat, an ice cube in the shower works well, directly over the tender spot.

The right way to find a good chiropractor is exactly the same as finding a good engineer, accountant and medical doctor; talk to friends and family and even your GP. Someone close by is usually, but not always best. Type find a good chiropractor into the search engine at Chiropractic Help; that might give you some ideas.

Perhaps print this out and take it with you to the chiropractor you choose. If they would like to phone me, that's fine. Like I said, it took me the best part of twenty five years to work out how to treat Tietze's syndrome. They can find my number in the navigation bar on your left.

Let us know how you get on.

Dr B

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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.

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