What is causing my chronic rib pain?

Question

Hello doctor,

I have been having severe left middle rib pain for about a month, and now it is always hurting. I had an upper endoscopy, colonoscopy, left kidney CT scan, gallbladder ultrasound, blood work, and HIDA scan, and found nothing, but I have a tortuous colon. The pain gets pretty bad, and I am worried it is something more serious, but I try reassuring myself that it is not, since I have had so many tests.

What could this be?
Should I be worrying so much?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

From your history, it seems to be an inflammation of one or more of the cartilages that connect the ribs to the breastbone. It is a condition called Tietze syndrome (when there is a swelling over the painful area) or costochondritis (no swelling, only pain). This condition has no known cause, although many theories do exist (none have been proved). The main features are local pain, with or without swelling. It generally resolves in 12 weeks. However, it would be best if you could get a chest X-ray and an ECG (electrocardiogram) to rule out a rib fracture and a heart condition (angina), respectively.

Treatment:-

1. Take tablet Aspirin 325 mg SOS (whenever you feel pain), up to a maximum of eight tablets a day.

2. Tablet Ranitidine 75 mg once a day. Whenever you take Aspirin, it reduces the stomach irritation caused by Aspirin.

3. Locally apply Diclofenac gel thrice daily.

4. Hot fermentation, local application of the analgesic gel.

Preventive measures:

Avoid weight-bearing over the shoulders or chest, chest exercises, or external impact over the area involved.

Review with a doctor after your ECG and chest X-ray are done.

I hope this helps.

Thank you.