Recently I was experiencing some pretty bad chest pain. Not the heart attack kind but the kind that hurt when I breathed, strained, and moved certain ways. Doc says I have costochondritis, inflammation of the chest wall between the ribs and lungs. Said it could be RA related. Gave me a new anti inflammatory. Last night I was so exhausted and loopy from a pain med change and ending up sleeping on my left side the night thru. I woke up with my right rib cage and collar bone in tremendous pain. I'm not even going to go into how awful side sleeping is for my hip bursitis. Have any of you experienced these types of pain upon waking?
RA or not?: Recently I was experiencing some pretty bad... - NRAS
RA or not?
28 Replies
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Hello Kelly
Yes the problem with the rib cage can be RA and yes the area between rib and lung can be inflamed.
If it is RA, the secondary ribs can be inflamed as well and this can prevent the ribs from moving as the lungs expand in the chest cavity although with you it would seem to be the latter. If you are having problems with collar bone you can suffer referred pain from a different part of the body, although I cannot say what the link is between collar bone and rib cage, although in practice you could be having back problems, I am not a Medical Man so be guided by the GP He will keep you right
I suffer from small joint arthritis and that effects the movement of the ribs, as this can also come from the false ribs that are more like grissel. If you are in flare you will most probably be suffering chronic pain and referred pain my also be present in various parts of the body.
As mentioned before be guided by your GP
All the very best
BOB
Happy New Year Kelly. It does sound as though you're in a lot of pain & whilst I've (fortunately) not experienced costochondritis I've read about other members on here suffering it. Seems to be RD related with most who have spoken about it so suppose that would lead on to whether your meds are controlling you well enough in my mind, inflammation not reduced enough? It's something you need to mention to your Rheumy at your next appointment certainly & maybe he'll review your bloods & order imaging to see if a change in treatment is necessary. It's what's I hope my Rheumy would do any way as it's so painful. Have you tried heat or cold packs or maybe if you have a TENS machine, some people find they can get relief from those in the meantime?
It doesn't sound as though your hip bursitis pain has been relieved any either. I don't know if you recall but alongside RD I also have trochanteric bursitis & OA. Both the latter have improved since my GP prescribed some excellent pain relief. I used to get in bed & for the first minute or so I'd feel some relief lying on my back but then the searing pain would hit & from then it was a case of trying to find a comfortable position until eventually getting up as it wasn't happening! Then back to bed to try again & so it went on each night, tears welling through frustration & pain. I was getting by, but only just, on a few hours fitful sleep a night but with my new meds the difference is marked. I've less of a messed up mind & I cope far better with the things that reduced me to tears far too easily by simple lack of proper sleep!
I hope you'll be able to get some relief & sooner rather than later. 
in reply to nomoreheels
I was finally started on methotrexate and pain med switched back to dilaudid. I'm very tolerant to some meds and very sensitive to others. Dr thinks the dilaudid keeps me more balanced without the severe spikes in pain. I cannot take steroids for the inflammation due to bone deterioration. At age 41 I have already had one hip replaced, hence the chronic bursitis. My ortho surgeon is still looking into a surgeon to do bursectomy that takes my health insurance.
nomoreheels in reply to
That's great I hope it works well for you & that it's one med you can tolerate. Are you prescribed anything to protect your bone density & help against further osteo problems? I hope your Ortho surgeon finds someone soon to sort your bursitis as well.
Oh my word yes!!!! I too have bursitis in both hips, costo etc. Sleeping is a broken thing in that i sleep for a an hour or so have to turn on to my side because of the pain inj my chest then wake up and have to move again because of pain in my hip and on and on. Just adds to the joy of the exhaustion I already feel. I can'[t take anti inflammations and my prednisone is being reduced so I am having fun!! I hope the anti inflammatory help it is just horrendous isn't it.
Do you think you'd tolerate amitriptyline as KIki suggests SOM? It's one of the meds that's helped me with my painful & restless nights (see 2nd para above). Might be worth seeking the advice of your GP or Rheumy, whether it may ease your pain to rest long enough to be of benefit. My GP started me off on 10mg & i'm now taking 25mg nightly which seems to be enough for me. Continually lost nights make the days more difficult. 
Hi Nomoreheels I am not game to take any more mind bending drugs after the last few I have had. They have had such terrible affects on me. Temazapam made me absolutely wired, which is not what it is supposed to do, and lyrica sent me demented and I was like some ancient woman with holes in her brain. So I am not game to touch anything that impacts on the brain like that again as I seem to have what my GP calls paradoxical side effects from some drugs. I don't seem to suffer from anything else other than extreme fatigue with the loss of sleep, thank heavens I don't get teary or angry, just want to lay down and sleep forever my body is so tired. I think I have almost gotten used to it after nearly 3 years of it. funny what our bodies can adapt to.
I'm not surprised on Temazepam & Lyrica. My h had an awful time on Lyrica, still not quite back to his normal self & intolerant to many meds they've tried but amitriptyline was one he did tolerate. Like me they started him on low dose, 10mg increasing slowly to 50mg but then it became less effective for his issues. Typical, he finds a med he's ok on & worked then had to come off it!
I hope there's something you can find, maybe not a tablet but something to give you restful sleep. There comes a point your body says no more! You must be worn out fighting RD & not sleeping, been there & glad I'm out the other end. x 
I have complex issues and not only inflammatory arthritis, so it is a bit of a juggling act. I am hoping my third cardiac ablation in February some time will fix the wolffe parkinson white and afib so that will be one less thing to deal with. Then on to biologic world to see if I can tolerate one of those. Nothing much they can do for the bursitis apparently and maybe at the end of the year when they fix my shoulder that will help too. As for the OA in my neck and other parts well it seems it is too bad so sad get used to it. hahaha
Oh, I fully understand you're not without other problems & especially why I hope there are other ways of approaching or investigating a broader spectrum other than meds to help your sleeping issues. Fortunately my OA & other pain has been relieved to an acceptable level & as it's altered my sleeping pattern I appreciate how a restful nights sleep makes us look at the world...... I wish the same for you, whichever form it comes in!
Thanks Nomoreheels. I have found since using the cpap machine for sleep apnea that I at least am not waking up choking all night long and that has helped me a lot. Maybe once I find something that can relieve the pain I will have a much better sleep, I won't know myself hahahah
I think OSA Is the devil. My h has it & rarely has she full nights sleep but is hesitant to ask for help. It bothers me sometimes & I have to give him a shove if he goes too long & not grunted back to breathing. Always worse when he's had a drink.
I hope you do find something you can tolerate for your pain.
I fully recommend doing the sleep lab test and getting a machine. That has helped me a lot as far as feeling a lot more with it in the mornings. It is surprising how much it helps. I also have restless legs it usually goes along with sleep apnea. I am just a body full of pain, leg shaking, choking sleeper. No wonder I have trouble hahahah
Aw, poor you. I'm pleased it's helped you, I may have another go at asking if he'll ask about being investigated once he's recuperate from his op. It's a big one & enough on his plate as he's to have another op once he's fighting fit again.
It is not hard to do . I am not sure how it is over there but it took a year to get a place for the study so it may be worth investigating to be on the waiting list. It is basically just going to sleep hooked up to lots of wires nothing too invasive and then once they see exactly what is wrong they trial a sleeping mask and machine and then if it is OK order a machine and mask. All up mine was $1,500 but I am paying it off over time payments. It may be different over there.
Thanks for that. I'll have a search round the internet & have words once we know the date of his op & afterwards the approx recuperation period. Little point doing it now & having to juggle!
yes absolutely, one thing at a time. Poor bloke. gee we make for some interesting mixtures of ailments don't we hahahah
Don't we just! We need putting in a sack, shaking up & see if we all come out right lol! 
hahaha mind you at the moment that would be extremely painful. Wait until I have something that might relieve my pain first
Ha ha ha!!! If you didn't laugh you'd cry. Let's hope it's soon.
yeah I choose to make fun of my situation and keep laughing. They are trying to get me in to a clinic late Jan early Feb. So I guess I will know some time after that. Mind you I would like to have the ablation over and done with before I start on them to minimize risk of infection in my heart.
You have the right attitude. I'm afraid not everyone can do that & it can drag then down but we're all made differently & react equally differently to what life throws at us.
Your ablation must take precedence of course but of the less stress & strain as a result of uncontrolled pain the better. I know how delicate the heart can be going through cardio issues with my h presently.
I have my moments but on the whole I try and stay positive. Yes the ablation is hard on the body and usually triggers a big flare. I have to lay on the table for 6-8 hours awake while they do it. Not looking forward to that bit, but hoping it cures the problem.
Oo, not easy I wouldn't think. Hope you avoid flaring but that's some stress on your body so little wonder. Are the able to put in place steroids for you in anticipation?
I am working my way back down to 5mg but I think I need to talk to all involved about that as last time it took me about two weeks to get back to where i felt well enough to work . Really took it out of me.
Best learning from past experience SOM & being prepared. I'd do the same in your place, ensure you're fit enough before going back. It's difficult I know when work has to be a consideration.
The rheumy and cardiologist work out of the same offices and chat to each other so I will talk to rheumy as see if it is Ok to up prednisone for op and if that works with cardiologist. I can feel myself getting worse each day as the dose is reduced I am slightly worried how I will be by the time I go on bioliogics. I know I am in trouble because I am having trouble using my arms and hands making it difficult to even wipe myself after using the bathroom. Just another fun thing to challenge me!
Oh yes I know the pain you describe. I have had Costachondritis for 3 years now. Anyone can get it and it's a well know sports injury with professional rowers. My Rheumy put me on Amitriptyline ( very low dose) which is an antidepressant used for nerve and bone pain. I also used ice packs. Since then I've slept pretty well when at home and it's settled right down. However I was at a hotel last weekend and the bed was too hard so I tossed n turned all night. My shoulder and ribs were so sore. I asked reception to put a duvet under my sheet ( my son and hubbie too) and I took 2 co-codamol at bedtime and I slept like a log. Hope it settles soon for you, if not ask about Amitriptyline.
Happy new year
Kikideelili x
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