Rib and chest pain?

[Stills]

diagnosed with Stills Disease aged 17 symptoms as RD , med free by mid 20s now 61 and use pain relief.

Recent weight loss and digestive issues with raised GGT caused GP to consider liver or ovarian cancer ( strange mix I thought). Omeprazole prescribed these last 3 months, now weaning to avoid rebound acid. Gastroscopy found nothing, colonoscopy pending.

My question is, lower rib pain left side, higher on right, also reaches under right shoulder and left neck. GP dismissed Stills Disease involvement instantly and has only spoken to me on the phone for 5 minutes. I’m not with a rheumatoid specialist.

For years I’ve had some rib pain and bad pain IN the hip bones ( like a million angry wasps inside bones) and always assumed it was just part of Stills. I use OTC pain relief.

Dr google ( I know, sorry but without any Dr support) suggests Costocondritis or pericarditis PERHAPS.

I feel abandoned by Dr. If pain increases I’ll call 111 but in the meantime any RD suffers who’ve experienced either possible conditions or who recognise this pain ?

[Runrig01]

I have ankylosing spondylitis, I was late getting diagnosed at 51, having had symptoms for 25yrs. By the time I was diagnosed, I had fused sacroiliac joints, and fused ribs. I have chest expansion of 0.8cm. So my ribs constantly feel they are trapped in a vice, the whole rib cage is tender to touch, which I’m told is partly inflamed enthesis, which is where tendons attach to bone, and we have many in the rib cage. My sternum is partially fused giving the constant costochondritis pain. I also have lung issues from the lack of expansion, so I have pockets of Atelectasis, which is areas of collapsed lung. My diaphragm is weak due to not being able to expand, which has resulted in a hiatus hernia, which has caused me to aspirate acid into my lungs causing scarring. Anti inflammatories are normally good at settling the inflammation but need to be taken regularly, or a short course of steroids may help. Perhaps ask your gp to refer you back to rheumatology, where they gave a wider choice of meds to treat you.

[Stills in reply to Runrig01]

Very useful thank you, I too suspect Costocondritis due to the existing chronic RD of Stills. I have enthetitis at the site of a recent muscle rupture so another likely candidate. The rib pain is surprisingly sharp and persistent compared to when my joints hurt which is best described as a deep throbbing ache, I recognise your description of a vice feeling too, I’ve had to stop wearing boned bras due to chest pressure which is a shame as I need all the help I can get in that area post menopause. I had a gastroscopy a few weeks ago which revealed nothing so I’m assuming no hernia but I do have heartburn, indigestion and acid reflux at the moment possibly as a result of raised GGT, I just don’t know.

It’s difficult to get any GP action whilst this other (digestive/cancer scare) is on going. I may try and self fund if I can find a rheumatoid worth the money.

Thanks again for your detailed reply and I’m sorry to read about your trials and wish you better days.

[Runrig01 in reply to Stills]

I completely relate to the issues around Bras. I’m an F cup, all natural unfortunately, and I did look into reduction to take the pressure off my ribs. It can’t be done on the nhs, unless my bmi is less than 25, currently 32. Impossible to lose weight as I’m on life long steroids for AI. Also because of the AI they won’t do it privately in case I go into crisis. I have a lovely pull on bra from M&S, called a flexifit non wired crop top, which is so comfy, and I use when just lounging at home, definitely recommend. Hope you get answers soon. I also do daily stretches on my ribs, to help break up any inflammation.

[Stills in reply to Runrig01]

the things we women go through with bras! I have crop tops and bra-lets for house lounging (34E) but can only manage ones I can step into and pull up like knickers as my shoulders are too stiff for over the head things. 😆

[cyberbarn]

The first thing I though was costoshrondritis too. There are two other similar possibilities, slipping rib syndrome or referred pain from the spine. The bottom ribs have a lot of cartilage that connects them together, and that can become inflamed. Also the ribs if the cartilage and tendons are lax can slip under each other. In-between each rib runs two bundles of nerves and blood vessels and they can be squashed either by the ribs slipping or subliming, or can be irritated by the inflammation.

When I presented this to my son's GP (I am an academic researcher) he said yep, this is a likely diagnosis, get thee to advance practice physio for diagnosis. He also added that he didn't know anything about these things!

[Stills in reply to cyberbarn]

thank you for your interesting reply, another response also mentions Costocondritis which was my initial thought so this deepens that idea. I do have shoulder and neck pain but I attribute that to chronic Stills, perhaps too assumptive of me. I don’t know a reasonable physio and imagine huge NHS waiting times so will try and self fund rheumy visit if I can find one worth the cost. Stills is rare and GPs know nothing of it and when I was diagnosed in 1979 at teaching hospital Addenbrookes the prof called in a group of 20 odd students or so to show it off. I still live near this hospital so will try there, I’m guilty of ignoring RD and just hoping it’s gone in the morning..... it’s never has yet bu5 there’s always tomorrow.

Many thsnks again.