Slipping Rib Syndrome/Costochondritis treatments

[sefi01]

Hi all,

New here and seeking anyone else who may have experience of this. I put the two diagnoses as 2 consultants have disagreed. Treatment for both is pretty similar though.

In short physically fit, training and lifting weights (40's female). Felt tired and drained but put down to training/winter colds etc. 4 trips to A&E over next 4 months with chest pain. Heart fine, X-ray fine. MRI and CT also okay.

Chest pain hasn't really gone away throughout the last 18 months. Largely bearable when at rest or pottering about. Walking brings on pain, feels like I can't breathe, muscles go into spasm. Dr says nerves are damaged and making rib problem harder to treat/improve.

Drugs- tried them all including Pregabalin, Amitriptyline, Tramadol, Morphine. Currently on Pregabalin 150mg 3x a day and going back on Tramadol.

Had 2 lots of nerve and facet blocks with very limited results. Physio, osteopathy, acupuncture (most successful but not available at my Pain Clinic)

Just wanted to chat to anyone else who might be experiencing this or similar. Anything else worked? My GP has been great but is a bit lost as to next steps... I'd love to rip the two culprit ribs right out but apparently, this is too extreme!

[karools16]

I empathise with you. 5 years ago, whilst on holiday, in S.Africa, I injured my ribs when getting out of the pool . My dr said he could give me painkillers but it would have to heal on its own.Was dreadfully painful, as you well know. Had airport/flight assistance, when returning to the UK. My local gp said much the same, and as far as I remember, I took prescribed co-codamol and morphine. It was several weeks before I was pain-free. Wish you well and soon.

[sefi01 in reply to karools16]

Thank you. It is extremely painful but reassuring it should ease albeit eventually. Went to new physio today so will see how that goes. I'm about 18 months in with this pretty continuous pain so I just need ways to manage it alwhen at it's worst.

Cheers

[Michiganpbc]

I get rib chest pain i find some relieve with a heating pad and aleve.

[sefi01 in reply to Michiganpbc]

Cheers. I'm rarely apart from my heat pad and tens machine.

[Hillwoody]

Hi - My 11 year old daughter had costochondritis in July which went away after a week and then it came back in September and didn't go away. It has turned into something more like Complex Regional Pain Syndrome, although no one will confirm that diagnosis as it is not in a limb - She has allodynia in her back (burning pain at the lightest touch) and very painful bodywide spasms, but particularly in her back, shoulder and side. It appears to have some relation to costochondritis, but not sure if it is now something new or if it is still a symptom of underlying costochondritis. We have had some success on the Costo with an osteopath and found an interesting website in New Zealand, which relates costochondritis much more to the back than the sternum - They seem to have some interesting theories about it, which go a bit further than - take 2 painkillers and rest - The video is interesting - we haven't got as far as trying the pod - bodystance.co.nz/en/costoch... - might be worth a try?

Good luck!

[sefi01]

Hi.

Thanks for your reply. This is pretty similar to my experience. My GP just says it's complex costochronditis as nerve damage around the ribs is making treatment ineffective.

Your poor daughter, I've been beside myself with frustration and really depressed at times. I hope you and she have found ways to cope with the pain. I went to two osteopaths for about 6 months each and got some relief from pain but largely just on the day of my appointment which became an expensive treatment for a few hours of pain relief.

I have been reading up on the New Zealand approach. I've held off on ordering the Backpod as no one I know have tried it. I may have to give myself a post-Christmas present. Will post if I do and start having any relief.

Best wishes to your daughter and you and thanks for contributing. I've felt quite alone in this long-term 'camp' as my GP and consultant haven't seen this complex case before.

[Panda05]

I also have costochronditis I have had it for many years all my gps ignore it so I just suffer through the pain. Some days it’s so bad it just makes everything else living hell. But no choice but to carry on I have 3 kids and I’m on my own in a wheelchair already paraplegic from CES. I keep reminding myself to smile and don’t let it show. Doesn’t help but it’s all I’ve got

[sefi01 in reply to Panda05]

Hi Panda05

Thanks for your response. Struggling with positivity right now but as you say, we just carry on. Finding the 'smiling' bit a stretch too far though and that's so out of character for me. Awaiting response from Pain Clinic about any other options available.

In the meantime, once again, thanks for your comments.

[oldowl]

When I get this pain so bad it is debilitating, I go to my Chiropractor and he adjusts the rotated disc where it stems from. It bring relief but remains tender for a few days when breathing deeply. I will not depend on a prescription or over the counter pill. I use Bromelain, a natural anti-inflammatory from pineapple and an occasional white willow bark natural pain killer. Turmeric is also an option for anti-inflammatory use.

[Ribresection]

If you r still in pain I had my 10th rib resected out to my left side. In 2009 I got sharp pain going across my lower chest then intense 10 pain for 4 years. I was diagnosed with costochondritis and got steroid shots down my sternum and in every costal rib joint. It did not help I lost 30 lbs the pain was so intense. I have really good insurance so I was able to pursue every avenue. I was imaged everyway and was told there was nothing wrong. Then I learned to touch my ribs and learn them and could feel the 10th rib would go up under my 9th when I bent over. I called every thoracic surgeon who would listen and finally Dr Burns who is now retired agreed to see me I stood in front of him he felt my rib cage and said”your rib Is detached from your rib cage can you come in two weeks and I’ll take it out”. Two weeks later I went into St Barnabas and had the rib removed I spent two days in the cardiac icu. As soon as I woke up I knew the pain was gone. It took about 7 months to totally go away and now I have no pain at all. The rib was detached from cartilage and broken so they performed a biopsy but the rib was normal. During those 4 years I also worked with a pain counselor who believed me and worked with me to find a solution.

[sefi01]

Thanks for your reply. So far I've had 4 lots of steroid injections into the ribcage, the effects are temporary with the last set lasting about 4 weeks. This is as well as Morphine, Pregabalin, my TENS machine and heat. With a this pain is manageable, but by no means relieved.

My Pain Consultant has suggested a neural stimulation device is the next step but has refused any other surgical procedures under the NHS.

I'm trying to be positive and find ways of managing it myself as 3 years in I don't seem to be closer to a permanent solution.

I'm glad you seem to have found answers and cheers for giving your insight.

[Ribresection in reply to sefi01]

Practical ways to solve this problem. It was really hard to get diagnosed because they don’t always show up on an imaging..This is what I recommend. Read everything you can on slipping ribs on the Internet learn all your ribs and feel them to see if they are clicking or displaced if you bend over do they move out of place then go back when you stand up straight again? Write in a book “how I will fix myself”, this relieves anxiety because it gives you a plan. In that plan don’t be afraid to write doctors names and numbers and call them up. These r in the United States the most knowledgeable... thoracic surgeons, sports surgeons, doctors that deal directly with sports injuries. If you can afford to see someone in US I can recommend the Vincera Sports Institute in Philly cash only. If you have insurance in US any major sports team surgeon at a major hospital because they deal with baseball, football and other sports where ribs become detached. I had no help with pain doctors or rheumatologist or chiropractors.But there many smart doctors who know about ribs. I went straight for the surgeons that deal with sports teams. Also surgeons who deal with thoracic surgery you might have to go to more than one so just keep trying. And this is very important every time you have any imaging X-ray or mri or ctscan get two copies of disc and two copies of radiologist report keep them organized. These are your records you take from doctor to doctor. You can heal yourself you are responsible those r your images before you leave imaging get copies of those disks the reports you have to get after the radiologist reads and writes them a couple days after, If don’t have them call the hospital or imaging place and request them they belong to you! You paid for the test you might have to pay a small fee to get a disk. Only with information can you get better. If this is too much for you get a counselor or friend to work with you to push you to stay on track. Don’t get discouraged. Slipping ribs r common if they haven’t heard of them it’s not your problem it’s yours. This took me 4 painful years to learn. Steroid shots do not work they r temporary they tried to put a spinal stimulator in me for pain but I refused. Your lower two ribs12-11 in your back are your floating ribs, 10-8 are false ribs they attach to cartilage then true ribs 1-7 attach attach to your sternum. Also ribs can get too close to each other and rub against each other this irritates the intercostal nerve in between in that case you might need dynamic ultrasound to see them clicking against each other. All these things you can google and educate yourself this is all written on the Internet. It hurts to have you rib taken out but not as much as it hurts to live in continual pain. And yes if a rib is broken off or detached they do take them out. I am not a doctor so these r just my experiences. In your book you keep also dates of calls, telephone numbers, appointments, who you contacted what they said and follow through. You usually get 15 minutes to make your case so bring your records organized and write down your top questions stay on track just the facts.

[sefi01]

Hi again

Thanks so much for your response. I have done much of what you suggest within the limits of our NHS and my own finances. Unfortunately without insurance I am limited although have had MRI, CT, X-rays resulting in the 'Slipping Rib/Costochondritis'.

I will ask about a dynamic ultrasound though.

[Ribresection in reply to sefi01]

If they have already diagnosed you with that where is it which rib? Can you feel it? Take your images stand in front of the doctor and show him how it is moving. My doctor did not believe me I put his hand on the rib bent over and the rib went under the 9th rib. I learned how to read the imaging and downloaded it on my computer the X-ray clearly showed a detached rib. My primary care doctor gave me a referral to a surgeon who agreed to see me I laid out my case to him showed him the X-ray made him feel the moving rib. If they say you have this which rib is it can you feel it. I had costochondritis for 4 years the rib kept inflaming my whole chest every joint was inflamed. There was no option for me not to figure it out. In the beginning the pain from the detached rib was more central to my sternum where it tore off and then my whole chest. By the 4 year the broken end was actually driving into my insides it felt like a spear going in my left abdomen and coming out my right back shoulder. It takes a lot of time to figure it out yourself because tour rib cage is like a barrel it is not flat so a good app is 3D human it’s free. You can rotate the rib cage and study what it looks like. Since my slipping rib in 2013 much more had been written so there are more studies on the Internet.

My primary care physician has diagnosed 2 more cases since mine but at the time of my slipping rib he had never heard of it. If you look up slipping rib and dynamic ultrasound you can see how it is added to the test to diagnose this hindawi is a good site describing this process. hindawi.com/journals/crim/2...