A pain in the side

Edited 19 July 2006: It seems that this particular page on my site gets four or five hits a day from people looking for information about costal chondritis (or variants thereof). I’m quite glad to be getting the attention, of course, but it’s kind of funny because I put so much effort into the rest of my site. Well, at least some good is coming out of this.

I understand the frustration of looking for information about this condition. I found nothing at WebMD, which is my personal favorite medical site, nor at WikiPedia, which is my favorite reference site (a search there for “costal chondritis” brings up “Tietze’s Syndrome”, which I’m not sure is the same thing). I guess that the best I can say is, talk to your doctor. Ice, heat, and non-steroidal anti-inflammatories seem to work for me (but please don’t think this is medical advice), though my doctor now recommends against stretching the affected area.

And six months after I wrote this original entry, I still suffer from costal chondritis. I think it’s primarily because I haven’t been free of asthmatic symptoms long enough during that period of time to really give the muscles and cartilege a chance to recover. On the plus side, since the pain’s been there, at a constant level, for so long, I can now be positive that it isn’t anything more serious.


Today I decided to go back to the doctor for this pain in my side which has been bugging me since August. In early December, the doctor who looked at it — not my regular doctor, who’s currently on maternity leave, but a good one by all accounts anyway — said it was probably something called costal chondritis. Back then I had a chest X-ray done, and the results were clear (well, as clear as a life-long asthmatic’s can be, when there’s airway remodeling and permanent scarring on the lung tissue). But despite the icing and the stretching and the Ibuprofin, the pain has not gone away. In fact, over the past few days, it’s gotten significantly worse.

I saw the same doctor today, and he looked at the results of the X-ray, listened to my symptoms, and did a couple of quick prods on my rib cage — “Does it hurt when I press down on your rib cage with 8,000 psi of pressure?” — and so on. And said Yep, very likely costal chondritis. But just to be sure, I get to go in for a bone scan this week, just to make sure there’s nothing there.

Because I am what I am, I naturally brought up the notion of cancer.

The doctor scoffed and told me that the odds of this being cancer are practically nil.

Anyway. So he explained costal chondritis more thoroughly this time, and I paid more attention. The “costal” part of the term refers to the ribs; you know, the bones that protect your heart and lungs and such. The ribs have cartilage between them to make sure they don’t rub together and damage each other. Between the bone and the rib is a joint; and it’s this joint which is out of whack. So, the cartilage is actually slipping because of the inflammation. Because this is happening, the smooth muscles surrounding the ribs — the intercostal muscles, a term I remember from the physiology classes I took in college — end up working harder to keep everything in place. But because this is not the sort of work the intercostal muscles are supposed to be doing, they wear out quickly and start to spasm. Pain ensues.

So, costal chondritis not only involves the inflammation along the costal/chondral joints, it also involves spasms of the intercostal muscles. The affected area could be just the bottom of your rib cage, or could extend all the way down the intercostal muscles and their associated muscles; from the collarbone, in other words, to just about the small of your back. That’s the affected area for me, though mostly it hurts at the bottom of my rib cage on my left flank.

The doctor believes this may have all started when I pulled a muscle in my back last August, and been exacerbated by a series of upper respiratory infections. This last cold, with all the coughing and the sneezing I had, probably just brought about the huge flareup I’m having now. There isn’t much I can do about it, though; take big doses of Iburprofin for a couple of weeks and see how it goes (in addition to the icing and the stretching), and if that doesn’t work, take a more aggressive approach. The doctor doesn’t like people to take anti-inflammatories if they can help it, but agrees that it’s time for that approach for me.

What it all boils down to, he explained, is normal wear and tear on the body, and it’s all probably exacerbated by the lifetime of asthma that I’ve had. Fortunately, I still have my pain management techniques that the neurologist taught me almost two years ago when I was dealing with my headaches, so I’ll break out that CD and see if I can get going on that again.

In other words: ouch. Frikkin’ ouch.

But other stuff is looking up. I’ve read through about four chapters of Fred Again and taken a lot of notes (including the huge, glaring, painful chronology issue right in chapter 2). And because I got a telescope for my birthday I’ve been listening to a lot of astronomy related podcasts, which are giving me ideas for the novel. 70% of the matter in the universe is dark matter, and no one knows what dark matter is. Except, of course, you and I know that it’s really just the ill will of Nyarlathotep and Azathoth that keep the universe together, right?

28 thoughts on “A pain in the side”

  1. Hi there,
    I was googling costal chondritis when I came upon your post. I too suffered from this condition, for five years and still experience the occasional flare up. Mine was so bad that I missed most of my first and second year classes in University (though I still passed), because I had a hard time sitting up for hours on end (well and being on Vioxx day in and day out doesn’t help). I hope things work out to your advantage, I have seen both the suffering and recovery aspects of the condition, the latter being so relieving..literally. Get tonnes of rest, sleep is the adversary to the condition for some reason and best of luck!

  2. Hi out there!
    I must have a mild enough case that it only hurts for about the first hour as I wake up in the morning, but unless I take my Celebrx, I can’t stay in bed for being so achey.The first time I had it, it fely like I was skewered by 2 opposing swords through my ribs after a night of laying on my ribs, but then I’ll be pain free the whole other waking hours of the day.Isn’t that wierd?
    The worst part is, I’m not sure what I did this time-overstretched in some yoga posture,lifted too many weights one day-it just isn’t clear.
    Does anyone know if its ok to do some calistenics-push ups ,for example or do I have to wait another 5 months till it goes away?
    Thanks for any suggestions/info.
    Becky

  3. Hello. I was recently convinced that something was seriously wrong with me due to a constant pain under my right breast plate. Having read up on IBC, (inflammatory breast cancer), I was convinced something was wrong only to have this diagnosis of CC. (I still demanded a sonogram, but nothing showed up).

    But from everything I’ve read, CC is caused by something else– I don’t play sports, so I can’t imagine why I am getting this. The pain makes it really hard to concentrate at work….

  4. My doctor thinks I have this basically by ruling out anything else. I started having chest pressure and a little aching on my sternum. I felt out of breath, not in a panting way, but in a way that every breath felt a little short. I had a panic attack over it and kept yawning all the time. I had blood work done, a chest x-ray, oxygen test (on my finger) and the works. Everything came back fine. It happened after exercising for a month and having a cold. After I went to the doctor i decided to take aspirin and the symptoms went away. that was in Feb. Now, I started exercising again and after two days, the symptoms are back. I don’t really know if this is chondroitis or not, since I don’t have acute sharp pain, just pressure and feeling like my chest is tight. Don’t know if I should go to a specialist or what to do, but I want to exercise.

  5. I am relieved to hear I am not the only one going through this. I first presented with symptoms almost 4 weeks ago. I pulled a muscle or so I thought swinging a golf club. I am a beginner and was hitting balls constantly. Sadly I am a jogger first and have resorted to mostly walking for some excercise. I am also pain free during the day and lay awake many nightsfor hours trying to find a good positing.I have definetly caught up on my reading. I also seem to feel better for a couple of days and will resume light jogging and sure enough I will spiral backwards. I keep hearing this will pass but ENOUGH ALREADY, I am going to get stomach issues from all the ibuprofen I am taking. Thanks for the chance to commiserate.

  6. Mine was caused by doing abdominals and was a mild irritation to outright painful. I went to a chiropractor who believes agitating the area will help get blood to the spot and therefore help it to heal faster. He adjusted my rib cage, used ultrasound, and performed accupuncture. You all might want to try it. I feel better this am

  7. I am convinced that CC is viral. Mine started about 12 years ago when I was in nursing school. I self-diagnosed pericarditis or possible MI but my primary physician told me it was a benign disorder called costal chondritis (or costochondritis) and treated me with naprosyn. The excruciating pain went away and I thought I was healed. But a flare-up came about a year later and actually landed me in the hospital on a holter monitor to rule out cardiac involvement. Again, the pain was excruciating and I was short of breath because it hurt to breathe. The doc at that time said he thought it was lupus but all of the tests came back negative. Back on naprosyn and I was discharged 2 days later. I still have flare-ups about once a year but I can’t connect it to any unusual acivity I’ve been involved in. I seem to notice it when I am a little more emotionally stressed than usual so, like herpes, this condition seems to me to be a dormant virus in my body that rears its’ ugly head now and then.

  8. I’m just curious, but did you ever have fever with your costochondritis? I was just given this as a possible cause for my pain, but I’ve also been running a fever of 99.1-99.5 daily for a long time. My chemistries, blood counts, and CT/ultrasound showed nothing. (Mine is also pain in my L. flank that radiates around the chest wall and stops in the ribcage under my L.arm. However,it also radiates “through and through.”)

  9. This is all really interesting to me, including that most posters here are female; I, however, am a late 30’s male. I have very similar symptoms to most above. Does anybody else feel the urge to push down on the breast-plate area for a feeling of relief ??? I often do this, and feel and often hear a “pop” or click. This provides temporary relief but it’s back again in no time.
    Also, mine started about 2 years ago around a trip to China when I was ill with a pneumonia they believe (I have had pneumonia before) — so, is there a viral link as someone alluded to. Since then I experience this constant discomfort, pressure, or need to “pop” my breat plate. I’ve described the feeling as though something is in and under the plate and need to be “scraped away” — strange, I know (and thus, once I thought it was cancer too — maybe it is). Also, though I say it is relieved generally by pressing down, sometimes I do press and I don’t achieve that “pop” and the sort of irritating, “tickley” feeling remains.
    Further, about 1.5 months ago I started feeling a bruised like feeling in my lower, left rib cage. Strange because I couldn’t remember any recent physical activity that would have done that. Then, I wondered if this is linked. Now, I’m worried that this irritating, chest pain is compromising the rest of my body.
    I too have been for all the EKGs, heart monitoring, X-rays, and the doctor says “just take your mind off it, you’re not dying”. As someone else noted, I have noticed that at times where perhaps I am a bit more anxious I may feel it a bit more, but it is alwasy there now. Crazy. I am healthy… other than this.

    Do anybody else feel the relief with pressing and a momentary “popping” feeling? Any other feelings I’ve described?
    Any other suggestions?? This is just stupid, but contrary to doctor’s opinions, very real.

    Markus

    1. i pop when i breathe! i can apply gentle pressure at the popping site and it stops popping. i pop when i sit or stand or twist. i hate that popping. my doc says it is like knuckle popping. things are trying to re align.

    2. G,day: i am in the exact same situation. im 43 into working out and sports. about 2yrs ago i began having l shoulder pain and grinding along with pain in l breast plate. i too press down on it to pop it and feel a little better(if only in my mind,lol). drs have not known what to do other then call it costro condrtis. i recently had shoulder surgery to remove my bursa sack and trim 10 mm of bone from my collarbone area. but i still have this breast plate pain. as a single dad of one child i really need to be active and on the go, the one thing that i do find gives me some relief is an aboriginal remedy, of emu oil , peppercorn, eucalyptas oil. (emu spirit.) i rub it on area just after a shower and it does help. cheers out there to everyone in this same situation. phil

  10. I’ve been dealing with severe upper right chest pain for 10 days now. The pain seems to also be showing up in my shoulder blade, plus my arm and especially my hand is a bit numb at times (kind of like carpal tunnel I think). And I get this weird fluttering/spasm in the area every few hours. I’m 47, in great cardio shape, exercise hard 3-4 times a week. Because of my chest pain, I went to the ER, wound up staying overnight. No heart problems fortunately.

    I have no idea what brought this on. Maybe progressive wear and tear from doing pullups, but there was no moment exercising where I felt any pain. My plan (due to the incredibly burdensome task of trotting to doctors and specialists, with the end result of taking ibuprofen and resting) is to just lay off the weights for the next few days and see what happens. I ran 8 miles last night with no problems, so at least I can keep up the cardio.

    Any advice would be appreciated. I will post again in a few days.

  11. No progress yet – pain has decreased some. Getting a cervical spine (neck) MRI – I went to a PT who noticed weaknesses in my right side. Also found info on “thoracic outlet syndrome” and scheduled an appt with a specialist….

  12. I am a 40 year old female who started having sharp pain under the left side of my ribcage. For years, the pain used to come and go right in the middle of my ribcage, where it meets. It is a strange pain. Almost like i swallowed a whole ice cube and it is sitting there. Now, the same exact pain has moved to just under the left ribcage. I am baffled and would like to get a heads up before I go to a dr who will probably tell me there is nothing wrong.

  13. Hello everyone-
    I have read a lot of everyones listings & i feel just about as hopeless as you all. Unfortunately I am 18 female & have been battling with this “cc” for just a year now. It is so frustrating. I do not think that is it at all because I only have the irritable pain right by my left breast. (very exact i know) I have gone through three doctors seen a cardiologist and I was diagnosed with mitral valve, but they say this has nothing to relate to my chest pain i dont understand. any help???? i went from a very active teenager to gaining almost 30 lbs for fear of exercising as I often feel like i cannot breathe and now carry an inhaler everywhere with me. please help, this is ruining my life. thank you.

    1. Lauren,

      I’m not a doctor or a nurse or a trainer or anything like that, so I can’t really advise you at all. If yoiu’re concerned about the pain getting in the way of exercise and activity, all I can suggest is contacting your doctor and talking to her about setting up an exercise plan. A qualified personal trainer or PT can help you design an exercise routine to help you recover or at least exercise around the pain.

      Richard

    2. What a relief to find this website!! I was recently diagnosed with costalchrondritis and cannot find enough information. In two weeks, i have seen two cardiologists, one lung doctor, stress test, ekg, blood tests,etc. They also told me i had Mitral Valve Prolapse but they see no connection with the costalchrondritis. I am in really good health and cannot figure out what happened here. It is extremely frustrating because i need to work and find it difficult to get through the day. The doctor prescribed Mobic and it worked for 2 weeks. I then quit taking it and the pain has returned. I would love to hear from more of you on this subject. Especially any suggestions on herbal treatments or vitamin supplements.

  14. I know that I have had intercostal muscle spasms for about 9 months now. Previous to having these attacks I use to get chronic muscle knots underneath the sholder blades. One day when I was washing my hair I reached around too far with my arm and shoulder raised and felt like I was stabbed in the back. On top of that, I box. I’m male, 44 years old and over the past 9 months in better and better shape except that boxing and hitting the heavy bag and twisting may have bothered the original injury, compounded it or may be completely different. I am not exactly sure, like the rest of the people posting here. What I do know is that the twisting from throwing right hooks seems to cause my intercostals to spasm. I have never taken this to a doctor because they don’t know what they should and never resolve this type of thing so I have lived through the past 9 months dealing with this off and on. Sleeping is difficult and pain comes in the morning and does clear. I’ve added Tai Chi breathing excercises which are great because they are done standing and do strengthen cartilage and joints. I also have herpes but I’ve had it for well over 12 years now and never saw the connection between “outbreaks” and CC but it does make sense. I am now noticing that emotional stress and being tired from being run down rather than being tired from excersize causes “outbreaks” similar to those from herpes but the outbreaks attack the intercostal muscles and it almost seems like its on the nerve level. Boxing no longer causes the spasms to flair up. As a matter of fact, those of you that are told to rest seem to be doing yourself a disservice. When my intercostals spasm and I’ve had a bad night sleep because of it, I warm up my muscles by going to the gym, I gently stretch, I do a 1 hour boxing routine with my trainer and by the end of the session feel great again. Pain only seems to come if I do not get enough sleep and or I am emotionally strained. Working out provides relief, not the other way around. These intercostal spasms, or CC or whatever label in my mind are now linked to something at a viral level and I am sure that at least for me they are outbreaks due to stress and no longer physically motivated. I am stronger now from working my way through it. I use to double over in pain and now as my lower back and abdominals strengthen, my recoveries quicken. Breath deeply, do meditation, do Tai Chi or some other form of gentle motion if you believe your motion triggers spasms but do not medicate and lie in bed. God bless you all and don’t forget to BREATH.

  15. For about the past year I have had a tightness/knotty feeling that feels like it is in my spine between my shoulder blades and a few inches below my shoulder blades. I had my gallbladder remover about the same time this began. The above tightness is accompanied simaultaneously by a tightness/knotty feeling in my sternum. This problem is there almost 100% of the time. 90%of the time the pain is about a 3 on a scale from 1 to 10.About 10% of the time this tightness in my spine and sternum increases to about a 5 or 6 on a pain scale of 1 to 10. As the pain increases it begins to radiate across my shoulders,in my neck and down into both arms. The only medication that has eased this pain has been predinsone. The pain is somewhat relieved by very hot showers but begins again after the shower and worsens throughout the day. The pain returned right after I finished the prednisone. I have found that I can press on the tightness in my sternum and it will pop my sternum and pop my back giving me a little relief. I am constantly popping my sternum and thorasic spine all day long just to get relief. I sometimes have sharp pains at other places in my ribcage then press on this sharp pain and it will pop my back directly opposite from the location of the pain. I have been cleared of all esopohageal and cardiac problems by my gi Dr. And cardio. I did have an mri is the t spine that showed mild arthritic changes which my gp said was normal for a 35 y/o male. Due to the chronic nature of this pain I have been struggling to continue living my normal happy life. My general practitier is at a loss of where to go next and has resorted to just treating my nerves/anxiety with zoloft. He thinks that my anxiety might be causing this. I do not believe this I lived 34 years before this without any anxiety problems and believe that this pain is what is bringing on my anxiety and not vice versa… Any insight is appreciated…

  16. for quite a while i have be suffering with really bad pain under my left ribcage . i have been to the doctors and i dont think he knows what it is which doesnt help as you cant get a cure but my breathing is sufferring and i dont no were to go next i thought i was having a heart attack the pain was that bad.

  17. unfortunately mine was CAUSED by a chiro doc who was manipulating the t7 and t8 vertabrae in order to remedy a frozen shoulder. when they applied pressure and the chiro table ‘popped’ as it should do, all hell broke loose. i was in the ER that nite and was told i have CC!! it is so very painful. basically cannot do much of anything including using the loo! it scares me to hear that it may last 6 months to a year. my doc said 6-8 weeks. geez!

    so to hell with chiropractors!

  18. I too have been suffering from cc. I have been complaining about rib pain for over a year. After a bone scan, Things showed up on my ribs, the doctors have been looking at bone cancer from another source. However, they believe 95% that it is not cancer. After an er trip, I thought was my gall bladder, an er nurse suggested CC. Now that I am reading, I think she is right. But I can’t help think about the cancer. Has anyone else had things show up on bone scans from their ribs? This is very frustrating. I also have swelling and pain between my breat bone and under my sternum. It hurts more when I push on it. My thoracic spine also has herniated discs. Anymore insight from anyone would ease my mind about the cancer.

  19. I happened on this site trying to find help for a friend whose symptoms are familar. I developed CC years ago in my 40\\\’s by lifing small rocks at a quarry and transporting them home for a garden border. It went away, but every so often it bothers me only a bit. I have learned to sleep on my side hugging a pillow. This tends to take off pressure in the area. Hope all of you are better.

  20. I was first diagnosed with CC in 1991 and had an operation in 92 to remove a rib and cartledge. Sadly, it didn’t improve and, in fact, got worse.
    In 2004 they decided to remove my gall bladder. Fantastic! For 12 months I was pain free, lost weight and very happy. However, it came back again and is now constantly painful.
    My doctor thinks I may have more gall stones and has recommended me for more tests. I disagree. It’s exactly the same pain as before and after the rib removal.
    I am now getting clinically depressed and don’t know how much longer I can cope with this.

  21. Hi i have had CC several times. first time it was really bad, felt like I was splitting down the middle, could neither move much at all or breathe in and out properly and I needed a very strong NSAID called indomethecin which helped a lot. Another time I had injections by my DR into the actual costal joints which again was very effective too.
    It bugged me on and off for about two years and then mysteriously went away. However it comes back periodically and I think the trigger is too much armwork, particularly extended armwork…I get a flare uo every time I sort out my wardrobe or attempt to put up curtains or paint so I avoid these things like the plague now. Also coughing gets it going too. I find that ice is good for me and believe it or not a frozen sausage wrapped in a tissue and applied to the right spots can really relieve things. No I am not kidding or nuts, really does help and unlike a frozen bag , does not freeze you to death just the inflamed bits. there is not much for it other than ice, rest and pain killers/anti/inflams and then learning what triggers it for you and avoiding it. Hope this info is helpful. Cheers all.

  22. About 6 weeks ago I had a viral infection and lost my voice. I strained a lot to talk since I have 3 kids. Three weeks after I went on a trip and lifted heavy bags. The next week I had a horrible pain in my chest and I could only take shallow breaths. I thought that I was having a heart attack. I went to the er and they said I was fine, that it was pleurisy. It made sense. When I got home, I made an appointment with my
    dr. and she said that it was chondral chondritis. That also made sense. It has now been about 6 weeks and the pain is still there. I can’t do any physical activity. My dr. says that it will last about another couple of weeks but from reading here, it seems that this just doesn’t go away.

  23. Hi,

    I’m 20 years old and suffer from this as well. I was very worried when I started having them the first time at work and nearly collapsed. After xrays and such my doctor said it caused from mass amounts of stress in my life, but there wasn’t anything he could do.

    I still have frequent pains due to this condition, and suffer from much pain due to it.

    However I have learned to cope with the pain and am living my life as best as I can still.

  24. I have had this problem for about five years. It started when I was pulling myself up on a barbell.

    It now is starting to fell like I have a bruise under my breastbone. If I press between my chest and ribcage I start to pass gas from my mouth. The Doctors think this is funny.It seems like gas gets trapped in this area.

    I have had all the test that has been mention already from the other comments.

    Please reply
    Joe

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