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Pain In Xiphoid Process. Treatment And Specialist ?

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Posted on Sat, 26 May 2012
Question: I have pain in xiphoid process and cant find a doctor who will treat it
doctor
Answered by Dr. Robert Galamaga (12 minutes later)
Hello and thanks for the query.

Your question is a good one and also a challenging question to answer. As far as pain in the sternum or chest wall there can be a number of issues which could contribute. First of all I wonder if you had any previous trauma to the chest wall either from a fall or some kind of accident. That can sometimes predispose recurrent symptoms of chest pain or a chronic degree of chest wall pain.

In addition we have to consider chronic arthritis as a potential cause. If you have any family history of any kind of arthritis or autoimmune disorder that would be something else to discuss.

As far as relief of the symptoms what you are experiencing I think we could talk about a couple of different angles.

First of all you should complete an aggressive course of anti-inflammatory therapy with something like high-dose ibuprofen or Naprosyn. I would suggest a course of ibuprofen 800 mg taking three times daily consistently for at least 14 to 21 days. This could cause a significant degree of improvement of your symptoms. If that does not work. You might consider a course of steroids. Prednisone is well known to help with chronic joint pains and may be of some benefit for you as well.

The next consideration would be for you to see a pain specialist. These are physicians which are highly trained in addressing chronic pain and pain that is not relieved by conventional medications. Generally this is a physician who is trained in both anesthesia as well as pain medicine. I would certainly seek a physician who has fellowship training and expertise to help you for your problem if it gets to that point.

I know you are dealing with a very difficult issue and answers are very hard to come by. I hope the information I have provided is helpful and informative. If you have any additional questions regarding this please do not hesitate to ask and I will address them.

Sincerely,

Dr. Galamaga
Above answer was peer-reviewed by : Dr. Prasad
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Follow up: Dr. Robert Galamaga (4 hours later)
Thank you for the quick response. Its greatly appreciated. I have had this pain for over a year. I had an MRI and it came back negative. I also saw a thoracic surgeon who said there is nothing he could do and that i have to live with the pain. Its defintely my xiphoid process. I have a small lump there. I tried to see another thoracic surgeon with no success. They would not see me since they are not familiar with the xiphoid process. Its now to the point where i cant sleep. The pain is worse. probably about a 5. tolerable but uncomfortable.

i have no idea what to do at this point or what type of doctor specializes in this. I pretty sure i hurt it playing golf, i play alot
doctor
Answered by Dr. Robert Galamaga (1 hour later)
Hello again.

I suggest you look into three types of specialists. The first is a physical medicine and rehabilitation doctor. These docs specialize in injuries, debilitating conditions and some chronic pain issues. I suggest you call some of them and inquire as to whether this may be something they might be willing to handle in the form of an office consultation.

A second specialist is of course a pure pain specialist who might consider a local injection to see if that improves the pain over a longer term.

Finally, a rheumatologist might also have some good recommendations for you. Rheumatologists specialize in disorders involving bones and joints as well as autoimmune diseases.

I encourage you to stay on and be persistent in calling some of these types of doctors until you get answers or someone who is willing to see you for a full exam and consultation. I am confident that if you pursue this you will find someone with the expertise to give you some answers and hopefully a solution to the chronic discomfort you have dealt with.

Again I hope this has been helpful for you. I remain available if there are additional concerns on your behalf.

Sincerely,

Dr. Galamaga
Note: For further follow up on related General & Family Physician Click here.

Above answer was peer-reviewed by : Dr. Raju A.T
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Answered by
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Dr. Robert Galamaga

Oncologist

Practicing since :2002

Answered : 2635 Questions

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Pain In Xiphoid Process. Treatment And Specialist ?

Hello and thanks for the query.

Your question is a good one and also a challenging question to answer. As far as pain in the sternum or chest wall there can be a number of issues which could contribute. First of all I wonder if you had any previous trauma to the chest wall either from a fall or some kind of accident. That can sometimes predispose recurrent symptoms of chest pain or a chronic degree of chest wall pain.

In addition we have to consider chronic arthritis as a potential cause. If you have any family history of any kind of arthritis or autoimmune disorder that would be something else to discuss.

As far as relief of the symptoms what you are experiencing I think we could talk about a couple of different angles.

First of all you should complete an aggressive course of anti-inflammatory therapy with something like high-dose ibuprofen or Naprosyn. I would suggest a course of ibuprofen 800 mg taking three times daily consistently for at least 14 to 21 days. This could cause a significant degree of improvement of your symptoms. If that does not work. You might consider a course of steroids. Prednisone is well known to help with chronic joint pains and may be of some benefit for you as well.

The next consideration would be for you to see a pain specialist. These are physicians which are highly trained in addressing chronic pain and pain that is not relieved by conventional medications. Generally this is a physician who is trained in both anesthesia as well as pain medicine. I would certainly seek a physician who has fellowship training and expertise to help you for your problem if it gets to that point.

I know you are dealing with a very difficult issue and answers are very hard to come by. I hope the information I have provided is helpful and informative. If you have any additional questions regarding this please do not hesitate to ask and I will address them.

Sincerely,

Dr. Galamaga