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What Causes Chest Pain At Joints Between Ribs And Sternum?
Question: I am a tall 73y.o. male civil engineer. Since back-slamming onto slippery concrete 19 years ago I have suffered intermittent sharp pain + prolonged intercostal spasm after repeated use of my right arm from hammering, shovelling etc. mainly behind my R shoulder blade. I aggravated this multiple rib injury again about 3 months ago in a heavy forward fall onto my sternum. It bites if I take more than a shallow breath. This is causing mild congestion in my lungs which is not improving. 25 months ago I survived pulmonary embolism in both lungs & 13 months ago (side issue?) a mild stroke overnight which affected my speech, muscle strength in legs & arms + mild jaw droop on R side. Fortunately I was already on Warfaren for chronic atrial irregularity (since 1998) & it cleared the scanned blood clot at the back of my brain < 12 hours & I have recovered almost fully since.That clot is suspected to have come directly from the top of an extensive deep vein thrombosis in my L leg (side issue)caused by a severe power-tool injury which severed my return circulation + nerve sensation below the knee.
My wife thinks I am becoming accident - prone in my XXXXXXX years ! I am looking for advice on how to hasten recovery from the re- disturbed old rib & spine injury which broke/detached 4 L +3 R ribs + spine at C3/4 & T3/4 as far as we can tell from the foggy old tomograms which were not taken until some months after the original injury. I gained some relief from a surgical thoracic corset which I used almost constantly for the first 3 years & that helped me to avoid pain relief medication altogether. I had 50+ chiropractic visits over the early years but have found more reliable relief from a good osteopath only 50 miles from home. I apologise for going into such detail particularly over what I think are probably unrelated side issues but I needed to include it all to provide a full background. Your comments will be welcomed. Norol Hill 3 Blanch St. Lemon Tree Passage 2319 NSW Australia.
Brief Answer:
Unusual problem that needs further work up
Detailed Answer:
Hi,
I'm sorry to hear about all of your medical problems. Your specific current question seems to be related to the ongoing pain in your chest at the joints between your ribs and your sternum (breast bone) that was exacerbated by a recent injury.
This is an unusual injury as you would more commonly break ribs rather than dislocate the joints between your ribs and your sternum or the ribs and your spine. If your symptoms have been under control for a number of years then it may be that they will improve again spontaneously when the inflammation from the current injury subsides.
If your symptoms are ongoing then you may have a number of options.
As you found a corset useful in the past then if you be refitted for a corset to see if this improved your symptoms.
Antiinflammatory and / or analgesic medication might help - you should be careful regarding the use of these drugs because of your other medication particularly your anticoagulants.
If these non-operative measures are not helpful then further investigation with cross sectional imaging such as a CT or MRI scan of the painful areas may be useful to identify the structural issues.
A bone scan may help localize those individual areas that are causing inflammation and pain.
After these investigations localized injections of local anesthetic and steroid into the affected joints may give you some relief.
Surgical resection of the joints is also possible but this would only be done very rarely for this type of problem.
I hope this information is useful to you and that you find resolution to your symptoms soon .
Best wishes
Note: For further follow-up it is advisable to consult an emergency medicine specialist. Click here.
Above answer was peer-reviewed by :
Dr. Vinay Bhardwaj
Answered by
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