What Causes Pain And Stiffness In Rib Cage?

Posted on Sat, 7 Jun 2014

Question: I WAS DIAGNOSED WITH XXXXXXX CHIARI I WITH SYRINGOMYLIA IN 2004 .HAD TWO SURGICAL PROCEEDURES DONE IN 2004 DRAINING FLUID FROM THE SYRINX. I,VE BEEN EXPERIENCING EXREME RIB CAGE PAIN AND STIFFNESS IN THE UPPER LEFT RIB CAGE FOR YEARS. THE PAIN IS PRIMARILY ALONG MY LEFT SIDE RADIATING AROUND TO MY LOWER BACK. PAIN MANAGEMENT SPECIALIST AND NEUROLOGIST HAVE YET TO COME UP WITH AN EFFECTIVE DRUG THERAPY. CAN YOU OFFER ANY SUGGESTIONS?

Answered by Dr. Karl Logan (2 hours later)

Brief Answer:
Intercostal nerve injection

Detailed Answer:
Hi,

Thanks for your question.

I wonder whether the pain is emanating from the intercostal nerves which supply your rib cage. These could have been effected by your previous surgery.

The intercostal nerves can be blocked with local anesthetic and I wonder whether this combined with steroid injections into these nerves along the side of the spine might confirm this as the diagnosis and be therapeutic in terms of helping with the pain.

If the effects of the injections are short lived the these nerves could be ablated with chemical injection or surgery.

I how this answer helps you.

best wishes

Above answer was peer-reviewed by : Dr. Vaishalee Punj

Follow up: Dr. Karl Logan (2 days later)

My pain management specialist welcomes your ideas with enthusiasm. After-all ,the main focus is for me to be as pain free as possible. She would like to try an anti-deppressant, pressure point injections and possibly botox in addition to the gabapentin and an opiod. Since my syrinx is rather large. It stretches from C-1 through C-7 or 8. She sees no signs of inflammation in the rib-cage.Rather the pain is most likely neuropathic pain. Please elaborate on your suggestions regarding steroid injections and local anesthetic for the rib-cage pain and stiffness. The pain can be described as a burning/pins & needles effect with stiffness. According to a Oct 2013 MRI the syrinx is still very large but stable. Please give your feedback.

Answered by Dr. Karl Logan (6 hours later)

Brief Answer:
Intercostal nerve blocks

Detailed Answer:
hi,

thanks for your question.

a syrinx does not usually cause pain.

if the pain is in the back of your chest and rib cage then the nerves that supply this area are the intercostal nerves which can be blocked posteriorly. this is most commonly done to relieve the pain associated with rib fractures.

this could be done in conjunction with the medication changes your pain doctor has prescribed.

I hope this answes your question.

best wishes

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Above answer was peer-reviewed by : Dr. Vinay Bhardwaj