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Dr. Andrew Rynne
MD
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What Causes Pain Around The Rib Cage After An Injury?

I fell down next to my bed on a rug and am sore round the rib cage, especially when I breathe or cough. The pain is concentrated on one part of the side rib cage and has significantly reduced in two days. Tylenol didn't do much but Naproxen (220 mg) did am taking it twice daily along with Famotidine. Can I increase this to 3 capsules daily?
Fri, 1 Dec 2017
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Ayurveda Specialist,  's  Response
**
Thanks for contacting with your health concern

1. as there is a history of Injury with pain around the rib cage, thus following should be the symptomwise approach:

i .Think of fractured rib.
ii. Think of costochondritis, very common anteriorly
iii. Think of muscle sprain

. If by adopting
- hot water fomentation
- rest with minimal movements
- chest strapping
- intercostal nerve block
- taking an analgesic, anti-inflammatory enzymes, and muscle relaxant, the pain goes away continue with the same, however, if the pain is not relieved ask for Hb%, WBC, ESR & X-ray Chest

2. since pain increases on coughing/breathing, pain could be a pleural pathology. [ask for chest X-ray to exclude pleuritis, pleural effusion]

3. Although naproxen is approved by FDA as an over the counter [OTC] drug, make sure to consult a chest specialist who will go for systemic examination and if any chest signs are present will ask for imaging scans of chest with Hb%, WBC, ESR and then will provide proper management [as they can ask more detailed questions on associated symptoms]
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What Causes Pain Around The Rib Cage After An Injury?

** Thanks for contacting with your health concern 1. as there is a history of Injury with pain around the rib cage, thus following should be the symptomwise approach: i .Think of fractured rib. ii. Think of costochondritis, very common anteriorly iii. Think of muscle sprain . If by adopting - hot water fomentation - rest with minimal movements - chest strapping - intercostal nerve block - taking an analgesic, anti-inflammatory enzymes, and muscle relaxant, the pain goes away continue with the same, however, if the pain is not relieved ask for Hb%, WBC, ESR & X-ray Chest 2. since pain increases on coughing/breathing, pain could be a pleural pathology. [ask for chest X-ray to exclude pleuritis, pleural effusion] 3. Although naproxen is approved by FDA as an over the counter [OTC] drug, make sure to consult a chest specialist who will go for systemic examination and if any chest signs are present will ask for imaging scans of chest with Hb%, WBC, ESR and then will provide proper management [as they can ask more detailed questions on associated symptoms]