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Chest cartilage??

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  • Chest cartilage??

    Hey Guys,

    The past year and a half to two years I have been getting pains in the chest that seem to be coming from the cartilage that joins the ribs to the sternum.

    I've seen doctors and an O.T. who have said there's not much I can do but take glucosamine to help rebuild the cartilage or anti-inflamatories, neither of which have worked over the past year. x-rays have shown up nothing.

    it doesn't hurt anymore or less when I climb, play footy or netball but hurts a fair bit when I get up after lying down on my side (leaning on my elbow) or sometimes other positions.

    Someone suggested it could be muscle related - I have been shirt-fronted playing footy before and my neck still gets a bit tight every now and then..

    any suggestions on what to do?

    cheers in advance..

  • #2
    This is a tough one, because non-unions of the rib joints definitely do exist, but they are very hard to treat (and even prove on imaging). I honestely don't know the best (or any) way to treat them. It is probably worth trying a cortisone injection to take pain away (and see whether this works). Maybe some sort of bone stimulator or shock wave or ultrasound might help stimulate healing.

    The good news is you won't die of it and it shouldn't get worse.


    • #3
      Cheers, not overly fond of the idea of cortisone, I not so sure it will fix the problem, but I will see about the others you mentioned and if they are done in WA...

      if anyone else reads this has any suggestions they are welcome..


      • #4
        What can cause this problem is that you have an excessive thoracic kyphosis, ie: rounded back. This approximates the sternum with the symphysis-pubis (creating sterno-symphyseal syndrome) and jams up the sterno-costal joints creating joint and therefore compensatory muscle problems. That may explain why when you lay on your side and load your joints, you get pain. Easy way to check for this is to get someone to look at you side on and to see if your shoulders and head are well forward of your body. You can try improving your flexibilty through the internal shoulder rotators, particularly pecs, to open up your chest and some mobes of the mid back eg: rolling backwards on a gym ball. Hard to make a functional diagnosis without observing or assessing you but give this a go. This can get advanced further if it proves to be beneficial, but list some more details such as age, occupation etc
        If you want to be the man, you've got to beat the man


        • #5
          I'm 25 and work in an office - in front of the computer for most of the day. I've only just started here so I am currently fixing my desk so it is ergonomically good for me (ie. raising the moniter,keyboard and phone in correct reaching distance and setting the chair properly....) and am still waiting for a couple of things...

          not sure what else you would want to know.

          I'll give the gym ball a bash and see how it works out....


          • #6
            I've got a sure way to stop your problem. Don't lye on your side for too long. This should completely resolve all symptoms.

            It could easily be the result of an old shirt-front and now some subsequant instability. If it is, try building your chest up which will help support the area and therefore less load will go through the area when propping yourself on your elbow.


            • #7
              Can I suggest you ask your doctor for some more tests? Whilst x-rays are a good place to begin to look for underlying causes, they can often miss important structural abnormalities or damage that could be contributing to your pain.

              If the pain is due to excessive kyphosis as suggested, stretching the pecs and front chest should help. Also strengthening the upper back muscles (eg. lat dorsi, rhomboids) and shoulder stabilisers (such as rotator cuffs) can assist in correcting posture and result in lessened rounding of the shoulders. It can also "draw" the shoulders down and backwards which will take the load of your costal joints.

              If it is due to front chest weakness resulting from being shirt-fronted, and you try to strengthen these muscles, you risk merely stremgthening the strongest muscles/side and only making the weaker group of muscles even less advantaged. Therefore, any exercises to strengthen this group should be closely monitored and supervised to ensure you're doing them correctly and most efficiently.

              Did you ever have the pain before the football injury??

              Did the glucosamine help??


              • #8
                Rib cartledge Injuries

                As a Paramedic, injuries of this type are common sometimes in the work place as well as with sport related injuries. Rib Cartledge Injury is a tough cookie. It takes a long time for complete healing. And the pain is very simaliar to injury against the plureal lining of the lungs.

                One caution to all who have this type of injury. If at anytime you have a rubbing sensation against the lung and an unproductive cough or if you feel as if you can not take a full breath: go and have another opinion from another doctor.

                I injuried myself on July 4th of 2003.. I fell posterior on a flight of steps while carrying weight. I landed on the right 7th posterior rib. That was bad enough, but the mechanism of injury caused a tramatic streach on the anterior of my chest wall...almost causing a penumothroax. The pain was intense to say the least. And I felt the pop of my cartledge pull away.

                Just one week ago having thought the tear of my rib cartledge was healed...I had to lie on my stomach to perform some general labor and much to my suprise I heard a type of pop in the same area of my rib and the pain was back.........

                So, in closing examine your mechanism of injury when you recieve these fractures closely...this will determine very much you course and for what you are in for as far as the length of time to heal also any postions of discomfort that you want to avoid at all times not to aggravate the injury more...and like me when you think it is healed ...think again before you put any pressure on this I am back to the Healing all over again.....


                • #9
                  In response to WA Bob:
                  I too suffered from a similar complaint for a few years. Has no one mentioned costochondritis? (inflammation of the rib cartilage), or tietze's syndrome? It can be reproduced by pushing on the rib of the affected cartilage. Mine was aggravated too by lying propped on my side, and also after lying on couch with head and neck flexed forward propped on arm rest. I feel it is brought about by compression of the cartilage between the ribs and sternum. I tried all the suggestions such as stretching pecs, improving thoracic spine extension, mobilising costovertebral joints, etc. However, simply avoiding the aggravating activities worked for me. If no luck, may want to see a rheumatolgist.


                  • #10
                    hey toddphysio,

                    costochondritis was why I was put onto anti-inflamatories and glucosamine to help with it....

                    I stopped all activites for about 7-8 months with no change so I have gone back to doing it all because I was bored of not being active.

                    it doesn't hurt any more when I am active and somedays I wont feel it unless I press agaist my sternum and I do avoid sitting or lying in positions that agravate it.

                    thanks everyone for your imput I am going to try most of it and I am going to get second and third opinions until I find someone that can help or it heals itself..which I think was one of the only solutions that came up with costochondritis wasn't it...

                    RoWAOT: I can't remember if it hurt before the footy incident...I dont think so although my chest used to click when I ran up stairs or sprinted from a standing start and the glucosamine and anti-inflamatories didn't help even a little bit..



                    • #11
                      Hey man

                      I have the exact symtoms. started about 8-10 mnths ago. they were very mild and recently they got really bad. they started when i used to work out.. i was benching 225lbs and for some reason i bounced teh bar on my chest.. and thas when i felt a pain.. but dint think much of it.

                      ANd recently.. it got so bad that i went into emergency thinkin i was havin a heart attack.. had an ecg and xray done.. every thing came out fine. WEnt to my family physician and he told me i had gastric reflux (fancy name for heart burn) and injured cartillage. I searched the net like a madddddd man tryin to find out how to fix my cartilage but there is no set way to fix it other than resting.

                      my symtoms are pretty wierd sometimes:
                      i feel the pin in the teh center... then someitmes lower ribs and sides aswel.. but its mostly when i m lyin on my back and try to get up straight or if i lean my chest forward. i feel a sharp pain in the middle of my chest..

                      i guess i juss have to wait it out... see wat happens..
                      hope u are feeling better tho.


                      • #12
                        Hey Meehap,

                        sounds similar. although I find my pain stays around the sternum and sometimes spreads out to the colllar bone. I get the same sensations when I am lying down & all that too...

                        I've been told the glucosamine works on most people (not sure why it didn't do anything for me) as it is supposed to help regenerate cartilage & make it stronger.

                        Magnesium helped me a little bit as it helped release tension from the muscles supporting the area.....

                        good luck mate, I'm still working on it. If I come across anything that cures me I'll let you know...


                        • #13
                          sorry Maheep...I swear I have a small case of dyslexia...



                          • #14
                            tietze's syndrome

                            I am a 22 year old female and was diagnosed today with tietze's syndrome / costochondritis. I have been reading the posts here on this website, and my symptoms seem to be different. My chest pains are brought on by emotional stress. It doesnt matter what position i sit or lay.. if i run or if i walk. The doctor did an ECG, which was clear, however by BP was 146 / 111, and my pulse rate was 101.
                            However, i am a full time second year nursing student, who is also looking after a chronically ill mother who has M.S.
                            Two more weeks for my mid year exams, hopefully i dont have a real myocardial infarction!!
                            I was wondering, is there any alternative treatments out there for this condition? I am already on Omega 3 for inflamation i get in my tissues around the knuckles on my hands. (i sound like a old woman). However i do find a hot bath and chocolate is quiet effective.
                            I dont want to be on pain killers for this condition for when it does occur. I want to be able to manage it before it gets too painful.
                            Any suggestions??


                            • #15
                              This is a tough condition to treat. I don't know why it gets painful. Seems like popping a rib cartilage is painful but 99 out of 100 of them go on to heal - can't work out why 1 in 100 leads to chronic pain. However, it makes sense as chronic pain from non-unions is recognised in many other areas of the body, so why not the rib cartilage?
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