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Suffer arthritis. Having neck pain. Been on pain management. Taking RF ablation, steroid injections and narcotic pain relievers. Guide?

Jul 2013
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Answered by

Orthopaedic Surgeon, Joint Replacement
Practicing since : 1996
Answered : 2148 Questions
I am a 62 year old male have been very physically active my entire life, until arthritis set in at about 42 yoa. Marathoner, ultra marathoner. Trashed my left pattelar tendon in right knee, had a good surgical repair. Continued to run 6 miles plus daily until age 48. Had to give it up due to back/kneck pain. Pursued alternate exercise. Stair steppers, elipticals, weights, swimming. Started to get general rib pain, both sides, continued to work out. two days after pretty strenuous chest lifting, got severe left side rib pain. Have been in pain management for around ten years. Back pain managed by RF ablation, steroid injections and narcotic pain relievers. I sit at a computer terminal 30 hours a week. Much stress in my life going through my daughters cancer (now in remission), and now my wife has multiple skin cancers. Heavy weight stress. My PCM diagnosed costoshondriitus (sp?) 4 days ago. I have never experienced severe rib pain before. Had a good day yesterday, tried the elliptical this AM and could not hack it. Exercise has been a major part of my life since age 29. When will this pain abate? I have done much research on this and the prognoses are not good, from what I have read. Lucky to be alive, at 62. I am 5'9" and 180 lbs, and need to knock off 10 lbs to feel comfortable with myself. I want to get back to my exercise routine. XXXXXXX the groping for my past fitness.
Posted Fri, 16 Aug 2013 in Bones, Muscles and Joints
Answered by Dr. K. Naga Ravi Prasad 1 hour later
Hi, thanks for writing to XXXXXXX

From your description, I understand that your concern is about the rib pain.

I don't think you have COSTOCHONDRITIS as said by your treating doctor because it usually involves more than one rib (which is not in your case), pain typically increases during deep respiration or coughing or any other activity that expands and puts strain on your rib cage.

I suspect that the cause of your rib pain is INTERCOSTAL MYALGIA or SPASM.

This could be managed conservatively by the following means -
* Rest to the injured part and dont involve in activities which puts additional strain on the injured tissues.
* Ice packing should be applied for about 20 minutes once in every 2 hours.
* once the acute pain subsides, moist heat fomentation to relax the muscle
* Analgesic & anti inflammatory medications

If the above measures fail to provide pain relief, then an intercostal nerve block or a local steroid shot may help.

Hope I have addressed your issues. Happy to help for any more clarifications.

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