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Having pain in chest. Feel lump when palpitate. Pain while breathing, sneezing and coughing. Suggestions?

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General & Family Physician
Practicing since : 2004
Answered : 1777 Questions
I wrote a question yesterday (I hope you can view) about falling on my chest on XXXXXXX 19. My pain is not going down, and I frankly was not impressed or told anything I didn't already know by the responding doctor (it seemed like he spent about 20 seconds on the answer). I specifically want to know what injury COULD I have sustained-- like I said, when I palpitate the area there is a huge knot/bump on my 2nd rib, about 2 inches from the sternum (lateral and on the left side). Pain radiates down my shoulder, my arm, and to make matters worse, I sustained a broken hand playing baseball mid-may. When I was mid-air falling, I reached out with my right hand to grab my left and landed straight on my left side; chest first, as stated before. It was extremely swollen everywhere until about 5 days ago until the swelling went down and I could feel the bump. I am a teacher and in the summers a camp director, of which I am very hands on. It hurts to breathe, causes me to wake up in the night, if I sneeze, cough, talk loud...I have extremely severe pain. I am not taking very deep breaths because it just hurts. I know people aren't supposed to diagnose themselves online, but within all the information I saw, I took extreme notice on the suggestion that shallow breaths may lead to chest colds, especially pneumonia. The pain also radiates down my back, medial to my scapula. I plan on getting it x-rayed tomorrow and am emailing my doctor additionally, but right now there is nothing I can do but worry. Thanks
Posted Sat, 27 Jul 2013 in General Health
Answered by Dr. Chakravarthy Mazumdar 2 hours later
Hello XXXXX;

I would be happy to answer your question. I am actually a pulmonary and critical care physician. It sounds like you either broke one of your ribs...or maybe you separated the cartilaginous connection where the rib meets the sternum. You easily could have done this when you fell. The symptoms of such would include...pain, increased pain with breathing...coughing...sneezing etc. The radiation of the pain could be referred nerve pain. Have you tried taking Advil or Alleve per the bottle recs for a week or so to see if this helps with the pain. Also, you could try to alternate warm and cold packs to the affected area every 30 min or so for 4 cycles to see if this helps.

A chest x-ray will help to make the diagnosis. There isn't much more that can be done for this other than pain control and to let it heal.

I hope this has answered your questions. Please let me know if I can be of additional help.
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Follow-up: Having pain in chest. Feel lump when palpitate. Pain while breathing, sneezing and coughing. Suggestions? 6 hours later
Thank you so much for giving me a better answer than I got before. Is there anything that can be done for referred nerve pain? I have been taking advil every day and it really doesn't help. I have been putting a heating pad on my chest every day and that makes it feel better for a bit (IE when the heating pad is actually on my chest). Since it has now been 11 days since my fall, I didn't think I needed to still be putting cold on it. However, I can do that. Can nerve damage cause all of the pain down my arm, up my neck and also down my back? I'm guessing it can, but again I am in a lot of pain. I am going in to see my PCP tomorrow, and will talk to him about all of this, but it is always nice to get a second opinion. As I said, I work with children in a camp setting, and it is very hard for me to talk and raise my voice. At what point would I go from advil to something else? It just really sucks because I am a hugely active person and normally have a high pain tolerance. I thought this would heal by itself but it is not.
Answered by Dr. Chakravarthy Mazumdar 12 minutes later

Thanks for writing back.

Yes, there are several things that can be done for referred nerve pain. Prescription Motril in an option. Of course, there are narcotic anti inflammatory combo medications such as Vicodin or Percocet etc.

A pain specialist can inject the region with a pain killer anti inflammatory combo etc.

Alternating the heat the cold should help. If you find that heat is better then do more of that...if you find that cold is better then that's what your body needs.

Eventually your body would heal itself but sometimes it takes a long time especially in this case where you have to breath..and use your chest muscles and ribs etc all the time. Sometimes we need some help to move things along.

I hope you get some relief from your PCP. Let me know if there is anything else I can do.

Take care.
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