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    Suggest treatment for pain in the ribs

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Posted on Mon, 17 Jul 2017 in Hypertension and Heart Disease
Question: I've been having these come and go tender spots pain on chest wall and on the edge of shoulder blades for years before. For some reason in the last few days especially yesterday, these come back on my left chest wall and on edge of my left shoulder blade. These spots sometimes cause very light pain feeling on the left chest, I've tried to locate them as usual by using my finger and found several tender spots on upper left chest wall, near left my nipple and of course on edge of my left shoulder blade. I was worried a lot last night if if was a heart attack but I did not have squeezing chest pain or difficult breathing, my blood pressure was normal (115/64). These tender spots moved around between left and right chest walls and rib cage before and cause some dull light pain. Could you please help to explain this? I talked to my doctor before but he did not have any concern about these spots. Thank you

Please note that I am a very active person, playing soccer almost daily.
doctor
Answered by Dr. Ilir Sharka 2 hours later
Brief Answer:
I would explain as follows:

Detailed Answer:
Hello!

Welcome and thank you for asking on HCM!

I passed carefully through your question and would explain that your symptoms do not seem to be related to any cardiac disorders (including coronary artery disease).

So, there is no reason to worry about any heart attack!

In my opinion your symptoms could be related to musculo-skeletal pain (inflammation) or nerve pain (caused by irradiating nerve pain from a possible cervical disk herniation or a pinched nerve).

The fact that these points are tender to touch makes a musculo-skeletal pain more probable.

Fibromyalgia can not be excluded either, considering the fact that you have had these complaints for a long time.

Coming to this point, if the pain persists, I would recommend consulting with your attending physician for a careful physical exam and some tests:

- a cervical spine X ray study for chronic degeneration of the cervical spine
- a chest X ray study
- complete blood count, PCR, ESR for inflammation
- a nerve conduction study to exclude a possible pinched nerve.

But, all these tests can wait until consulting with your doctor, because your complaints are not indicative of any serious medical disorder.

Hope to have been helpful!

Wishing good health,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Follow up: Dr. Ilir Sharka 47 minutes later
Thank you Dr Iliri, that makes really sense and eased my fear. Is costochondritis considered in my case?
doctor
Answered by Dr. Ilir Sharka 19 minutes later
Brief Answer:
My opinion as follows:

Detailed Answer:
Hello again!

Regarding your concern, I would explain that the location of the pain (in the shoulder and chest) is not typical of chostocondritis.

But this diagnosis can not be excluded either, as some symptoms (tenderness during touching) go in favor of this diagnosis too.

For this reason, I recommend performing inflammation tests to exclude inflammation (which is part of chostochondritis too).

From the other hand the treatment of musculo-skeletal pain and chostochondritis is quite the same: anti-inflammatory drugs like ibuprofen, ketoprofen, etc..

So, it is not really important distinguishing these issues, as the treatment is basically the same.

Only nerve pain has other treatment options. That is why I recommended performing the cervical X ray study and the nerve conduction study.

Hope to have clarified some of your uncertainties!

Wishing all the best,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
doctor
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Follow up: Dr. Ilir Sharka 12 minutes later
Thank you for your helps Dr. Iliri.
doctor
Answered by Dr. Ilir Sharka 1 minute later
Brief Answer:
You are welcome!

Detailed Answer:
I am glad to have been helpful to you!

Kind regards,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
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Dr. Ilir Sharka

Cardiologist

Practicing since :2001

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