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Dr. Andrew Rynne
Dr. Andrew Rynne

Family Physician

Exp 50 years

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What causes muscle twitching under the left rib cage?

Answered by
Dr. Ilir Sharka


Practicing since :2001

Answered : 7005 Questions

Posted on Wed, 2 Dec 2015 in General Health
Question: Hello
I am a healthy 43 yr old women not over weight no heart issues in my family, last week I had like a muscle twitch under my left rib cage no pain no shortness of breath no neasua or anything I went to my GP she checked blood pressure she said was good did ECG normal and chest xray normal ...
This comes and goes ...didnt have it again till yesterday now it is here this morning again ...I was wondering ..I have done all the heart tests within the last year blood work/ ecg/x-ray/stress test 2012 and loop test last year all came back normal ..
I do suffer from fybromyalgia and costochondritis ...although this is not painful at all it is annoying ...
Any other tests I should suggest to my GP ....I did have an upset stomach for about 1.5 weeks before last .
Answered by Dr. Ilir Sharka 1 hour later
Brief Answer:
I would explain as follows:

Detailed Answer:


Welcome and thank you for asking on HCM!

Regarding your concern, I would like to explain that facing your chest discomfort nature, your coronary risk factors epidemiology and normal results of already performed cardiac tests, a cardiac origin of your complains is satisfactorily excluded.

Coming to this point a differential diagnosis should be done to conclude about another responsible cause of that muscle twitching feeling.

Of course fibromyalgia includes also complains similar to muscle spasms, muscle twitching, paresthesia, etc. and from the other part even costochondritis may be expressed with similar chest discomfort and even pain.

So, both of these two etiologies should be part of differential diagnosis work up.

from the other hand, other causes should be sought, like a nerve damage usually mentioned a "pinched" nerve, or a muscular disorder like myoclonia (involuntary, nonrhythmic contractions of individual muscle groups), or even a radicular nerve compression at the backbone level.

Also functional bowel disturbances (frequently found in fibromyalgia) may explain such a clinical picture. Colon spasms may be found in an abdominal ultrasound exam.

Coming to this point, I would recommend performing additional tests, like:

- a new complete blood count and PCR to rule in/out inflammation (costochondritis)
- ENMG (electro-neuro-myography) to investigate for a pinched nerve or muscle disorders,
- a backbone chest X ray study for possible degenerative changes,
- an abdominal ultrasound to explore the visceral status

You should discuss with your attending physician about the above mentioned suggestions,

Hope to have been helpful to you!

In case of further uncertainties, feel free to ask me!

Kind regards,


Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ilir Sharka 11 minutes later
Hi thank u for ur response so again I just want to be sure these are the tests I have had in the last 2 years
ECG several times normal
Stress test 2012 normal
Blood work - normal
Traponin2015 normal
Loop 2015 normal
Xray normal
I just want to make sure it isn't cardiac in ur opinion as a cardiologist
Answered by Dr. Ilir Sharka 21 minutes later
Brief Answer:
Your symptoms are not cardiac related.

Detailed Answer:

Hi again!

As I explained you above, it doesn't seem to be cardiac related.

So, relax!

No further tests are necessary to explore cardiac issues.

Just follow a healthy life style and diet, avoiding so cardiac risk factors in the future.

Best wishes,

Dr. Iliri
Above answer was peer-reviewed by : Dr. Chakravarthy Mazumdar
Follow up: Dr. Ilir Sharka 3 hours later
Hi thank you
I guess I am just abit in a panic as I feel like my heart beat is fast but that could be my anxiety like I am in a constant state
I will follow up with my gp for those additional tests
Answered by Dr. Ilir Sharka 17 minutes later
Brief Answer:
Nothing to worry about.

Detailed Answer:


I just wanted to assure that your complains are not an expression of a life-threatening disorder.

So, relax!

A careful medical diagnostic work up will clarify underlying factors.

So there is no place for being anxious.

Wishing you a good health,



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

The User accepted the expert's answer

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